A 6-month assessment of patient satisfaction, discomfort, pain perception and the effect of socioeconomic status on clear aligner and fixed appliance treatments

Aim: To compare the satisfaction and psychosocial and physical discomfort levels of patients who receive orthodontic treatment with clear aligners or labial fixed appliances.
Materials and methods: The study included 44 participants who were aged over 16 years, had no severe transverse or vertical problems, had easy to moderate severity of malocclusion, and needed treatment in both arches without extraction. Patients were divided into clear aligner and labial fixed appliance groups according to their treatment preferences. A visual analogue scale was used to evaluate the results of the questionnaires obtained after 1 (T1), 3 (T2) and 6 months (T3) of treatment.
Results: In both groups, negative social reactions, discomfort due to appearance, and impact on social life and daily activities were found to be highest at T1 and decreased gradually over time. Impact on social life, difficulty adapting to the treatment system, discomfort due to appearance and difficulty maintaining hygiene were found to be lower in the clear aligner group than in the labial fixed appliance group (P 0.05). The pain level was similar between the groups at all periods. Tongue discomfort was more frequent in the clear aligner group, whereas lip and cheek discomfort were more frequent in the labial fixed appliance group. Satisfaction with the treatment process was found to be similar between the groups; however, satisfaction with the cost was higher in the clear aligner group.
Conclusion: Patients experienced similar pain levels and a similar degree of satisfaction in both groups, but reduced psychosocial and physical discomfort with clear aligners compared with labial fixed appliances over the 6-month observation period. Keywords: clear aligners, Invisalign, labial fixed appliances, oral health–related quality of life, pain perception, patient perspective