COMPARATIVE EVALUATION OF CLEAR ALIGNERS AND CONVENTIONAL FIXED ORTHODONTIC APPLIANCES

This article comparatively evaluates clear aligners and conventional fixed orthodontic appliances using contemporary clinical evidence. The study is not a primary clinical trial; it is a secondary evidence synthesis based on systematic reviews, meta-analyses, comparative clinical studies published between 2023 and 2026, and selected Uzbek orthodontic literature. A 2025 systematic review and meta-analysis including 15 trials and 1,084 patients found no significant difference in overall treatment quality or duration between clear aligners and fixed appliances in non-extraction cases, whereas fixed appliances achieved superior treatment quality in extraction cases because of better control of complex tooth movements. A 2024 meta-analysis showed significantly less external apical root resorption with clear aligners for maxillary central incisors (SMD −0.62), maxillary lateral incisors (SMD −0.47), and mandibular central incisors (SMD −0.27). A 2026 systematic review and meta-analysis reported better periodontal indices with clear aligners, including plaque index (MD −0.437), gingival index (MD −0.233), and probing depth (MD −0.332), together with lower early pain intensity (SMD −0.419). However, a 2026 systematic review of anterior tooth movement suggested that fixed appliances may provide more reliable rotation and torque control, although evidence remains limited. Clear aligners also depend strongly on patient adherence and may require refinements in more complex movements. The evidence therefore supports individualized appliance selection based on malocclusion complexity, extraction status, planned biomechanics, periodontal health, root-resorption risk, esthetic priorities, and patient compliance.