Invisible orthodontic aligners: a review
Keywords:Orthodontics; Aesthetics; Smile; Dental movement.
Orthodontics is a specialty that assesses the growth and development of the face and teeth, preventing and correcting dental malocclusions up to deviations from normal face. Orthodontic treatment causes changes in aesthetics and function, thus impacting patients' quality of life. The existing protocols for tooth movement consist of the traditional fixed methods using brackets (metallic, plastic or ceramic) and metallic wires, and the invisible removable braces, made of thermoplastic material that present several benefits, such as their aesthetics and facilitating oral hygiene. Thus, this work has the general objective of conducting a literature review of the studies and research carried out in relation to invisible orthodontic appliances and to evaluate the available evidence on the clinical effectiveness of the system. 76 studies were analyzed. It was observed by the review analysis of the articles presented in the study that the system of invisible and removable appliances applied to orthodontic treatment has numerous advantages, therefore, this system has become increasingly demanded and chosen as an option for orthodontic treatment. It is concluded that advances in the quality of aligner materials, accessories and complementary systems, in the use of digital systems for processing initial data, as well as in virtual three-dimensional planning have expanded the range of possibilities of orthodontic treatment with invisible and removable appliances applied to various orthodontic problems, whether of lesser or greater complexity. The system has been widely used and its effectiveness, precision and predictability in treatment are observed in the studies.
Align Technology (2020). Invisaline for adults and teens. www.invisalign.com/braces-for-adults-and-teens.
Aljabaa, A. H. (2020). Clear aligner therapy––Narrative review. Journal of International Oral Health, 12(7), 1.
Almasoud N. N. (2018). Pain perception among patients treated with passive selfligating fixed appliances and Invisalign ® aligners during the first week of orthodontic treatment. Korean J Orthod, 48(5):326–32.
Al-Omiri, M. K., & Abu Alhaija, E.S. (2006). Factors affecting patient satisfaction after orthodontic treatment. Angle Orthod, 76(3):422–31.
Azaripour, A., Weusmann, J., Mahmoodi, B., Peppas, D., Gerhold-Ay, A, & Van Noorden, C. J. F., Willershause, B. (2015). Braces versus Invisalign®: gingival parameters and patients’ satisfaction during treatment: a cross-sectional study BMC Oral Health, 15:69.
Balachandran, S., Ganapathy, D., & Ramanatha, V. (2019) Clear aligners – A review. Drug Invention Today, 12 (10), 2280-2284.
Beers, A. C., Choi W., & Pavlovskaia E. (2003). Computer-assisted treatment planning and analysis, Orthod Craniofac Res, 6 (1), 117-25.
Bergius, M., Berggren U., & Kiliaridis S. (2002). Experience of pain during an orthodontic procedure, Eur J Oral Sci, 110(2), 92–8.
Bollen A. M., Cunha-Cruz J., Bakko D.W., Huang G.J., & Hujoel P.P. (2008). The effects of orthodontic therapy on periodontal health: A systematic review of controlled evidence, J Am Dent Assoc., 139, 413–22.
Boyd R. L. (2008). Esthetic orthodontic treatment using the invisalign appliance for moderate to complex malocclusions. J Dent Educ, 72, 948-67.
Brandão, R. C. B., & Brandão, L. B. C. (2008). Ajuste oclusal na Ortodontia: por que, quando e como?. Rev. Dent. Press Ortodon. Ortop. Facial. 13, 124 - 156.
Buschang, P. H., Shaw, S. G., Ross, M, Crosby, .D., & Campbell, P. M. (2014). Comparative time efficiency of aligner therapy and conventional edgewise braces. Angle Orthod. 84, 391‐396.
Cardoso, P. C., Espinosa, D.G., Mecenas, P., Flores-Mir, C., & Normando, D. (2020). Pain level between clear aligners and fixed appliances: a systematic review. Progress in Orthodontics, 21, 3.
Chevitarese, O., & Ruellas, A. C. O. (2005). Braquetes Ortodônticos como utilizá-los. Livraria Santos Editora.
