Treatment Satisfaction and Quality of Life Changes in Patients Receiving Conventional Fixed Orthodontic Appliances and Clear Aligner Therapy: A Questionnaire Based Cross-sectional Study

Abstract

Introduction: The orthodontic outcome is mainly decided by the objective evaluation by orthodontists with minimal subjective considerations. Although there is increasing patient acceptance of orthodontic aligners for malocclusion treatment, minimal evidence exists regarding their efficacy and adverse effects compared to conventional fixed orthodontic appliances. Aim: To assess patient satisfaction and quality of life changes after these two modalities of orthodontic treatment and to analyse the influencing co-factors. Materials and Methods: A web-based three-part questionnaire survey was done amongst 303 participants who underwent either fixed orthodontic therapy or invisalign treatment. The first part collected the participants’ demographic details and their treatment type. The second part of five questions addressed their preferences, facilitators, and factors preventing them from undergoing orthodontic treatment. The final part of ten questions measured the satisfaction ratio on a five-point Likert scale. Descriptive statistics were computed to provide an overview of responses using frequencies and percentages. Inferential statistics were computed using the chi-square test, and a p-value less than 0.05 was considered statistically significant. Results: This study of 303 orthodontic patients found no significant difference in overall satisfaction between fixed braces and clear aligners (p=0.989), although aligners were favoured for facial appearance, increased treatment costs were a concern for the majority. Female participants (185, 61.1%) constituted the majority of the participants, with 178 (58.7%) aged between 19- 29 years. Clear aligner users experienced more discomfort with additional visits and appointment booking, while fixed braces users had greater concerns about appearance and increased brushing time. Younger patients reported higher satisfaction across several treatment aspects (p=0.013). Men were more satisfied with treatment duration and costs than women. Conclusion: In conclusion, while clear aligners provide aesthetic and hygiene benefits, overall satisfaction was comparable to fixed braces, with cost being a significant factor. Comprehensive consultations are essential to align treatment with patient needs. Future research should involve larger, more diverse samples for validation.