Ortodontik Şeffaf Plakların Stomatognatik Sistem Üzerindeki Etkileri

Yıl 2025, Cilt: 11 Sayı: 3, 329 - 341, 31.12.2025

Gizem Fatma Örnek , Muhsin Çifter

Öz

Şeffaf plaklar ile yapılan ortodontik tedaviler, estetik kaygıları ve konfor beklentileri yüksek bireyler için son yıllarda popülaritesi giderek artan bir alternatif haline gelmiştir. Bu tedavi türünün yaygınlaşması sonucu şeffaf plak kullanımının stomatognatik sistem üzerindeki etkileri de araştırmacılar tarafından merak edilen ve cevaplandırılması gereken bir konu haline gelmiştir. Bu derleme, şeffaf plakların stomatognatik sistem üzerindeki etkilerini incelemeyi amaçlamaktadır.

Anahtar Kelimeler

Çiğneme kasları , Çiğneme sistemi , Oklüzyon , Ortodonti , Şeffaf plak apareyleri

Etik Beyan

Makalemiz derleme türünde olduğu için etik kurul onayı gerekmemektedir.

The Effects Of Orthodontic Clear Aligners On The Stomatognathic System

Öz

Orthodontic treatment with clear aligners has become an increasingly popular alternative in recent years, particularly among individuals with heightened aesthetic concerns and expectations of comfort. With the widespread adoption of this treatment modality, the potential effects of clear aligner therapy on the stomatognathic system have garnered increasing attention from researchers. This review aims to evaluate the impact of clear aligners on the stomatognathic system.

Anahtar Kelimeler

Clear aligner appliances , Masticatory muscle , Occlusion , Orthodontics , Stomatognathic system

Etik Beyan

Since this study is a review article based solely on previously published literature, it does not require ethical committee approval.

