Clear Aligners vs. Fixed Appliances in the Management of Mild to Moderate Malocclusion: A Review of Treatment Efficacy, Stability, and Patient- Centered Outcomes

Author(s): Abdullah AHAH Aloufan

Aim: To evaluate and compare clear vs fixed orthodontic appliances in the management of mild to moderate malocclusions with respect to the treatment efficacy, stability and patient centred outcomes.

Methods: Peer reviewed published articles between 2010 and 2025 were structurally searched across PubMed, Scopus and Google Scholar. The search strategy included cohort studies, clinical trials, systematic reviews and meta-analyses directly comparing fixed aligners and fixed appliances. Furthermore, utilising relevant keywords. Studies were assessed for quality, relevance, and outcome reporting on treatment effectiveness, duration, periodontal health, and patient experience.

Results: Favourable outcomes were reported with clear aligners, which included shorter treatment time, improved periodontal health, and higher reported patient satisfaction in terms of comfort and aesthetics. However, fixed appliances were occasionally superior in achieving occlusal control, management of torque, and precision of tooth movement. Some studies found no significant difference between the two appliances across various parameters, highlighting variability based on type of malocclusion, complexity of treatment, and patient adherence.

Conclusion: Clear aligners offer a promising alternative to traditional fixed appliances, especially for adults seeking discreet and comfortable treatment. While clear aligners are associated with improved oral hygiene and reduction in discomfort, fixed appliances may provide superior control in specific cases. The evidence remains moderate, and high-quality clinical trials are needed to further clarify comparative effectiveness and inform personalized orthodontic treatment planning.