Comparison between clear aligners and 2 x 4 mechanics in the mixed dentition: a randomized clinical trial

Objectives: To compare the efficacy and efficiency between clear aligners and 2 x 4 fixed appliances for correcting maxillary incisor position irregularities in the mixed dentition.Materials and Methods: The sample comprised 32 patients from 7 to 11 years of age randomly allocated into two parallel treatment groups: the clear aligners group, 14 patients (6 girls, 8 boys) with a mean initial age of 9.33 years (standard deviation [SD] = 1.01) treated with clear aligners; and the fixed appliances group, 13 patients (9 girls, 4 boys) with a mean initial age of 9.65 years (SD = 0.80) treated with partial (2 x 4) fixed appliances. Digital models were acquired before treatment and after appliance removal. Primary outcomes were incisor irregularity index and treatment time. Secondary outcomes were arch width, perimeter, length, size and shape, incisor leveling, incisor mesiodistal angulation, plaque index, and white spot lesion formation (International Caries Detection and Assessment System index). Intergroup comparisons were evaluated using t -tests or Mann-Whitney U-tests with Holm-Bonferroni correction (P < .05). Results: Treatment time was approximately 8 months in both groups. No intergroup differences were observed for changes in any of the variables. Similar posttreatment arch shapes were observed in both groups.Conclusions: Clear aligners and 2 x 4 mechanics displayed similar efficacy and efficiency for maxillary incisor position corrections in the mixed dentition. The choice of appliance should be guided by clinician and family preference. (Angle Orthod. 2022;93:3-10.)