Kaynakça

• Proffit WR FH, Sarver DM. Contemporary orthodontics. 6th ed: Elsevier; 2018.
• Kravitz ND, Kusnoto B, BeGole E, Obrez A, Agran B. How well does Invisalign work? A prospective clinical study evaluating the efficacy of tooth movement with Invisalign. Am J Orthod Dentofacial Orthop. 2009;135(1):27-35. doi: 10.1016/j.ajodo.2007.05.018.
• Weir T. Clear aligners in orthodontic treatment. Aust Dent J. 2017;62 Suppl 1:58-62. doi: 10.1111/adj.12480.
• Almalki SA, Al Jameel AH, Gowdar IM, et al. Impact of clear aligner therapy on masticatory musculature and stomatognathic system: a systematic review conducted according to PRISMA guidelines and the Cochrane handbook for systematic reviews of interventions. BMC Oral Health. 2024;24(1):350. doi: 10.1186/ s12903-024-04029-8.
• Cuccia A, Caradonna C. The relationship between the stomatognathic system and body posture. Clinics (Sao Paulo). 2009;64(1):61-6. doi: 10.1590/s1807-59322009000100011.
• Bordoni B, Varacallo MA. Anatomy, Head and Neck, Temporomandibular Joint. Treasure Island (FL): StatPearls Publishing; 2025.
• Castroflorio T, Parrini S, Rossini G. Aligner biomechanics: Where we are now and where we are heading for. J World Fed Orthod. 2024;13(2):57-64. doi: 10.1016/j. ejwf.2023.12.005.
• Tai SK. Clear Aligner Technique. 2nd ed. Batavia,IL,USA: Ouintessence Publishing Co,Inc; 2025. 7-16 p.
• Lombardo L, Marafioti M, Stefanoni F, Mollica F, Siciliani G. Load deflection characteristics and force level of nickel titanium initial archwires. Angle Orthod. 2012;82(3):507-21. doi: 10.2319/032511-213.1.
• Skaik A, Wei XL, Abusamak I, Iddi I. Effects of time and clear aligner removal frequency on the force delivered by different polyethylene terephthalate glycol-modified materials determined with thin-film pressure sensors. Am J Orthod Dentofacial Orthop. 2019;155(1):98- 107. doi: 10.1016/j.ajodo.2018.03.017.
• Xiang B, Wang X, Wu G, et al. The force effects of two types of polyethylene terephthalate glycolmodified clear aligners immersed in artificial saliva. Sci Rep. 2021;11(1):10052. doi: 10.1038/ s41598-021-89425-8.
• Inoue S, Yamaguchi S, Uyama H, Yamashiro T, Imazato S. Influence of constant strain on the elasticity of thermoplastic orthodontic materials. Dent Mater J. 2020;39(3):415-21. doi: 10.4012/ dmj.2019-104.
• Hu W. [Vertical control in clear aligner treatment]. Zhonghua Kou Qiang Yi Xue Za Zhi. 2020;55(8):526-30. doi: 10.3760/ cma.j.cn112144-20200509-00251.
• Goto M, Yanagisawa W, Kimura H, Inou N, Maki K. A method for evaluation of the effects of attachments in aligner-type orthodontic appliance: Three-dimensional finite element analysis. Orthodontic Waves. 2017;76(4):207- 14. doi: 10.1016/j.odw.2017.09.001.
• Ke Y, Zhu Y, Zhu M. A comparison of treatment effectiveness between clear aligner and fixed appliance therapies. BMC Oral Health. 2019;19(1):24. doi: 10.1186/s12903-018- 0695-z.
• Rossini G, Parrini S, Castroflorio T, Deregibus A, Debernardi CL. Efficacy of clear aligners in controlling orthodontic tooth movement: a systematic review. Angle Orthod. 2015;85(5):881-9. doi: 10.2319/061614-436.1.
• Simon M, Keilig L, Schwarze J, Jung BA, Bourauel C. Forces and moments generated by removable thermoplastic aligners: incisor torque, premolar derotation, and molar distalization. Am J Orthod Dentofacial Orthop. 2014;145(6):728- 36. doi: 10.1016/j.ajodo.2014.03.015.
• Seo JH, Kim MS, Lee JH, et al. Biomechanical Efficacy and Effectiveness of Orthodontic Treatment with Transparent Aligners in Mild Crowding Dentition-A Finite Element Analysis. Materials (Basel). 2022;15(9):3118. doi: 10.3390/ma15093118.
• Cao H, Hua X, Yang L, Aoki K, Shang S, Lin D. A systematic review of biomechanics of clear aligners by finite element analysis. BMC Oral Health. 2025;25(1):1026. doi: 10.1186/s12903- 025-06295-6.
• Xia Q, Wang W, Wang C, et al. Comparative assessment of orthodontic clear aligner versus fixed appliance for anterior retraction: a finite element study. BMC Oral Health. 2024;24(1):80. doi: 10.1186/s12903-023-03704-6.
