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Abstract
Objective:
The purpose of this randomized controlled trial (RCT) was to compare the biomechanical effects of clear aligners versus traditional fixed braces on orthodontic tooth movement, pain levels, and treatment duration in patients presenting with mild to moderate malocclusion at a tertiary care hospital in the southern region of Punjab, Pakistan.
Methods:
A total of 120 participants were enrolled and randomly assigned into two groups: clear aligner group (n = 60) and conventional fixed braces group (n = 60). Standardized protocols for appliance delivery, force application, and follow‑up visits were utilized. Primary outcomes included objective tooth movement measured by digital superimposition of intraoral scans and radiographs, and secondary outcomes involved self‑reported pain scores using a validated visual analogue scale (VAS) and total treatment time in months. Patient compliance and periodontal health parameters were also recorded at predefined intervals.
Results:
Both groups showed significant improvements in dental alignment and occlusal relationships over the study period. Clear aligners produced predictable segmental tooth movement with reduced soft‑tissue irritation and lower early pain scores compared to fixed braces, particularly in the first week of treatment. The fixed braces group demonstrated marginally greater control of complex three‑dimensional movements, such as torque and rotation, consistent with prior clinical findings. Treatment duration was comparable between the two modalities for mild to moderate cases, though clear aligners showed slight reductions in chair time and emergency visits. Clear aligner therapy preserved periodontal health more effectively, reflected in lower plaque and gingival indices. These clinical outcomes aligned with recent systematic evidence comparing aligners and fixed appliances.
Conclusion:
Within the studied cohort, both clear aligners and traditional fixed braces were effective in achieving orthodontic tooth movement. Clear aligners demonstrated advantages in comfort, periodontal health, and early treatment pain. Fixed appliances provided superior control of certain biomechanical challenges. These findings support the tailored use of either modality based on case complexity, patient priorities, and compliance.