TITLE:
Finishing Quality in Orthodontics: Aligners vs. Fixed Appliances: A Systematic Review
AUTHORS:
Manal Sabour, Safia El Alaoui Talibi, Meriem Bellamine, Hicham El Bouri, Ihsane Ben Yahya
KEYWORDS:
Clear Aligners, Fixed Appliances, Orthodontic Finishing Quality
JOURNAL NAME:
Open Access Library Journal,
Vol.12 No.11,
November
5,
2025
ABSTRACT: Introduction: Fixed appliances are widely regarded as the gold standard in orthodontic treatment due to their ability to deliver precise control over tooth movements. However, the rising demand for more aesthetic options has driven the development and widespread adoption of clear aligners. This systematic review aims to evaluate and compare the finishing quality of orthodontic treatments completed with clear aligners versus fixed appliances. Materials and Methods: A systematic review was conducted in accordance with PRISMA guidelines. Searches were performed across three databases: PubMed, Scopus, and ScienceDirect and included analytical and interventional studies published between 2015 and 2025. Eligible studies assessed orthodontic treatment outcomes using standardized evaluation tools such as The American Board of Orthodontics Objective Grading System (ABO-OGS), Peer Assessment Rating (PAR) Index, Little’s Irregularity Index (LII), or cephalometric analysis. The methodological quality of the included studies was evaluated using The National Institutes of Health (NIH), Quality Assessment Tools for randomized controlled trials and observational studies. Risk of bias was assessed using the ROB2 and ROBINS-I tools. Results: Twelve studies met the inclusion criteria (four randomized controlled trials, five cohort studies, and three case-control studies). Although the findings were somewhat heterogeneous, the majority of studies reported that clear aligners achieved a finishing quality comparable to that of fixed appliances in treating mild to moderate malocclusions. However, in cases involving extractions, fixed appliances demonstrated superior control over tooth movement and finishing outcomes. Conclusion: Clear aligners are a valid alternative to multi-bracket systems for orthodontic treatments of mild to moderate complexity. Nonetheless, their effectiveness remains limited in more complex cases requiring extractions or extensive tooth movements. Further research with more standardized methodologies is warranted to strengthen these findings.