• Svensson P, Wang K, Sessle BJ, Arendt-Nielsen L. Associations between pain and neuromuscular activity in the human jaw and neck muscles. Pain. 2004;109(3):225-32. doi: 10.1016/j. pain.2003.12.031.
• Grunheid T, Langenbach GE, Korfage JA, Zentner A, van Eijden TM. The adaptive response of jaw muscles to varying functional demands. Eur J Orthod. 2009;31(6):596-612. doi: 10.1093/ejo/cjp093.
• Adams GR, Hather BM, Baldwin KM, Dudley GA. Skeletal muscle myosin heavy chain composition and resistance training. J Appl Physiol (1985). 1993;74(2):911-5. doi: 10.1152/ jappl.1993.74.2.911.
• Hather BM, Tesch PA, Buchanan P, Dudley GA. Influence of eccentric actions on skeletal muscle adaptations to resistance training. Acta Physiol Scand. 1991;143(2):177-85. doi: 10.1111/j.1748- 1716.1991.tb09219.x.
• Liu P, Wu G, Liu J, Jiao D, Guo J. Assessment of oral parafunctional behaviors and electromyographic activities of the masticatory muscles in young female patients with orthodontic Invisalign treatment. Int J Clin Exp Med. 2017;10(11):15323-8.
• Pullman SL, Goodin DS, Marquinez AI, Tabbal S, Rubin M. Clinical utility of surface EMG. Neurology. 2000;55(2):171-7. doi: 10.1212/ WNL.55.2.171.
• Farina D, Enoka RM. Evolution of surface electromyography: From muscle electrophysiology towards neural recording and interfacing. J Electromyogr Kinesiol. 2023;71:102796. doi: 10.1016/j. jelekin.2023.102796.
• Nota A, Caruso S, Ehsani S, Ferrazzano GF, Gatto R, Tecco S. Short-Term Effect of Orthodontic Treatment with Clear Aligners on Pain and sEMG Activity of Masticatory Muscles. Medicina (Kaunas). 2021;57(2):178. doi: 10.3390/medicina57020178.
• Manfredini D, Lombardo L, Vigiani L, Arreghini A, Siciliani G. Effects of invisible orthodontic retainers on masticatory muscles activity during sleep: a controlled trial. Prog Orthod. 2018;19(1):24. doi: 10.1186/s40510-018-0228-y.
• Paes-Souza SA, Garcia MAC, Souza VH, Morais LS, Nojima LI, Nojima M. Response of masticatory muscles to treatment with orthodontic aligners: a preliminary prospective longitudinal study. Dental Press J Orthod. 2023;28(1):e232198. doi: 10.1590/2177- 6709.28.1.e232198.oar.
• Pittar N, Sicignano A, Bardini G, Farella M. Effect of orthodontic appliances on masticatory muscle activity. Semin Orthod. 2024;30(3):341- 5. doi: 10.1053/j.sodo.2023.12.014.
• Lou T, Tran J, Castroflorio T, Tassi A, Cioffi I. Evaluation of masticatory muscle response to clear aligner therapy using ambulatory electromyographic recording. Am J Orthod Dentofacial Orthop. 2021;159(1):e25-e33. doi: 10.1016/j.ajodo.2020.08.012.
• Tepedino M, Colasante P, Staderini E, Masedu F, Ciavarella D. Short-term effect of orthodontic clear aligners on muscular activity and occlusal contacts: A cohort study. Am J Orthod Dentofacial Orthop. 2023;164(1):34-44. doi: 10.1016/j.ajodo.2022.10.025.
• Lekaviciute R, Paldauskaite S, Stucinskaite S, Trakiniene G. The effect of clear aligner treatment on masticatory muscles (masseter, temporalis) activity in adults: a systematic review and metaanalysis. Eur J Orthod. 2024;46(4):cjae030. doi: 10.1093/ejo/cjae030.
• White DW, Julien KC, Jacob H, Campbell PM, Buschang PH. Discomfort associated with Invisalign and traditional brackets: A randomized, prospective trial. Angle Orthod. 2017;87(6):801-8. doi: 10.2319/091416-687.1.
• Bergius M, Kiliaridis S, Berggren U. Pain in orthodontics. A review and discussion of the literature. J Orofac Orthop. 2000;61(2):125-37. doi: 10.1007/BF01300354.
• El Tumi H, Johnson MI, Dantas PBF, Maynard MJ, Tashani OA. Age-related changes in pain sensitivity in healthy humans: A systematic review with meta-analysis. Eur J Pain. 2017;21(6):955-64. doi: 10.1002/ejp.1011.
• Dianiskova S, Bucci R, Solazzo L, et al. Patient and Parental Satisfaction following Orthodontic Treatment with Clear Aligners and Elastodontic Appliances during Mixed Dentition: A Cross- Sectional Case–Control Study. Appl Sci. 2023;13(7):4074. doi: 10.3390/app13074074.
