{"id":"https://openalex.org/W7225453336","doi":"https://doi.org/10.1186/s12903-026-10422-2","title":"Clear aligners versus removable appliances in mixed dentition: short-term pain, anxiety, and oral health outcomes\u2014a prospective cohort study","display_name":"Clear aligners versus removable appliances in mixed dentition: short-term pain, anxiety, and oral health outcomes\u2014a prospective cohort study","publication_year":2026,"publication_date":"2026-11-07","ids":{"openalex":"https://openalex.org/W7225453336","doi":"https://doi.org/10.1186/s12903-026-10422-2"},"language":"en","primary_location":{"id":"doi:10.1186/s12903-026-10422-2","doi":"https://doi.org/10.1186/s12903-026-10422-2","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12903-026-10422-2","pdf_url":null,"source":{"id":"https://openalex.org/S60760007","display_name":"BMC Oral Health","issn_l":"1472-6831","issn":["1472-6831"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","medline","norway-2","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Oral Health","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1186/s12903-026-10422-2","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5104927369","display_name":"Neslihan Atmaca","orcid":"https://orcid.org/0009-0006-7726-5236","observed_orcids":["https://orcid.org/0009-0006-7726-5236","https://orcid.org/0009-0008-6343-4240"]},"institutions":[{"id":"https://openalex.org/I74897591","display_name":"Marmara University","ror":"https://ror.org/02kswqa67","country_code":"TR","type":"education","lineage":["https://openalex.org/I74897591"]}],"countries":["TR"],"is_corresponding":true,"raw_author_name":"Neslihan Atmaca","raw_affiliation_strings":["Department of Pediatric Dentistry, Faculty of Dentistry, Marmara University, Istanbul, T\u00fcrkiye"],"raw_orcid":"https://orcid.org/0009-0006-7726-5236","affiliations":[{"raw_affiliation_string":"Department of Pediatric Dentistry, Faculty of Dentistry, Marmara University, Istanbul, T\u00fcrkiye","institution_ids":["https://openalex.org/I74897591"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5076188362","display_name":"Murat Tozlu","orcid":"https://orcid.org/0000-0002-3571-1430","observed_orcids":["https://orcid.org/0000-0002-3571-1430"]},"institutions":[{"id":"https://openalex.org/I74897591","display_name":"Marmara University","ror":"https://ror.org/02kswqa67","country_code":"TR","type":"education","lineage":["https://openalex.org/I74897591"]}],"countries":["TR"],"is_corresponding":false,"raw_author_name":"Murat Tozlu","raw_affiliation_strings":["Department of Orthodontics, Faculty of Dentistry, Marmara University, Istanbul, T\u00fcrkiye"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Orthodontics, Faculty of Dentistry, Marmara University, Istanbul, T\u00fcrkiye","institution_ids":["https://openalex.org/I74897591"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5002391167","display_name":"Serta\u00e7 Peker","orcid":"https://orcid.org/0000-0002-9659-1292","observed_orcids":["https://orcid.org/0000-0002-9659-1292"]},"institutions":[{"id":"https://openalex.org/I74897591","display_name":"Marmara University","ror":"https://ror.org/02kswqa67","country_code":"TR","type":"education","lineage":["https://openalex.org/I74897591"]}],"countries":["TR"],"is_corresponding":false,"raw_author_name":"Serta\u00e7 Peker","raw_affiliation_strings":["Department of Pediatric Dentistry, Faculty of Dentistry, Marmara University, Istanbul, T\u00fcrkiye"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pediatric Dentistry, Faculty of Dentistry, Marmara University, Istanbul, T\u00fcrkiye","institution_ids":["https://openalex.org/I74897591"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5104927369"],"corresponding_institution_ids":["https://openalex.org/I74897591"],"apc_list":{"value":3190,"currency":"USD","value_usd":3190},"apc_paid":{"value":3190,"currency":"USD","value_usd":3190},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10356","display_name":"Orthodontics