In recent years, as clear aligners have become more common in our market, patients are increasingly attracted to transparent, comfortable, and discreet braces that can be easily removed. One of the most frequently asked questions is: “Can clear aligners achieve the same results as fixed orthodontic treatment?”
Although fixed braces have become the gold standard in orthodontics over the past twenty years, both techniques can achieve excellent results. When comparing clear aligners and fixed braces, the biomechanics of tooth movement differ significantly. Simply put, the wire pulls the tooth in the desired direction in fixed braces, whereas with clear aligners, the plastic pushes the tooth. If the orthodontic specialist understands and accounts for the biomechanics of tooth movement with clear aligners, most orthodontic issues can be effectively treated with them.
Clear aligners are comfortable, nearly invisible, and removable, but they require strong patient cooperation and discipline, as they must be worn for at least 20 hours a day. However, appointments with clear aligners are less frequent, and treatment often takes less time than with fixed braces, although this is not always the case. On the other hand, with fixed braces, patient discipline is less critical—but not entirely irrelevant—because more frequent orthodontic check-ups are required, and maintaining impeccable oral hygiene is more demanding.
Due to the different biomechanics of tooth movement, there are certain movements where fixed braces are still superior. However, over time, clear aligners have proven to be much more efficient for specific types of tooth movement. A prime example is moving molars backward to create space for aligning other teeth, which can sometimes help avoid tooth extractions in borderline cases.
In such cases, clear aligners have proven to be very efficient and fast—according to some authors, this is one of the most predictable tooth movements with clear aligners—while the same movement with fixed braces is highly demanding and almost impossible. However, when the same molar needs to be moved forward, fixed braces make it very simple, whereas clear aligners make it more challenging.
An orthodontic specialist familiar with both techniques can effectively treat most anomalies with either method, allowing the patient to choose the option that best suits their preferences.
From all of the above, we must be aware that when a patient comes for an orthodontic consultation, they are not coming just for a device, they are coming for orthodontic treatment. It is the orthodontist's responsibility to recommend therapy using the optimal appliance or a combination of appliances, taking into account all biomechanical aspects as well as the patient's preferences regarding aesthetics and function.
For a certain number of patients, we sometimes combine both techniques to achieve optimal results in the shortest possible time and with maximum comfort. For example, some patients may wear clear aligners in one dental arch and a fixed appliance in another. In other cases, treatment may begin with clear aligners and finish with fixed braces, or vice versa.
This approach allows the patient to achieve the best possible outcome in the shortest time. This type of treatment, called hybrid orthodontics, has become increasingly popular in recent years.
Karlo Sudarević, DDS, Orthodontic Specialist, Director of the Clinic
Source: The List magazine
