Patient Perspective in Orthodontic Treatments Performedwith Clear Aligners and Fixed Appliance Treatments

The aim of this study was to compare the pretreatment expectations of patients who started treatment with clear aligners (CA) or labial fixed appliances (LFA), their motivation for choosing the treatment system, the psychosocial and physical discomfort and pain levels they experienced during the treatment, and their satisfaction at the end of 6-month treatment. The study included 44 participants who were over 16 years old, had no severe transversal, vertical or sagittal problems, had easy-to-moderate malocclusion severity, and needed treatment in both dental arches without extraction. Patients who were treated at Başkent University Faculty of Dentistry Department of Orthodontics and in four different private clinics were divided into CA and LFA groups according to their treatment preferences. Demographic data and the expectations of the patients with the treatment were assessed at pretreatment (T0) questionnaire. The "Visual Analog Scale" (VAS) was used to evaluate the satisfaction, psychosocial and physical discomfort levels of the patients in the questionnaires obtained at the end of the first (T1), third (T2), and sixth months (T3) of treatment. The pretreatment motivations of the patients in the CA group were aesthetics and comfort, whereas those in the LFA group had expectations of an economical, reliable, and shorter treatment. In both groups, negative social reactions, discomfort due to appearance, and impact on social life and daily activities were measured highest at T1 and gradually decreased over time. Impact on social life, difficulty in adapting to the treatment system, discomfort due to appearance, and difficulty in maintaining hygiene were observed to be lower in the CA group than in the LFA group. (p<0,05) The pain level was similar between the groups at all periods. Tongue discomfort in the CA group, lip, and cheek discomfort in the LFA group were more common. Although clear aligner treatments are more expensive, patients in the CA group stated that they were more satisfied with the cost of treatment than the patients in the LFA group. Satisfaction with the treatment process was found to be similar between the groups. Patients experienced similar pain levels and a similar degree of satisfaction in both groups but reduced psychosocial and physical discomfort with clear aligners than with labial fixed appliances over the 6-month observation period. In both groups, patients were satisfied with the treatment process in line with their expectations, and more than 85% stated they would prefer to be treated again with the same mechanics. Keywords: Clear Aligner, Aligner, Fixed Orthodontic Treatment, Patient Perspective, Patient Satisfaction, Patient Comfort, Survey Study