• Al-Omiri MK, Abu Alhaija ES. Factors affecting patient satisfaction after orthodontic treatment. Angle Orthod. 2006;76(3):422-31. doi:10.1043/0003-3219(2006)076[0422:FAPS AO]2.0.CO;2.
• Kazanci F, Aydogan C, Alkan O. Patients' and parents' concerns and decisions about orthodontic treatment. Korean J Orthod. 2016;46(1):20-6. doi: 10.4041/kjod.2016.46.1.20.
• Chow J, Cioffi I. Pain and orthodontic patient compliance: A clinical perspective. Semin Orthod. 2018;24(2):242-7. doi: 10.1053/j. sodo.2018.04.006.
• Furstman L, Bernick S. Clinical considerations of the periodontium. Am J Orthod. 1972;61(2):138- 55. doi: 10.1016/0002-9416(72)90092-9.
• Dray A. Inflammatory mediators of pain. Br J Anaesth. 1995;75(2):125-31. doi: 10.1093/ bja/75.2.125.
• Grieve WG, 3rd, Johnson GK, Moore RN, Reinhardt RA, DuBois LM. Prostaglandin E (PGE) and interleukin-1 beta (IL-1 beta) levels in gingival crevicular fluid during human orthodontic tooth movement. Am J Orthod Dentofacial Orthop. 1994;105(4):369-74. doi: 10.1016/s0889-5406(94)70131-8.
• Ngan P, Kess B, Wilson S. Perception of discomfort by patients undergoing orthodontic treatment. Am J Orthod Dentofacial Orthop. 1989;96(1):47-53. doi: 10.1016/0889- 5406(89)90228-x.
• Scheurer PA, Firestone AR, Burgin WB. Perception of pain as a result of orthodontic treatment with fixed appliances. Eur J Orthod. 1996;18(4):349-57. doi: 10.1093/ejo/18.4.349.
• Shalish M, Cooper-Kazaz R, Ivgi I, et al. Adult patients' adjustability to orthodontic appliances. Part I: a comparison between Labial, Lingual, and Invisalign. Eur J Orthod. 2012;34(6):724- 30. doi: 10.1093/ejo/cjr086.
• Cardoso PC, Espinosa DG, Mecenas P, Flores- Mir C, Normando D. Pain level between clear aligners and fixed appliances: a systematic review. Prog Orthod. 2020;21(1):3. doi: 10.1186/ s40510-019-0303-z.
• Fujiyama K, Honjo T, Suzuki M, Matsuoka S, Deguchi T. Analysis of pain level in cases treated with Invisalign aligner: comparison with fixed edgewise appliance therapy. Prog Orthod. 2014;15(1):64. doi: 10.1186/s40510-014-0064- 7.
• Tran J, Lou T, Nebiolo B, Castroflorio T, Tassi A, Cioffi I. Impact of clear aligner therapy on tooth pain and masticatory muscle soreness. J Oral Rehabil. 2020;47(12):1521-9. doi: 10.1111/ joor.13088.
• Miller KB, McGorray SP, Womack R, et al. A comparison of treatment impacts between Invisalign aligner and fixed appliance therapy during the first week of treatment. Am J Orthod Dentofacial Orthop. 2007;131(3):302.e1-9. doi: 10.1016/j.ajodo.2006.05.031.
• Opree A, Kress M. Involvement of the proinflammatory cytokines tumor necrosis factoralpha, IL-1 beta, and IL-6 but not IL-8 in the development of heat hyperalgesia: effects on heatevoked calcitonin gene-related peptide release from rat skin. J Neurosci. 2000;20(16):6289-93. doi: 10.1523/JNEUROSCI.20-16-06289.2000.
• Sharma S, Gupta D, Pal U, Jurel S. Etiological factors of temporomandibular joint disorders. Natl J Maxillofac Surg. 2011;2(2):116-9. doi: 10.4103/0975-5950.94463.
• Shukri N, Kumar S, Balasubramaniam A. Prevalence of Temporomandibular Joint Disorders Among Dental Patients in A Private Institution. International Journal of Research in Pharmaceutical Sciences. 2020;11:1309-15. doi: 10.26452/ijrps.v11ispl3.3383.
• Gauer RL, Semidey MJ. Diagnosis and treatment of temporomandibular disorders. Am Fam Physician. 2015;91(6):378-86.
• Jedynak B, Jaworska-Zaremba M, Grzechocinska B, Chmurska M, Janicka J, Kostrzewa-Janicka J. TMD in Females with Menstrual Disorders. Int J Environ Res Public Health. 2021;18(14):7263. doi: 10.3390/ijerph18147263.
• Al-Tayar B, Al-Somairi MAA, LH AL, et al. Impact of molar teeth distalization by clear aligners on temporomandibular joint: a threedimensional study. Prog Orthod. 2023;24(1):25. doi: 10.1186/s40510-023-00474-3.
