Orthodontics
Invisalign, brackets, crooked teeth treatment
Crooked Teeth Treatment
Crooked teeth treatment moves overlapping teeth into the space they lack using braces or clear aligners, with space creation or extraction where indicated.
Invisalign Treatment
Invisalign is an orthodontic system that aligns teeth with a custom series of clear trays, worn 20-22 hours a day and taken out to eat and brush.
Bracket Treatment
Bracket treatment, or fixed braces, moves teeth in three planes using metal or ceramic brackets bonded to the teeth and an archwire running through them.
Orthodontic treatment moves teeth into a planned position and corrects how the jaws meet, using either clear aligners or fixed brackets. Case complexity decides the appliance in orthodontics, and patient preference comes second. A systematic review and meta-analysis of 15 trials covering 1,084 patients found no significant difference in treatment quality or duration between clear aligners and fixed appliances in non-extraction cases, while in extraction cases fixed appliances produced better treatment quality through greater control of tooth movement (PubMed 41127933). The section covers crowding treatment, Invisalign and bracket treatment, and which one applies is decided at examination from the degree of crowding, the extraction decision and how reliably the patient will wear aligners for the recommended hours each day.
- 01Appliance type does not set the treatment time. In mild to moderate crowding, a systematic review of ten studies found no significant difference in treatment duration between clear aligners and fixed appliances, rated low certainty under GRADE, and heterogeneity was too high for meta-analysis (PubMed 38607436). Treatment length is therefore a planning question, not a product question.
- 02The extraction decision is where the two separate. In the same review of 15 trials, fixed appliances gave better treatment quality in extraction cases through greater control of tooth movement, and post-treatment stability was similar on limited evidence (PubMed 41127933).
- 03Treatment does not end when the appliance comes off. A Cochrane review of 47 studies and 4,377 participants found no clinically significant difference in tooth stability between removable and fixed retainers, on low to very low certainty evidence (PubMed 37219527). For a patient treated abroad this is the part of the plan to settle before flying home, including who checks the retainer.
- 04Crowding treatment names an indication rather than an appliance. Which appliance carries it out depends on age, the type of malocclusion and the extraction decision.
- 1.Alhafi ZM, Hajeer MY, Alam MK, Jaber ST. Quality and stability of orthodontic treatment outcomes with clear aligners versus fixed appliances: a systematic review and meta-analysis. Eur J Orthod 2025;47(6):cjaf091. PubMed 41127933
- 2.Alhamwi AM, Burhan AS, Idris MI, Nawaya FR. Duration of orthodontic treatment with clear aligners versus fixed appliances in crowding cases: a systematic review. Clin Oral Investig 2024;28(5):249. PubMed 38607436
- 3.Martin C, Littlewood SJ, Millett DT, Doubleday B, Bearn D, Worthington HV, Limones A. Retention procedures for stabilising tooth position after treatment with orthodontic braces. Cochrane Database Syst Rev 2023;5:CD002283. PubMed 37219527