A Comparative Evaluation of Treatment Related Outcome in Patients Treated with Clear Aligners and Fixed Orthodontic Appliances

Abstract

Background: Pain and discomfort are common during the initial phase of orthodontic treatment and can affect patient cooperation and satisfaction. Clear aligners are increasingly used as an alternative to fixed appliances, requiring a comparison of patient experiences. The manuscript focuses on the role of patient-centered outcomes in the early stages of orthodontic treatment by comparing clear aligners and fixed appliances. It also provides evidence for pain, discomfort, and quality of life, making it more significant in making decisions and counseling patients. It also discusses the increasing role of clear aligner therapy and the need for more research to improve treatment outcomes. Aim: To compare initial pain, discomfort, and oral health-related quality of life between clear aligner and fixed appliance patients. Materials and Methods: A cross-sectional questionnaire study was conducted among 120 adult orthodontic patients treated with clear aligners or fixed appliances from November 2025 to February 2026. A structured self- administered Google Forms questionnaire assessed pain intensity, duration, functional limitations, psychosocial impact, pain management, and treatment preference during the first week. Descriptive statistics and Chi- square test were used, with p < 0.05 considered significant. Results: More than half of the participants experienced pain within 24 hours, mostly moderate in intensity. Pain was commonly worse at night and lasted one to five days. Eating difficulty, tooth soreness, and soft tissue irritation were frequently reported. Most patients did not use medication, and ice packs were commonly used. Clear aligner patients reported significantly higher satisfaction and preference. Limitations: This study is limited by its cross-sectional design and reliance on self-reported questionnaires, which may introduce response bias. Additionally, the unequal sample distribution and relatively small sample size may limit the generalizability of the findings. Conclusion: Pain and discomfort are common initially. However, clear aligners provide greater comfort, satisfaction, and better oral health-related quality of life compared to fixed orthodontic appliances.