Treatment outcomes of 3D-printed custom brackets and clear aligners in adolescents and young adults with simple to moderate malocclusions: A retrospective study

Objectives: The aims of this study were to evaluate the treatment quality, duration and accuracy of 3D-printed custom brackets (LightForce™, LF) and clear aligners (Invisalign®, CA) in comparison to conventional brackets (3M™ Victory Series™, CB). Methods: This retrospective study included 94 subjects who underwent comprehensive orthodontic treatment with one of three modalities: LightForce™ custom brackets (LightForce™, Burlington, MA; LF; n = 37), clear aligners (Invisalign®, Align Tech, San Jose, CA; CA; n = 33), or conventional brackets (3M™ Victory Series™, Solventum, Saint Paul, MN; CB; n = 24). Data were collected at pre-treatment (T0), planned final tooth position via LightPlan or ClinCheck (TP), and immediately post-treatment (T1). Overall treatment quality was evaluated using the ABO Cast-Radiograph evaluation (C-R Eval). Treatment duration was recorded in months. Treatment accuracy was assessed by comparing the planned TP and achieved T1 arch width changes at maxillary and mandibular canines, first premolars and first molars. Results: There was no significant difference in the total C-R Eval scores between the groups. Treatment duration was significantly shorter in the LF (15.89 months) and CA (14.39 months) groups compared to the CB (27.79 months) (P < 0.001). There was a significant difference between LF and CA groups in T_P-T₁ of the maxillary inter-canine width (LF = 0.87 mm, CA = 0.23 mm, P-Adj = 0.013). Conclusions: Treatment quality was comparable between LF, CA and CB in mild to moderate crowding cases. Treatment duration was significantly shorter in LF and CA in comparison to CB. However, variations in provider experience may have influenced treatment outcomes. CA demonstrated accuracy in arch width predictions, whereas LF showed accuracy in predicting maxillary and mandibular inter-premolar and mandibular intermolar widths only.