Chisari, J. R., McGorray, S. P, Nair, M, & Wheeler, T.T. (2014). Variables affecting orthodontic tooth movement with clear aligners. Am J Orthod Dentofac Orthop, 145, 82–91.
Djeu, G., Shelton, C., & Maganzini, A. (2005). Outcome assessment of Invisalign and traditional orthodontic treatment compared with the American Board of Orthodontics objective grading system. Am J Orthod Dentofacial Orthop. 128, 292‐298.
Drake C. T., McGorray S. P., Dolce C, Nair M, Wheeler T. T. (2012). Orthodontic tooth movement with clear aligners. ISRN Dent, 657-673.
Duncan, L. O., Piedade, L., Lekic, M., Cunha, R. S., & Wiltshire W. A. (2016). Changes in mandibular incisor position and arch form resulting from Invisalign correction of crowded dentition treated nonextraction. Angle Orthod, 86, 577-83.
Eissa, O., Carlyle, T., El-Bialy, T. (2018). Evaluation of root length following treatment with clear aligners and two different fixed orthodontic appliances: A pilot study. J Orthod Sci, 7, 11.
Elkholy, F., Schmidt, F., Jaeger, R., & Lapatki B. G. (2017). Forces and moments applied during derotation of a maxillary central incisor with thinner aligners: An in‐vitro study. Am J Orthod Dentofacial Orthop. 151, 407‐415.
Elkholy, F., Schmidt, F., Jaeger, R., Lapatki, G. (2016). Forces and moments delivered by novel, thinner PET‐G aligners during labiopalatal bodily movement of a maxillary central incisor: An in vitro study. Angle Orthod. 86, 883‐890.
Fujiyama K., Honjo T., Suzuki M., Matsuoka S., & Deguchi T. (2014). Analysis of pain level in cases treated with Invisalign aligner: comparison with fixed edgewise appliance therapy. Prog Orthod., 15-64.
Fuller, J. (2008). A simple aligner system for minor anterior correction. Clin Impressions, 16, 21-2.
Galan-Lopez, L., Barcia-Gonzalez, J., & Plasencia E. (2019). A systematic review of the accuracy and efficiency of dental movements with Invisalign®. Korean J Orthod, 49, 140-149.
Grünheid, T., Gaalaas, S., Hamdan, H., Larson, B. E. (2016). Effect of clear aligner therapy on the buccolingual inclination of mandibular canines and the intercanine distance. Angle Orthod. 86(1), 10–6.
Gu, J., Tang, J. S., Skulski, B, Campos, H. W., & Beck, F. M, Firestone, A. R. (2017). Avaliação da eficácia do tratamento Invisalign e eficiência em comparação com dispositivos fixos convencionais, utilizando o índice de pares classificação da avaliação. Am J Orthod Dentofacial Orthop, 151, 259-66.
Guedes, F. P., Ferronato, E., Martins, R. P. (2019). Protocolo clínico para instalação de attachments em casos tratados com alinhadores ortodônticos – descrição da técnica. Orthod. Sci. Pract., 12(48), 102-112.
Hajeer M. Y., Millett D. T., Ayoub A. F., & Siebert J. P. (2004). Applications of 3D imaging in orthodontics: part II. J Orthod, 31, 154-62.
Hennessy, J., & Al-Awadhi E. A. (2016). Clear aligners generations and orthodontic tooth movement. J Orthod, 43, 68-76.
Hennessy, J., Garvey, T., & Al-Awadhi E. A. (2016). A randomized clinical trial comparing mandibular incisor proclination produced by fixed labial appliances and clear aligners. Angle Orthod, 86(5), 706–12.
Houle, J. P., Piedade, L, Todescan, R., & Pinheiro F. H. (2017). The predictability of transverse changes with Invisalign. Angle Orthod, 87, 19-24.
Iliadi, A., Koletsi, D., & Eliades, T. (2019). Forces and moments generated by aligner‐type appliances for orthodontic tooth movement: A systematic review and metaanalysis. Orthod Craniofac Res. 22, 248–258.
