Are clear aligners environment friendly?

Peter, Elbe; J, Monisha; George, Suja Ani

doi:10.1016/j.ajodo.2021.12.012

Cited by 19 publications

(9 citation statements)

References 14 publications

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“…An overall total of 35,174 aligners were prescribed to patients in this study. This raises the issue of how aligners are managed after their use to ensure that the deleterious environmental impact of the non-biodegradable plastic used in their manufacture is kept to a minimum ( Peter et al, 2022 ).…”

Section: Discussionmentioning

confidence: 99%

Digital treatment planning and clear aligner therapy: A retrospective cohort study

Meade

Weir

2023

J Orthod

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Objective: To investigate the total number of digital treatment plan (DTPs) and aligners manufactured for clear aligner therapy (CAT) by Invisalign® from initial treatment planning to the completion of CAT. Design: A retrospective cohort study. Material and methods: A total of 30 patients, from each of 11 experienced orthodontists, who commenced treatment over a 12-month period were assessed regarding the number of DTPs and aligners prescribed from initial planning to completion of CAT. Patients were categorised according to the number of aligners prescribed by the initial DTP into mild (<15), moderate (15–29) or severe (>29). Results: After the application of inclusion/exclusion criteria, 324 patients (71.9% women; median age = 28.5 years) undergoing non-extraction treatment with the Invisalign® appliance were assessed. The median number of initial DTPs was 3 (interquartile range [IQR] = 2, 1–9) per patient before acceptance by the orthodontist. Most (99.4%) patients required a refinement phase with a median of 2 (IQR = 2, 2–7) refinement plans recorded. A total of 9135 aligners per dental arch was prescribed in the initial DTP of the 324 patients assessed and 8452 in the refinement phase. The median number of aligners per dental arch prescribed from the initial DTP was 26 (IQR = 12, 6–78) and from the refinement plans was 20.5 (IQR = 17, 0–132). Conclusion: A median of three initial DTPs and two refinement plans were required for patients undergoing non-extraction treatment with the Invisalign® appliance. Patients were prescribed almost double the number of aligners initially predicted to manage their malocclusion.

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Section: Discussionmentioning

confidence: 99%

Digital treatment planning and clear aligner therapy: A retrospective cohort study

Meade

Weir

2023

J Orthod

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“…Clear aligner therapy (CAT), termed the ‘Plastic Orthodontics’, involves the use of thermoplastic trays (Peter et al, 2022). Considering the long duration of orthodontic treatment, the use of such polymer-based materials in the oral cavity has become a matter of public health concern (Freitas, 2022; Peter et al, 2022). Though claimed to be BPA-free, studies on the same are contradictory (Alhendi et al, 2022; Katras et al, 2021; Schuster et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

Bisphenol-A release from thermoplastic clear aligner materials: A systematic review

Peter

J²,

George

2023

J Orthod

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Background: The aim of the present study was to systematically review the available evidence on the release of bisphenol-A (BPA) from thermoplastic materials used in the fabrication of clear aligners (CA). Methods: Electronic databases, such as MEDLINE (via PubMed), Google Scholar, Scopus, Cochrane Library, Web of Science, OpenGrey, and the U.S. National Institute of Heath-Clinical Trials, were searched up to 27 October 2022. In vivo/in vitro studies that assessed the release of BPA from different thermoplastic CA materials, with or without a control group, were selected. The risk of bias (RoB) in the randomised controlled trials (RCT) and in vitro studies was assessed using the Cochrane RoB tool and the guidelines for the reporting of pre-clinical studies, respectively. The quality of evidence was determined using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) Pro tool. Results: Six studies were considered for review from a total of 1926 records. This included one RCT and five in vitro studies. Only two studies found leaching of BPA, while four did not report any traces. The RoB was found to be moderate to high. The GRADE evidence level ranged from low to very low. Five of the included studies were conducted in vitro. Significant heterogeneity among the included studies prevented a quantitative synthesis. Conclusion: In light of the available conflicting evidence, BPA release from CAs can neither be confirmed nor denied. Safety remains questionable until high-quality in vivo trials prove otherwise. Registration: PROSPERO CRD42022310434.

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“…Patients are typically provided multiple plastic aligners, each of which is worn for a week or two and all of these aligners, generally end up as trash with no hope of recycling. The plastic burden on the environment related to clear aligners has become a major concern [ 150 ]. Fig.…”

Section: Emerging Trendsmentioning

confidence: 99%