Evaluation of General Knowledge and Understanding of Clear Aligner Therapy Among Dental Students
Keywords:
aesthetics , clear aligner therapy, orthodontic knowledgeAbstract
Background: The growing importance of dental aesthetics has driven increasing demand for adult orthodontic treatment. Clear Aligner Therapy (CAT) has emerged as a prominent aesthetic alternative to conventional fixed appliances.
Aim: To evaluate the general knowledge, understanding, and perceptions of CAT among undergraduate dental students in Iraq, and to assess how this knowledge influences their clinical preferences.
Materials and Methods: A cross-sectional digital survey was conducted using Google Forms and distributed via WhatsApp and Telegram to dental students across several dental colleges in Iraq during January–March 2026. A total of 164 respondents were included, data were analyzed using Microsoft Excel 2021.
Results: The sample comprised 164 students (mean age was 21.5 years). Overall, CAT awareness was 61%. The majority correctly identified that clear aligners are not universally indicated (81.7%) and are more expensive than fixed braces (70.1%). Despite higher cost, 65.2% preferred clear aligners. Most students considered CAT less painful (62.8%), requiring fewer clinic visits (71.3%), and posing a lower risk of tooth decay (81.7%). Furthermore, 56.7% believed CAT achieves equivalent clinical efficacy to fixed appliances.
Conclusion: Dental students demonstrate a moderate-to-high level of knowledge about CAT with a strong aesthetic preference for clear aligners. Dedicated curricular workshops and clinical case exposure are recommended to bridge the remaining knowledge gaps.
References
1. Papadimitriou A, Mousoulea S, Gkantidis N, Kloukos D. Clinical effectiveness of Invisalign® orthodontic treatment: a systematic review. Prog Orthod. 2018;19(1):37. doi: 10.1186/s40510-018-0235-z.
2. Tamer I, Öztaş E, Marşan G. Orthodontic treatment with clear aligners and the current status of the Invisalign® system. Turk J Orthod. 2019;32(3):173–180. doi: 10.5152/TurkJOrthod.2019.18083.
3. Livas C, Delli K, Pandis N. Perceived attractiveness of different orthodontic appliances: a systematic review and meta-analysis. Eur J Orthod. 2023;45(1):1–9. doi: 10.1093/ejo/cjr142.
4. Vijayaalakshmi R, Sumathi Felicita A. Clear aligners — a review. Biomed Pharmacol J. 2017;10(2):941–946.
5. Azaripour A, Weusmann J, Mahmoodi B, Peppas D, Gerhold-Ay A, Van Noorden CJF, et al. Braces versus Invisalign®: gingival parameters and patients’ satisfaction during treatment: a cross-sectional study. BMC Oral Health. 2015;15(1):69. doi: 10.1186/s12903-015-0060-4.
6. Al-Nadawi M, Kravitz ND, Hansa I, Makki L, Ferguson DJ, Vaid NR. Effect of clear aligner wear protocol on the efficacy of tooth movement: a randomised clinical trial. Angle Orthod. 2021;91(2):157–163. doi: 10.2319/052220-473.1.
7. Chakraborty A, Mishra S, Panda A. Limitations of aligners and how to overcome them. Int Res J Multidiscip Scope. 2024;5(2):577–582. doi: 10.47857/irjms.2024.v05i02.0581.
8. Rostamzadeh M, Rahimi F. Aesthetic dentistry and ethics: a systematic review of marketing practices and overtreatment in cosmetic dental procedures. BMC Med Ethics. 2025;26(1):12. doi: 10.1186/s12910-025-01169-6.
9. Alharbi IS, Alharbi AS, Ansari SH. Awareness and perception of orthodontic treatment using Invisalign among the general public of Qassim, Saudi Arabia. Ann Dent Spec. 2022;10(1):65–68. doi: 10.51847/BGIgrRy37q.
10. Pawar R, Prasad T, Ganiger CR, Phaphe S, Ahammed Y, Mane P, et al. Awareness regarding clear aligners as an orthodontic treatment modality among the general population of Maharashtra, India. J Clin Diagn Res. 2024;18(4):ZC09–ZC11. doi: 10.7860/JCDR/2024/68024.19255.
11. Jedliński M, Belfus J, Milona M, Mazur M, Grocholewicz K, Janiszewska-Olszowska J. Orthodontic treatment demand for fixed treatment and aligners among young adults in middle Europe and South America: a questionnaire study. BMC Oral Health. 2024;24(1):292. doi: 10.1186/s12903-024-04053-6.
12. Bilal MF, Ali AQ, Ibrahim LK. Evaluation of awareness and perception of clear aligner orthodontic treatment among students of Hawler Medical University. Erbil Dent J. 2024;6(3):240–248.
13. Chawla S, Deshmukh S, Bhosale V. An assessment of orthodontists’ perception about efficiency of various tooth movements carried out using clear aligner therapy. J Indian Orthod Soc. 2024;58(1):65–74. doi: 10.1177/03015742231202303.
14. Littlewood SJ, Mitchell L. An Introduction to Orthodontics. 5th ed. Oxford: Oxford University Press; 2019.
15. Alansari RA. Youth perception of different orthodontic appliances: patient preference and adherence. Patient Prefer Adherence. 2020;14:1011–1019. doi: 10.2147/PPA.S250064.
16. Fujiyama K, Honjo T, Suzuki M, Matsuoka S, Deguchi T. Analysis of pain level in cases treated with Invisalign aligner: comparison with fixed edgewise appliance therapy. Prog Orthod. 2014;15(1):1–7. doi: 10.1186/s40510-014-0064-7.
17. Buschang PH, Shaw SG, Ross M, Crosby D, Campbell PM. Comparative time efficiency of aligner therapy and conventional edgewise braces. Angle Orthod. 2014;84(3):391–396. doi: 10.2319/011613-49.1.
18. Levrini L, Novara F, Margherini S, Tenconi C, Raspanti M. Scanning electron microscopy analysis of the growth of dental plaque on the surfaces of removable orthodontic aligners after the use of different cleaning methods. Clin Cosmet Investig Dent. 2015;7:125–131. doi: 10.2147/CCIDE.S95814.
19. Kaur K, Quadri SA, Saini RS, et al. Comparative impact of clear aligners versus fixed orthodontic appliances on periodontal health, pain, and quality of life: a systematic review and meta-analysis. BDJ Open. 2026;12:60. doi:10.1038/s41405-026-00450-z. doi: 10.1038/s41405-026-00450-z.
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