Major considerations and clinical outcomes of aligner plates in orthodontic treatments to achieve dental harmonization: a concise systematic review

Abstract

Introduction: Harmonized teeth are synonymous with a healthy mouth, and age is no longer an obstacle to starting orthodontic treatment. There are numerous options involving technologies that serve people of the most varied ages and lifestyles. Among them, the aligner plates are ideal for those who want to correct imperfections in the dental position. Objective: It was to carry out a concise systematic review to highlight the main considerations and clinical outcomes of aligner plates in orthodontic treatments to achieve dental harmonization and aesthetic balance. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from December 2022 to February 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 2012 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed accordingly, according to the Cochrane instrument. Results and Conclusion: A total of 68 articles were found, 22 articles were evaluated and 16 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 14 studies with a high risk of bias and 22 studies that did not meet GRADE. It was concluded that the aligners are created by computer software, require only one impression, require a few additional tests, and allow excellent predictability of the treatment when used within their indications. They have a satisfactory aesthetic level, are comfortable, easy to clean, and cause less trauma when compared to conventional fixed appliances. However, serious skeletal discrepancies cannot be treated with the aligner plates, there may also be non-cooperation on the part of the patient, in which the use of the device is insufficient, making the treatment ineffective, high cost, slight intrusion of posterior teeth may occur, speech disturbances, dysphagia, and increased salivary flow.