and Dentofacial Orthopedics","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/3505","display_name":"Orthodontics"},"field":{"id":"https://openalex.org/fields/35","display_name":"Dentistry"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10356","display_name":"Orthodontics and Dentofacial Orthopedics","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/3505","display_name":"Orthodontics"},"field":{"id":"https://openalex.org/fields/35","display_name":"Dentistry"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12367","display_name":"Dental Trauma and Treatments","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/3500","display_name":"General Dentistry"},"field":{"id":"https://openalex.org/fields/35","display_name":"Dentistry"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11919","display_name":"dental development and anomalies","score":0.0,"subfield":{"id":"https://openalex.org/subfields/3500","display_name":"General Dentistry"},"field":{"id":"https://openalex.org/fields/35","display_name":"Dentistry"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/clear-aligners","display_name":"clear aligners","score":0.9990000128746033},{"id":"https://openalex.org/keywords/removable-orthodontic-appliances","display_name":"removable orthodontic appliances","score":0.9789999723434448},{"id":"https://openalex.org/keywords/mixed-dentition","display_name":"mixed dentition","score":0.9539999961853027},{"id":"https://openalex.org/keywords/anterior-crossbite","display_name":"anterior crossbite","score":0.7279999852180481},{"id":"https://openalex.org/keywords/orthodontic-pain","display_name":"orthodontic pain","score":0.8130000233650208},{"id":"https://openalex.org/keywords/state-anxiety","display_name":"state anxiety","score":0.8090000152587891},{"id":"https://openalex.org/keywords/oral-hygiene","display_name":"oral hygiene","score":0.8820000290870667},{"id":"https://openalex.org/keywords/plaque-index","display_name":"plaque index","score":0.7749999761581421},{"id":"https://openalex.org/keywords/gingival-index","display_name":"gingival index","score":0.9810000061988831},{"id":"https://openalex.org/keywords/children","display_name":"children","score":0.652999997138977},{"id":"https://openalex.org/keywords/early-orthodontic-treatment","display_name":"early orthodontic treatment","score":0.8859999775886536},{"id":"https://openalex.org/keywords/orthodontic-treatment-outcomes","display_name":"orthodontic treatment outcomes","score":0.4309999942779541},{"id":"https://openalex.org/keywords/oral-health-behavior","display_name":"oral health behavior","score":0.39899998903274536},{"id":"https://openalex.org/keywords/oral-hygiene-education","display_name":"dental hygiene education","score":0.45899999141693115},{"id":"https://openalex.org/keywords/gingivitis","display_name":"gingivitis","score":0.7350000143051147},{"id":"https://openalex.org/keywords/orthodontic-appliances","display_name":"orthodontic appliances","score":0.35100001096725464},{"id":"https://openalex.org/keywords/orthodontic-treatment","display_name":"orthodontic treatment","score":0.3440000116825104}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.95660001039505},{"id":"https://openalex.org/C558461103","wikidata":"https://www.wikidata.org/wiki/Q154430","display_name":"Anxiety","level":2,"score":0.6521000266075134},{"id":"https://openalex.org/C188816634","wikidata":"https://www.wikidata.org/wiki/Q2113324","display_name":"Prospective cohort study","level":2,"score":0.5896000266075134},{"id":"https://openalex.org/C515851188","wikidata":"https://www.wikidata.org/wiki/Q13445028","display_name":"Oral hygiene","level":2,"score":0.5823000073432922},{"id":"https://openalex.org/C199343813","wikidata":"https://www.wikidata.org/wiki/Q12128","display_name":"Dentistry","level":1,"score":0.5616999864578247},{"id":"https://openalex.org/C14184104","wikidata":"https://www.wikidata.org/wiki/Q1362526","display_name":"Visual