CONTEMPORARY ASPECTS AND PROGNOSTIC CRITERIA OF DENTAL HEALTH IN ADOLESCENT AND YOUNG ADULT PATIENTS UNDERGOING ORTHODONTIC TREATMENT WITH CLEAR ALIGNERS: AN ANALYTICAL REVIEW
DOI:
https://doi.org/10.32782/2786-7684/2026-2-14Keywords:
clear aligners, orthodontic treatment, adolescents, dental health, periodontium, white spot lesions, oral microbiome, quality of life, compliance, prognostic criteriaAbstract
Introduction. Dentofacial anomalies represent one of the most prevalent forms of dental pathology among adolescents and young adults, with a reported prevalence of 65,7–83,3% in Ukraine, generating a consistently increasing demand for orthodontic treatment. Clear aligner therapy (CAT) has gained widespread clinical adoption, primarily owing to its aesthetic advantages. Nevertheless, the implications of CAT for dental health in adolescent patients remain a subject of debate, and the prognostic criteria for the development of treatment-associated complications require systematic appraisal. Objective. To synthesize current evidence regarding the effects of orthodontic clear aligners on periodontal status, hard dental tissues, the oral microbiome, and oral health-related quality of life in adolescent and young adult patients. Materials and Methods. A systematic analytical literature review was conducted using PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library, covering publications from 2018 to 2025. Inclusion criteria encompassed prospective and retrospective clinical studies, randomized controlled trials (RCTs), systematic reviews, and meta-analyses. Results. CAT demonstrates significantly superior periodontal outcomes compared to fixed appliances; however, it does not eliminate the risk of gingivitis, which is significantly higher in adolescents than in adults (p<0,05). White spot lesions (WSL) occur in 35,5% of adolescent patients undergoing CAT and are associated with both behavioral and clinical predictors. Salivary pro-inflammatory cytokines – CXCL8, IL-1β, and MMP-8 – serve as early biomarkers of treatment-related complications. Oral health-related quality of life (OHRQoL) is significantly better during the active phase of CAT, with a clinically meaningful difference on the OHIP-14 questionnaire at six months. Compliance (≥20–22 hours per day) constitutes the primary prognostic determinant. Conclusions. CAT is an effective orthodontic treatment modality for adolescents and young adults. The leading prognostic criteria for dental health outcomes include oral hygiene status, the presence of WSL and gingivitis at treatment onset, salivary pro-inflammatory cytokine levels, dietary habits, and patient compliance.
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