Jiang, Q., Li, J., Mei, L., Du, J., Levrini, L., Abbate, G. M., & Li, H. (2018). Periodontal health during orthodontic treatment with clear aligners and fixed appliances: A meta-analysis. The Journal of the American Dental Association, 149(8), 712-720
Kamatovic, M. (2004). A retrospective evaluation of the effectiveness of the Invisalign appliance using the PAR and irregularity indices. Toronto: University of Toronto (Canada).
Kazancı, F., Aydoğan, C., & Alkan Ö. (2016). Patients’ and parents’ concerns and decisions about orthodontic treatment. Korean J Orthod. 46(1), 20–6.
Kesling, H. D. (1945). The philospohy of the tooth positioning appliance. Am J Orthod Oral Surg, 31, 297-304.
Khosravi, R., Cohanim, B., Hujoel, P., Daher, S., Neal, M., Liu, W., & Huang, G. (2017). Management of overbite with the Invisalign appliance. American journal of orthodontics and dentofacial orthopedics, 151(4), 691-699.
Kojima, Y., & Fukui, H. (2011). A finite element simulation of initial movement, orthodontic movement, and the centre of resistance of the maxillary teeth connected with an archwire. The European Journal of Orthodontics. 36, 255 – 261.
Krieger, E., Seiferth, J., Marinello, I., Jung, B. A., Wriedt, S., Jacobs, C., & Wehrbein, H. (2012). Invisalign® treatment in the anterior region. Journal of Orofacial Orthopedics/Fortschritte der Kieferorthopädie, 73(5), 365-376.
Kuncio, D., Maganzini, A., Shelton, C., & Freeman, K. (2007). Invisalign and traditional orthodontic treatment postretention outcomes using the American Board of Orthodontics objective grading system. Angle Orthod, 77(5), 864–9.
Lagrave` re M. O., & Flores-Mir C. (2005). The treatment effects of Invisalign orthodontic aligners: a systematic review. J Am Dent Assoc. 136, 1724–1729.
Levrini, L., Abbate, G. M., Migliori, F., Orrù, G., Sauro, S. & Caprioglio A. (2013). Assessment of the periodontal health status in patients undergoing orthodontic treatment with fixed or removable appliances. A microbiological and preliminary clinical study. Cumhuriyet Dent J. 2013;16:296–307.
Li W., Wang S, & Zhang Y. (2015). The effectiveness of the Invisalign appliance in extraction cases using the the ABO model grading system: a multicenter randomized controlled trial. Int J Clin Exp Med., 8(5), 8276–82.
Liu, H., Sun, J., Dong, Y., Lu, H., Zhou, H., Hansen, B. F., & Song, X. (2011). Periodontal health and relative quantity of subgingival Porphyromonas gingivalis during orthodontic treatment. The Angle Orthodontist, 81(4), 609-615.
Macena, M. C. B, Catão, C. D., Rodrigues R. Q. F., & Vieira J. M. F. (2015). Fios ortodônticos, propriedades microestruturais e suas aplicações clínicas: visão geral. Revista saúde e ciência Online, 4; 90 -108.
Madotti V, Matos C, Woitchunas F. E., Kochenborger R, & Woitchunas D. R. (2014). Aparelhos removíveis em adultos: avaliação perceptiva do sistema Invisalign®. Orthodont, Scienc Pract., 7(25), 21-26.
Maltagliati L. A. (2006). Bráquetes estéticos – considerações clínicas. Rev. Clin. Ortodon., 5(3), 89-95.
Melsen B. (2011). Northcroft Lecture: how has the spectrum of orthodontics changed over the past decades? J Orthod., 38, 134-143.
Miethke, R. R., & Brauner, K. A Comparison of the periodontal health of patients during treatment with the Invisalign system and with fixed lingual appliances. J Orofac Orthop. 2007;68:223–31.
