Treatment outcome comparison of Invisalign vs fixed appliance treatment in first premolar extraction patients

Abstract

In this study, we compared the dentitional changes after Invisalign and conventional orthodontic treatment with 4 first premolar extractions. This retrospective study included 57 patients whose orthodontic treatment involved the extraction of 4 first premolars because of bialveolar protrusion. A total of 27 patients were treated with Invisalign (mean age, 25.5 ± 5.2 years) and 30 patients with the fixed appliance (mean age, 24.4 ± 5.8 years). The angular and linear changes of the maxillary and mandibular central incisors, second premolars, first molars, and second molars were measured from the recordings on the basis of the lateral cephalograms taken before and after treatment. The angular changes of the canines and second premolars were measured using panoramic radiographs. The overbite and interincisal angle increased significantly in the Invisalign group compared with in the conventional fixed appliance group (P<0.05). The maxillary central incisors showed increased lingual tipping in the Invisalign group (P<0.05), whereas there was no statistically significant difference in the angular change of the mandibular incisors between groups (P>0.05). The maxillary first and second molars showed mesial tipping in the Invisalign group (P<0.05). The maxillary second premolars, first and second molars, and the mandibular second molars showed mesial movement in the Invisalign group (P<0.05). The Invisalign group showed more statistically significant lingual tipping of the maxillary central incisors, distal tipping of the maxillary canines, and mesial tipping of the maxillary first and second molars after maximum retraction of the anterior teeth compared with the fixed appliance group.