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Review
. 2022 Jan 11;15(2):533.
doi: 10.3390/ma15020533.

Effects of Composite Attachments on Orthodontic Clear Aligners Therapy: A Systematic Review

Riccardo Nucera  1 , Carolina Dolci  2 , Angela Mirea Bellocchio  1 , Stefania Costa  1 , Serena Barbera  1 , Lorenzo Rustico  1 , Marco Farronato  2 , Angela Militi  1 , Marco Portelli  1
Affiliations
Review

Effects of Composite Attachments on Orthodontic Clear Aligners Therapy: A Systematic Review

Riccardo Nucera et al. Materials (Basel). .

Abstract

This systematic review aims to highlight the differences between different clear aligner therapies that differ in the presence of attachments or in attachment configuration. Eight electronic databases were searched up to March 2020. Two authors independently proceeded to study selection, data extraction, and risk of bias assessment. The analysis of the results was carried out examining six groups of movements (mesio-distal tipping/bodily movement; anterior bucco-lingual tipping/root torque; posterior bucco-lingual tipping/expansion; intrusion; extrusion; rotation). Five clinical trials were selected and all of them showed a medium risk of bias. Literature showed that attachments mostly increase the effectiveness of orthodontic treatment with clear aligners, improving anterior root torque, rotation, and mesio-distal (M-D) movement; they are also important to increase posterior anchorage. However, some articles showed contradictory or not statistically significant results. Attachments also seem to improve intrusion, but the evidence about this movement, as well as extrusion, is lacking. No studies evaluated posterior bucco-lingual tipping/expansion. Further clinical trials are strongly suggested to clarify the influence of attachments and their number, size, shape, and position on each orthodontic movement.

Keywords: attachments; auxiliary elements; clear aligner therapy; clear aligners; invisalign; invisible orthodontics; systematic review.

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Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

Figure 1
Figure 1
Flow chart of studies selection.
See this image and copyright information in PMC

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