Association of Orthodontic Clear Aligners with Root Resorption Using Three-dimension Measurements: A Systematic Review.

AIM: This paper aims to assess the evidence in the literature reporting orthodontically induced inflammatory root resorption (OIIRR) in treatment with orthodontic clear aligners using 3D measurements.

MATERIALS AND METHODS: Following preferred reporting Items for systematic reviews (PRISMA) statement, eight electronic databases were searched for relevant published and unpublished records. Data collected according to restricted inclusion and exclusion criteria.

RESULTS: A total of 236 articles were identified as relevant to our topic. Duplicates were excluded resulting in 226 papers, out of which 31 papers were relevant after screening titles and abstracts. Only 2 high-level evidence papers out of the 31 met the inclusion criteria for the qualitative synthesis.

CONCLUSION: Based on the available studies with high level of evidence in the literature, we conclude that orthodontic clear aligners are non-inferior to light-force fixed orthodontic appliances, and superior to heavy-force fixed orthodontic appliances in terms of the risk for developing apical root resorption.

CLINICAL SIGNIFICANCE: Orthodontists can be more assured about the low-risk of OIIRR associated with clear aligners compared to other orthodontic treatment modalities, and it remains up to the practitioner's assessment to select the appropriate treatment on a case by case basis.