Changes of maxillary central incisor and alveolar bone in Class II Division 2 nonextraction treatment with a fixed appliance or clear aligner: A pilot cone-beam computed tomography study

External Apical Root Resorption in Clear Aligner Vs. Fixed Orthodontic Appliances: Systematic Review And Meta-Analysis

“…Four studies were excluded for the following reasons: two studies were excluded because they were theses [20,21], one study was considered not suitable as it was a case-control genetic association study [22], and another study was excluded since it was published in Mandarin [23]. Hence, 6 publications [9,12,14,16,24,25], were included in the qualitative and quantitative data analysis.…”

“…All of the included studies compared clear aligner therapy with fixed orthodontic appliances. Two studies compared clear aligners with two different types of fixed orthodontic appliances [12,25]. All 6 publications evaluated maxillary incisors, and four of them assessed mandibular incisors [9,14,16,24].…”

“…Two studies evaluated canines additionally [14,16]. Four studies assessed EARR by using CBCT [9,12,16,25], one study performed measurements using a 2D panoramic radiograph [14] and one study performed measurements using a 2D periapical radiograph [24].…”

“…Two out of five studies had moderate bias due to deviations from intended interventions [9,12], one had a moderate risk of measurement of outcomes [9] and one had a moderate risk classification on intervention bias [16]. Two studies had a low risk of bias for all of the analyzed factors [14,25]. According to the Cochrane risk-of-bias tool for randomized trials (RoB 2), one study had a moderate risk of bias in blinding participants and personnel [24].…”

“…According to the Cochrane risk-of-bias tool for randomized trials (RoB 2), one study had a moderate risk of bias in blinding participants and personnel [24]. Overall, three studies had moderate [9,12,16], and three had low risk of bias [14,24,25] (Figure 2).…”