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BMC Oral Health

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Open Access 01-12-2023 | Aligner | Research

White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared to fixed orthodontic treatment. A systematic review and meta- analysis

Authors: Shailaja Raghavan, Elham S. Abu Alhaija, Mandeep Singh Duggal, Srinivasan Narasimhan, Sadeq Ali Al-Maweri

Published in: BMC Oral Health | Issue 1/2023

Abstract

Objective

To analyse the available evidence regarding the incidence and severity of white spot lesions (WSLs), plaque accumulation and salivary caries-associated bacteria(SCB) in clear aligners (CA) verses conventional fixed (CF) orthodontic appliances.

Methods

Electronic searches of MEDLINE, Scopus, Embase, Google Scholar, Clinical trial registry, OpenGrey and ProQuest were done for all relevant studies. Eligibility criteria were; Randomized Controlled Trials and Non-Randomized Studies that compared the incidence and severity of WSLs, plaque accumulation and SCB between CA and CF appliances in patients undergoing orthodontic treatment. The risk of bias(ROB) and certainty of evidence was assessed independently by two reviewers using Cochrane’s ROB and GRADEpro, respectively. Standardized mean difference (SMD) was used to estimate the effect size using STATA 17 software.

Results

A total of 14 studies met the eligibility criteria, and eight were suitable for meta-analysis. The qualitative results showed lower incidence and severity of WSLs, plaque accumulation, and SCB in CA group compared to CF appliances. The pooled results showed significantly lower plaque accumulation(SMD − 1.58;95%CI:-2.57,0.58;p = 0.002) in CA compared to CF appliances.

Conclusions

A moderate-quality evidence reveals less plaque accumulation and less SCB in CA, which might be related to the reduced incidence and severity of WSLs associated with CA when compared with CF appliances. However, the results of the present study should be interpreted with caution given the high ROB among some of the included studies as well as the marked heterogeneity across the studies.

Clinical relevance

For patients who can be treated with either CA or CF appliances, CA may be a better choice concerning oral health.

Registration

Open Science Framework (DOI:https://doi.org/10.17605/osf.io/kcpvb).

Available only for authorised users

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Title: White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared to fixed orthodontic treatment. A systematic review and meta- analysis
Authors: Shailaja Raghavan
Elham S. Abu Alhaija
Mandeep Singh Duggal
Srinivasan Narasimhan
Sadeq Ali Al-Maweri
Publication date: 01-12-2023
Publisher: BioMed Central
Keyword: Aligner
Published in: BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI: https://doi.org/10.1186/s12903-023-03257-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared to fixed orthodontic treatment. A systematic review and meta- analysis

Abstract

Objective

Methods

Results

Conclusions

Clinical relevance

Registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

Clinical relevance

Registration

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