EARLY TREATMENT EFFICIENCY, COMFORT, AND PATIENT-REPORTED EXPERIENCE WITH DIFFERENT ORTHODONTIC APPLIANCE TYPES IN ADULT PATIENTS IN PESHAWAR: A MULTI-CENTER CROSS-SECTIONAL STUDY
Main Article Content
Keywords
Orthodontic appliances, clear aligners, ceramic brackets, treatment efficiency, patient-reported outcomes, cross-sectional study.
Abstract
Background:
Adult orthodontic treatment demand has increased in urban Pakistan. Appliance selection influences early treatment efficiency indicators and patient-reported experience. This study compared mechanical performance indicators and psychosocial outcomes among adult patients treated with different orthodontic appliances.
Methods:
This multi-center comparative cross-sectional study was conducted from December 2024 to August 2025 across four tertiary dental institutions in Peshawar. A total of 440 adult patients (18–45 years) in the active alignment phase (3–9 months) were included. Appliance-related complications were recorded at the time of clinical assessment. Pain intensity was measured using a 0–100 Numerical Rating Scale (NRS). Gingival health was assessed using the Löe and Silness Gingival Index. Psychosocial measures were evaluated using a 5-point Likert scale. One-way ANOVA and Chi-square tests were used. A p-value < 0.05 was considered statistically significant.
Results:
Clear aligners demonstrated the lowest hardware-related complication frequency (4.1%) compared to metal brackets (12.8%) and ceramic braces (34.2%) (p < 0.001). Mean pain scores were significantly lower in aligner users (21.4) compared to metal (62.5) and ceramic systems (68.3) (p < 0.001). Gingival health scores were significantly better among aligner users (p < 0.01). Social confidence ratings were highest in the aligner group (93%).
Conclusion:
In this multi-center cross-sectional study, clear aligners were associated with lower complication frequency and improved early-stage patient-reported outcomes compared to fixed orthodontic appliances. Longitudinal studies are needed to determine long-term treatment efficiency.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
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Wasif Ali Shah
BDS, MDS(Orthodontics), MHPE Lecturer, Department of Orthodontics, KMU-IDS Kohat
Palwasha Ibrahim
BDS, Resident Orthodontist, Bacha Khan College of Dentistry (MMC), Mardan
Rehana Fayyaz
BDS, FCPS Orthodontics, Assistant Professor, Department of Orthodontics, KMU-IDS Kohat
Mutaqaim Hussain
BDS Dental Surgeon Cat-D-Hospital Alizai Lower Kurram
Asma Rahamdil
BDS General Dentist, Olympus Dental and Aesthetics, Islamabad
Saad Umar
BDS PGR, Department of Orthodontics, Sardar Begum Dental Collage, Peshawar.
