Title
Management of complex orthodontic cases using aligners: A comparative study
Authors
Mohammed Ali Hamid Syed1,*, Chaitanya Chappidi2, Zeeshan Mubashir3, Vijay Shekhar4, LahariPriya Singareddy5, Rahul Tiwari6 & Heena Dixit Tiwari7
Affiliation
1Department Orthodontics and Dentofacial Orthopedics, Al harkan Medical Center, Unaizah, Al Qassim, Saudi Arabia; 2Department of Dental Medicine, Metro Health Family Dentistry, Cleveland, Ohio, United States of America; 3Department of Orthodontics and Dentofacial Orthopaedics, Al Jouf Specialised Dental Center, Ministry of Health, Sakaka, Al Jouf Province, Kingdom of Saudi Arabia; 4Department of Dentistry, Nalanda Medical College Hospital, Agamkuan, Patna, Bihar, India; 5Department of Public Health, St. Francis College, New York, United States of America; 6Department of Dental Research Cell, Dr. D. Y. Patil Dental College & Hospital, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pimpri, Pune 411018, Maharashtra, India; 7Department of blood cell, Consultant, Blood Cell, Commissionerate of Health and Family Welfare, Government of Telangana, Hyderabad, Telangana, India; *Corresponding author
Mohammed Ali Hamid Syed - E-mail: syedmohammedali86@gmail.com
Chaitanya Chappidi - E-mail: chaitanyabhuma@gmail.com
Zeeshan Mubashir - E-mail: dr.zeeshanmubashir@gmail.com
Vijay Shekhar - E-mail: vjsspitzer@yahoo.in
LahariPriya Singareddy - E-mail: laharisinga@gmail.com
Rahul Tiwari - E-mail: rahul.tiwari@dpu.edu.in
\ Heena Dixit Tiwari - E-mail: drheenatiwari@gmail.com
Article Type
Research Article
Date
Received March 1, 2026; Revised March 31, 2026; Accepted March 31, 2026, Published March 31, 2026
Abstract
Clear aligners are increasingly being used for complex malocclusions; however, adequate outcome data comparing them with fixed appliances in high-difficulty cases is still limited. Therefore, it is of interest to compare occlusal outcomes, efficiency and patient-reported experience between clear aligners and fixed appliances in complex orthodontic cases. Using a prospective comparative design, complex cases were randomly assigned to treatment with clear aligner therapy or conventional fixed appliances and assessed by Peer Assessment Rating (PAR) score change, length of treatment time needed, burden of appointments required, refinements/finishes and OHIP-14. Both modalities produced clinically significant occlusal correction; however, fixed appliances showed increased efficiency in extraction heavy biomechanics while aligners showed increased initial patient-reported comfort and oral health related quality of life. Aligners may be useful in complex cases when biomechanics has been well-staged and compliance is high and yet fixed appliances might still be beneficial in providing efficiency benefits in hard-to-root control and extraction space closure.
Keywords
Clear aligner; fixed appliance; complex malocclusion; peer assessment rating (PAR); Oral Health Impact Profile-14 (OHIP-14)
Citation
Syed et al. Bioinformation 22(3): 1429-1432 (2026)
Edited by
Vini Mehta
ISSN
0973-2063
Publisher
License
This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. This is distributed under the terms of the Creative Commons Attribution License.