Mota Júnior, S. L. Cinco tópicos tecnológicos na ortodontia atual. HU Revista, Juiz de Fora. 2018; 44; 77 - 84 (1).
Nahoum H. Forces and moments generated by removable thermoplastic aligners. Am J Orthod Dentofacial Orthop 2014; 146: 545–6.
Pacheco-Pereira, C., Brandelli, J., & Flores-Mir, C, (2018). Patient satisfaction and quality of life changes after Invisalign treatment, Am J Orthod Dentofacial Orthop, 153:834-41.
Papadimitriou, A., Mousoulea, S., Gkantidis, N., Kloukos, D. (2018). Clinical effectiveness of Invisalign® orthodontic treatment: a systematic review. Progress in Orthodontics, 19, 37.
Pavoni, C., Lione, R., & Laganà P.C. (2011). Self-ligating versus Invisalign: analysis of dento-alveolar effects. Ann Stomatol, 2(1–2), 23–7.
Rossinia, G., Parrinia, S., Castrofloriob, T., Deregibusc, A., & Debernardid, C. L. (2015). Efficacy of clear aligners in controlling orthodontic tooth movement: A systematic review. Angle Orthodontist., 85.
Rosvall M. D, Fields H. W., Ziuchkovski J., Rosenstiel S. F., & Johnston W. M. (2009). Attractiveness, acceptability, and value of orthodontic appliances. Am J Orthod Dentofacial Orthop. 135, 276-277.
Rothier E. K. C., & Vilella O. V. (2010). Invisalign®: uma alternativa estética para a movimentação dentária. Orthodont Scienc Prat., 3, 268-72.
Simon, M., Keilig, G. J., Jung B. A., & Bourauel C. (2014). Tratamento resultado e eficácia de uma técnica alinhador - sobre binário incisivo, de redução de rotação pré-molares e molares distalizar. Oral Saúde, 14, 68.
Simon, M., Keilig, L., Schwarze, G., Jung, B.A., Bourauele, C. (2014). Forces and moments generated by removable thermoplastic aligners: Incisor torque, premolar derotation, and molar distalization. Am J Orthod Dentofacial Orthop. 145, 728–36.
Takehara E. C., & Casa M. A., Carvalho, S. (2013). Plano de tratamento virtual na ortodontia. Orthodont Scienc Pract., 6(23), 346-52.
Vianna, V. F., & Mucha, J. N. (2006). O posicionamento vertical dos acessórios na montagem do aparelho ortodôntico fixo. Rev. Dent. Press Ortodon. Ortop. Facial., 11, 66-75.
Walton D. K., Fields H. W., Johnston W. M., Rosenstiel S. F., Firestone A. R., & Christensen J. C. (2010). Orthodontic appliance preferences of children and adolescents. Am J Orthod Dentofacial Orthop, 138, 698.
Weir, T. (2017). Clear aligners in orthodontic treatment, Australian Dental Journal, 62, 58–62.
White, D.W., Julien, K.C., Jacob, H., Campbell P. M., Buschang, P. H. (2017). Discomfort associated with Invisalign and traditional brackets: a randomized , prospective trial. Angle Orthod., 87(6), 801–8.
Yezdani, A. (2015). Transparent aligners: An invisible approach to correct mild skeletal class III malocclusion. Journal of Pharmacy and Bioallied Sciences, 7, 1, 301-306
Zheng, M., Liu, R., Ni, Z., & Yu, Z. (2017). Efficiency, effectiveness and treatment stability of clear aligners: A systematic review and meta‐analysis. Orthodontics & craniofacial research, 20(3), 127-133.
Zhou, N., & Guo, J. (2019). Efficiency of upper arch expansion with the Invisalign system. Angle Orthod.
How to Cite
Copyright (c) 2021 Heloisa Alves de Figueiredo Sousa; José Julio Pereira Nunes Ferreira do Nascimento; Marcos Alves de Figueiredo Sousa; Bruna Genari ; Andreia Oliveira Souza; Felipe Weidenbach Degrazia
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.