Background and objectives A modified aligner appliance with nickel-titanium springs (MAA) is a relatively new appliance that has not received extensive attention in orthodontics. This study evaluated the patient-reported outcomes when orthodontic treatment was provided using a modified aligner appliance to treat mild lower incisor crowding. Materials and methods This prospective cohort study consisted of 42 patients (11 males and 31 females; mean age 21.69 ± 2.56 years) with mild crowding. Twenty-one patients were treated using a modified aligner with nickel-titanium springs, while the remaining patients were treated with a conventional fixed orthodontic appliance (FA). Patient responses regarding pain, discomfort, and difficulty in chewing, swallowing, and speaking were recorded using a visual analog scale (VAS) at six assessment times: 24 hours (T1), two days (T2), three days (T3), two weeks (T4), one month (T5), and two months (T6) after appliance application. Results The mean perceived pain and discomfort levels were generally lower in the traditional fixed appliance (FA) group than the modified aligner appliance with nickel-titanium springs group at most assessment times. However, no statistically significant differences were found between the two groups. Chewing difficulty levels were similar between the two groups with no substantial differences. Swallowing and speech difficulty were significantly higher in the MAA group compared to the FA group during the first two days of treatment (P < 0.008). Conclusions Patients using both types of orthodontic appliances experienced temporary discomfort, including pain and difficulty chewing. While the modified aligners appliance with nickel-titanium springs caused additional challenges with swallowing and speaking, these issues were resolved over time, allowing patients to adjust to the treatment.
Patient-reported outcome measures (PROMs) have become increasingly important in orthodontic treatment as they reflect patients' perceptions of treatment outcomes. Understanding patient satisfaction with orthodontic treatment is crucial for improving healthcare delivery and patient-centered care. This systematic review aimed to critically appraise the evidence regarding patient satisfaction after orthodontic treatment, exploring the effects of different treatment types, patient demographics, and other factors on satisfaction levels. Eight electronic bibliographic databases were searched without publication time or language restrictions, including PubMed®, Scopus®, the Cochrane Central Register of Controlled Trials, Web of Science™, Embase®, Google™ Scholar, Trip, and OpenGrey. A manual search was conducted on the references in the included papers. Eligibility criteria were established based on the Population, Intervention, Comparison, Outcomes, and Study (PICOS) framework. Studies were included if they reported patient satisfaction levels following orthodontic treatment using standardized questionnaires. Two reviewers independently collected and analyzed the data. The risk of bias was assessed using Cochrane's risk of bias tool (RoB2) for randomized clinical trials, and the methodologic quality for cohort and cross-sectional studies was assessed using the modified version of the Newcastle-Ottawa scale. Fourteen studies employed various questionnaires and timings to gauge post-orthodontic treatment satisfaction. Patient satisfaction levels were generally high, with most studies reporting satisfaction rates above 91%. Fixed orthodontic appliances were associated with higher satisfaction levels compared to removable appliances. While age and gender did not significantly influence satisfaction, the quality of care and doctor-patient relationships were crucial factors in patient satisfaction. This systematic review proves that patient satisfaction with orthodontic treatment is generally high, with fixed appliances and positive doctor-patient relationships contributing to higher satisfaction levels. However, the quality of the evidence was moderate to low, highlighting the need for further high-quality clinical studies in this area.