analogue scale","level":2,"score":0.5031999945640564},{"id":"https://openalex.org/C2778636310","wikidata":"https://www.wikidata.org/wiki/Q504033","display_name":"Oral and maxillofacial surgery","level":2,"score":0.4625999927520752},{"id":"https://openalex.org/C23131810","wikidata":"https://www.wikidata.org/wiki/Q818574","display_name":"Observational study","level":2,"score":0.45969998836517334},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.42160001397132874},{"id":"https://openalex.org/C2780739003","wikidata":"https://www.wikidata.org/wiki/Q2005391","display_name":"Early childhood caries","level":3,"score":0.3977000117301941},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.36719998717308044},{"id":"https://openalex.org/C102959455","wikidata":"https://www.wikidata.org/wiki/Q7313954","display_name":"Repeated measures design","level":2,"score":0.35830000042915344},{"id":"https://openalex.org/C188126409","wikidata":"https://www.wikidata.org/wiki/Q641973","display_name":"Dentition","level":2,"score":0.350600004196167},{"id":"https://openalex.org/C2777417529","wikidata":"https://www.wikidata.org/wiki/Q7602980","display_name":"State-Trait Anxiety Inventory","level":3,"score":0.3441999852657318},{"id":"https://openalex.org/C1862650","wikidata":"https://www.wikidata.org/wiki/Q186005","display_name":"Physical therapy","level":1,"score":0.3402000069618225},{"id":"https://openalex.org/C168563851","wikidata":"https://www.wikidata.org/wiki/Q1436668","display_name":"Randomized controlled trial","level":2,"score":0.32839998602867126},{"id":"https://openalex.org/C2777765862","wikidata":"https://www.wikidata.org/wiki/Q62903","display_name":"Anxiolytic","level":3,"score":0.3158999979496002},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.3109000027179718},{"id":"https://openalex.org/C99476002","wikidata":"https://www.wikidata.org/wiki/Q42297","display_name":"Analysis of variance","level":2,"score":0.3018999993801117},{"id":"https://openalex.org/C2992672162","wikidata":"https://www.wikidata.org/wiki/Q12128","display_name":"Oral health","level":2,"score":0.29339998960494995},{"id":"https://openalex.org/C2992367442","wikidata":"https://www.wikidata.org/wiki/Q154430","display_name":"Trait anxiety","level":3,"score":0.2793999910354614},{"id":"https://openalex.org/C2776814669","wikidata":"https://www.wikidata.org/wiki/Q7144965","display_name":"Patient-centered outcomes","level":2,"score":0.271699994802475}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1186/s12903-026-10422-2","doi":"https://doi.org/10.1186/s12903-026-10422-2","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12903-026-10422-2","pdf_url":null,"source":{"id":"https://openalex.org/S60760007","display_name":"BMC Oral Health","issn_l":"1472-6831","issn":["1472-6831"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","medline","norway-2","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Oral Health","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.1186/s12903-026-10422-2","doi":"https://doi.org/10.1186/s12903-026-10422-2","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12903-026-10422-2","pdf_url":null,"source":{"id":"https://openalex.org/S60760007","display_name":"BMC Oral Health","issn_l":"1472-6831","issn":["1472-6831"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","medline","norway-2","oarl","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Oral