• Al-Worafi N, Al-Nasri A, Al-Warafi L, et al. Effect of maxillary molars distalization using clear aligners and fixed orthodontic appliances on the positional and dimensional temporomandibular joint parameters: a three dimensional comparative study. BMC Oral Health. 2024;24:1372. doi: 10.1186/s12903- 024-05148-y.
• Al-Somairi MAA, Zheng B, Yang X, et al. Threedimensional quantitative temporomandibular joint changes in skeletal class I malocclusion treated with extraction and non-extraction protocols: a comparative study of fixed orthodontic appliances and clear aligners. Prog Orthod. 2025;26(1):4. doi: 10.1186/s40510-024- 00551-1.
• Carlton KL, Nanda RS. Prospective study of posttreatment changes in the temporomandibular joint. Am J Orthod Dentofacial Orthop. 2002;122(5):486-90. doi: 10.1067/ mod.2002.128863.
• Zheng J, Zhang Y, Wu Q, Xiao H, Li F. Three-dimensional spatial analysis of the temporomandibular joint in adult patients with Class II division 2 malocclusion before and after orthodontic treatment: a retrospective study. BMC Oral Health. 2023;23(1):477. doi: 10.1186/s12903-023-03210-9.
• Uzunçıbuk H, Marrapodi MM, Meto A, Ronsivalle V, Cicciù M, Minervini G. Prevalence of temporomandibular disorders in clear aligner patients using orthodontic intermaxillary elastics assessed with diagnostic criteria for temporomandibular disorders (DC/TMD) axis II evaluation: A cross-sectional study. J Oral Rehabil. 2024;51(3):500-9. doi: 10.1111/ joor.13614.
• Davies S. What is occlusion? Part 1. Br Dent J. 2024;236(6):447-52. doi: 10.1038/s41415-024- 7173-6.
• Djeu G, Shelton C, Maganzini A. Outcome assessment of Invisalign and traditional orthodontic treatment compared with the American Board of Orthodontics objective grading system. Am J Orthod Dentofacial Orthop. 2005;128(3):292-8. doi: 10.1016/j. ajodo.2005.06.002.
• Buschang PH, Ross M, Shaw SG, Crosby D, Campbell PM. Predicted and actual end-oftreatment occlusion produced with aligner therapy. Angle Orthod. 2015;85(5):723-7. doi: 10.2319/043014-311.1.
• Borda AF, Garfinkle JS, Covell DA, Wang M, Doyle L, Sedgley CM. Outcome assessment of orthodontic clear aligner vs fixed appliance treatment in a teenage population with mild malocclusions. Angle Orthod. 2020;90(4):485- 90. doi: 10.2319/122919-844.1.
• Frenkel ES, Mustafa M, Khosravi R, Woloshyn H, Mancl L, Bollen A-M. Occlusal contact changes in patients treated with clear aligners: A retrospective evaluation using digital dental models. Am J Orthod Dentofacial Orthop. 2024;165(6):680-8.e4. doi: 10.1016/j. ajodo.2024.01.015.
• Marcelino V, Baptista S, Marcelino S, et al. Occlusal Changes with Clear Aligners and the Case Complexity Influence: A Longitudinal Cohort Clinical Study. J Clin Med. 2023;12(10):3435. doi: 10.3390/jcm12103435.
• Dincer M, Isik Aslan B. Effects of thermoplastic retainers on occlusal contacts. Eur J Orthod. 2010;32(1):6-10. doi: 10.1093/ejo/cjp062.
• Riede U, Wai S, Neururer S, et al. Maxillary expansion or contraction and occlusal contact adjustment: effectiveness of current aligner treatment. Clin Oral Investig. 2021;25(7):4671- 9. doi: 10.1007/s00784-021-03780-4.
• Mantovani E, Castroflorio E, Rossini G, et al. Scanning electron microscopy evaluation of aligner fit on teeth. Angle Orthod. 2018;88(5):596- 601. doi: 10.2319/120417-827.1.
• Ohrbach R. Assessment and further development of RDC/TMD Axis II biobehavioural instruments: a research programme progress report. J Oral Rehabil. 2010;37(10):784-98. doi: 10.1111/j.1365-2842.2010.02144.x.
• Yarnitsky D. Conditioned pain modulation (the diffuse noxious inhibitory control-like effect): its relevance for acute and chronic pain states. Curr Opin Anaesthesiol. 2010;23(5):611-5. doi: 10.1097/ACO.0b013e32833c348b.
• Bargellini A, Castroflorio T, Casasco F, et al. Short Term Evaluation of the Effects of Orthodontic Clear Aligners on Sleep Bruxism Activity. Iran J Orthod. 2017;12(2):1-5. doi: 10.5812/ijo.7916.