Impact of COVID-19 Pandemic on Treatment with Conventional Fixed Orthodontic Appliances Versus Clear Aligners in Saudi Arabia: A Multi-Center Cross-sectional Study

Abstract

Background: This study aimed to compare the treatment progress and complications between patients receiving conventional orthodontic treatment and clear aligners during the coronavirus disease-2019 (COVID-19) pandemic. Methods: An electronic survey was distributed randomly among orthodontic patients in Saudi Arabia to understand how the global health crisis caused by COVID-19 affected orthodontic patients. The survey questions were structured into four sections, including demographic data, continuation of orthodontic follow-up appointments during the COVID-19, reasons for missed appointments, and problems of orthodontic patients. Data analysis consisted of simple descriptive statistics presented in frequency tables and percentages. Statistical significance was set at P≤0.05. Results: A total of 512 electronic responses were received. Sixty-two (12.11%) participants missed no orthodontic follow-up appointment during the COVID-19 lockdown. Hence, the study included 450 (87.89%) participants to evaluate the impact of COVID-19 pandemic on sustained orthodontic treatment. The proportion of patients in the fixed appliance group (35.2%, 86 patients) who responded that “they had not even once tried to communicate with their orthodontists” was significantly higher than that in the clear aligner group (9.2%, 19 patients) (P<0.001). The proportion of participants who received fixed appliances (62.3%, 152 patients) and disagreed with the lockdown of orthodontic clinics during the COVID-19 was significantly higher than that in clear aligner users (19.4%, 40 patients) (P<0.001). Conclusion: The results indicated that most issues were reported by patients who had fixed appliances. Thus, tele-orthodontics could provide a solution to continue dental practice during the COVID-19, and clear aligners are preferable to traditional orthodontic treatment methods.