Health","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":1.0}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W3039190161","https://openalex.org/W4397023070","https://openalex.org/W4414149656","https://openalex.org/W7160105084","https://openalex.org/W7117315286","https://openalex.org/W7164151715","https://openalex.org/W7140369503","https://openalex.org/W4388968480","https://openalex.org/W6888761200","https://openalex.org/W3023096355"],"abstract_inverted_index":{"Abstract":[0],"Background":[1],"Early":[2],"orthodontic":[3],"treatment":[4,174,343],"during":[5],"mixed":[6,140],"dentition":[7],"may":[8],"influence":[9],"children\u2019s":[10],"pain,":[11],"anxiety,":[12],"and":[13,67,103,113,120,128,135,164,171,205,212,223,242,296,298,305,313,345],"oral":[14,79],"hygiene.":[15],"This":[16,32],"study":[17,36],"compared":[18,307],"these":[19],"outcomes":[20],"in":[21,155,246,253,274,316,325],"children":[22,39],"treated":[23],"with":[24,43,142,178,249,289,308,319],"clear":[25,49,179,255,285],"aligners":[26,50,286],"or":[27,55],"conventional":[28,56,309],"removable":[29,57,182,310],"appliances.":[30,311],"Methods":[31],"prospective":[33],"observational":[34],"cohort":[35],"included":[37],"24":[38],"aged":[40],"6\u201312":[41],"years":[42],"anterior":[44],"dental":[45],"crossbite":[46],"who":[47],"received":[48,77],"(":[51,59],"n":[52,60],"=":[53,61],"12)":[54],"appliances":[58],"12).":[62],"Treatment":[63],"allocation":[64],"was":[65,87,145],"non-random":[66],"determined":[68],"as":[69],"part":[70],"of":[71,94,271],"routine":[72],"clinical":[73],"care.":[74],"All":[75],"participants":[76],"standardized":[78],"hygiene":[80],"education":[81],"before":[82],"appliance":[83,183],"delivery.":[84],"Trait":[85],"anxiety":[86,105,166,215,301],"assessed":[88,107,133],"pretreatment":[89,134,158],"using":[90,115],"the":[91,95,116,156,181,254,259,280,336],"trait":[92,161],"subscale":[93],"State-Trait":[96],"Anxiety":[97],"Inventory":[98],"for":[99],"Children":[100],"(STAI-C).":[101],"Pain":[102,163],"state":[104,122,165,214,300],"were":[106,132,153,264,287],"on":[108,136,188,216,232,292,302,355],"days":[109,293,303],"1,":[110],"3,":[111,294],"7,":[112,295],"14":[114,207,234,297],"Visual":[117],"Analog":[118],"Scale":[119],"STAI-C":[121],"subscale,":[123],"respectively;":[124],"Plaque":[125,240],"Index":[126,130,241,244],"(PI)":[127],"Gingival":[129,243],"(GI)":[131],"day":[137,189,199,206,217,224,233],"14.":[138],"Two-way":[139],"ANOVA":[141],"Bonferroni-adjusted":[143],"comparisons":[144],"used.":[146],"Results":[147],"No":[148],"statistically":[149,266,321],"significant":[150,168,322],"between-group":[151,272,323],"differences":[152,273,324],"detected":[154],"measured":[157],"characteristics,":[159],"including":[160],"anxiety.":[162],"showed":[167],"time,":[169],"treatment,":[170],"time":[172],"\u00d7":[173,261],"interaction":[175],"effects.":[176],"Compared":[177],"aligners,":[180],"group":[184],"reported":[185],"higher":[186,213],"pain":[187,291],"3":[190,218,304],"(mean":[191],"difference":[192],"1.50,":[193],"95%":[194],"CI":[195],"0.67":[196],"to":[197,203,210,221,228,238],"2.33),":[198],"7":[200,225,306],"(2.58,":[201],"1.76":[202],"3.41)":[204],"(1.00,":[208],"0.33":[209],"1.67),":[211],"(7.92,":[219],"4.79":[220],"11.05)":[222],"(5.75,":[226],"2.81":[227],"8.69),":[229],"but":[230],"not":[231,265],"(2.17,":[235],"\u2212":[236],"0.17":[237],"4.51).":[239],"decreased":[245,315],"both":[247,317],"groups,":[248,318],"lower":[250,290,299],"day-14":[251],"values":[252],"aligner":[256],"group;":[257],"however,":[258],"Time":[260],"Intervention":[262],"interactions":[263],"significant,":[267],"indicating":[268],"no":[269,320],"evidence":[270],"changes":[275,326],"over":[276,327],"time.":[277,328],"Conclusions":[278],"During":[279],"initial":[281],"14-day":[282],"adaptation":[283],"period,":[284],"associated":[288],"PI":[312],"GI":[314],"These":[329],"findings":[330],"should":[331],"be":[332],"interpreted":[333],"cautiously":[334],"given":[335],"small":[337],"sample":[338],"size,":[339],"single-center":[340],"setting,":[341],"non-randomized":[342],"allocation,":[344],"short":[346],"follow-up":[347],"period.":[348],"Trial":[349],"registration":[350],"ClinicalTrials.gov,":[351],"NCT07331090;":[352],"retrospectively":[353],"registered":[354],"9":[356],"January":[357],"2026.":[358]},"counts_by_year":[],"updated_date":"2026-11-09T13:22:03.289127","created_date":"2026-11-08T00:00:00"}
