Effect of clear aligners on oral health‐related quality of life: A systematic review

Clear aligners have been frequently applied in orthodontic clinic practice. However, its effect on oral health-related quality of life (OHRQoL) compared with fixed appliance treatment (FAT) remains inconclusive. This systematic review aimed to compare the impacts of clear aligner treatment (CAT) with FAT on patients' OHRQoL. Electronic searches of databases (PubMed, Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, Embase, Medline, two Chinese databases and six grey literature databases) were conducted up to July 2019. Randomized controlled trials, controlled clinical trials, cohort studies and cross-sectional studies comparing the impact of CAT and FAT on OHRQoL with validated instruments were included. Extraction of data and assessment of the risk of bias were conducted using ROBINS-I-tool, Newcastle-Ottawa Scale and ROB 2.0 based on study design. Of the 1112 records initially identified, 2 studies were included in this review. One study evaluated OHRQoL at the last debonding appointment, while the other made evaluation at the early stage of treatment. In the aspect of functional dimensions, both studies reported less eating disturbance in CAT patients than FAT ones. Based on currently limited information, the effect of CAT on the overall OHRQoL compared to FTA was still inconclusive. In individual dimensions, however, weak evidence supported that CAT might cause less eating disturbance than FAT. More high-quality clinical trials using validated OHRQoL instruments are needed to draw more reliable conclusions in the effect of CAT and FAT on OHRQoL.