“Evaluation of Difference Between Predicted and Achieved Outcome in Maxillary Dentoalveolar Expansion with Clear Aligner Therapy- A Systematic Review”

Abstract

Aim: The aim of this systematic review is to evaluate the difference between predicted and achieved outcome in maxillary dentoalveolar expansion with Clear aligner therapy. Material and methods: A search of the keywords “Clear Aligner Therapy, Maxillary Expansion, Predictability OR Efficacy, Expansion with clear aligner therapy, Expansion in adults, Clear Aligners, Predictability was conducted on search engines like PubMed, Google Scholar, and Cochrane Library from the year 1997-2023. Inclusion criteria for this systematic review included: all Randomized clinical trials (RCTs) and prospective and retrospective studies with concurrent untreated control groups (CCTs). Article in English language, only human clinical trial, Articles regarding the expansion using the clear aligner therapy along with its efficacy and predictability by the respective software in adult patients, published from the year 1997-2023. Statistical analysis: The following characteristics were evaluated: study design, sample size, sample description, error analysis, and statistical analysis. The quantified data on Efficacy of the treatment and Predictability of the software used, was extracted from the selected articles. Risk of bias (whether mentioned or not) was checked and quality assessments of studies were performed. Results: Ten studies were reviewed in this article. From the included articles, the following data were extracted independently: author names, year of publication, type of studies, sample size, mean age of subjects, Efficacy and Predictability in inter canine, inter 1st premolar, inter 2nd premolar, inter 1st molar and inter 2nd molar regions. Maximum efficacy of clear aligner treatment was found in the 1st premolar region with average of 82.13% and minimum in the 1st and 2nd molar region with an average of 66.8% and 53.3% respectively. Maximum loss of predictability in the treatment i.e., 33.2% and 46.7% was found in 1st and 2nd molar region respectively. Conclusion: Based on the results it is recommended to have careful planning with overcorrection and other auxiliary methods of expansion which may help reduce the rate of midcourse corrections and refinements, especially in the posterior region of the maxilla.