Impact of Lingual Attachment on WSL Development in Clear Aligner Patients: A Randomized Controlled Clinical Trial

Jordan University of Science and Technology

Status: Active, not recruiting

Conditions: White Spot Lesion of Tooth

Treatments: Other: Lingual attachment participants

Study type: Interventional

Funder types: Other

Identifiers

NCT07368296

JUST20240550

Details and patient eligibility

About

White spot lesions (WSLs) are a common esthetic complication during orthodontic treatment. While clear aligners (CAs) generally reduce WSL risk compared to fixed appliances, composite attachments remain plaque-retentive sites. This two-arm clinical trial investigated the effect of shifting attachments to lingual surfaces on WSL development.

Full description

A randomized controlled trial was conducted on 52 patients (18-35 years) undergoing CA therapy. Participants were allocated to two groups (n=26) for each: conventional buccal attachments (control) and lingual/palatal attachments (intervention). WSLs and plaque were assessed at baseline (T0) and six months (T1) using quantitative light-induced fluorescence (QLF). Outcomes included lesion area (pixels), mean fluorescence loss (ΔF), maximum depth (ΔFmax), and plaque index (ΔR30). Statistical analysis employed paired and independent t-tests, chi-square, and multivariable regression (α<0.05).

Enrollment: 52 patients

Sex: All

Ages: 18 to 35 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Medically fit young adults
• The patient should have mild to moderate crowding or spacing of teeth.
• The treatment plan should be non-extraction.
• Patients should have optimum oral hygiene before beginning the treatment.
• The patient may have a maximum of three teeth with either fillings or dental prostheses.

(According to the British national institute of health, NIH 2016).

Exclusion criteria

• Patients with defective enamel, generalized enamel disorder, or extensive dental restorations.
• Patients with syndromes or orofacial anomalies.
• Patients with salivary gland diseases or taking medications that may affect oral flora or salivary functions.
• Patients who are pregnant or diabetic.
• Patients use mouth rinses or any extra form of fluoride other than toothpaste.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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52 participants in 2 patient groups

Lingual attachment participants

Active Comparator group

Description:

In this group composite attachments were placed on the lingual/palatal surfaces of teeth for clear aligner therapy

Treatment:

Other: Lingual attachment participants

Buccal attachment participants

Active Comparator group

Description:

In this group composite attachments were placed on the buccal surfaces of teeth for clear aligner therapy

Treatment:

Other: Lingual attachment participants