Although standard
fixed appliances are better suited to control difficult tooth movement in three planes of space, clear aligner orthodontic treatment may be requested by patients because of the superior esthetics compared with conventional
fixed appliances when clear aligners can be considered. Several clinical trials have shown improved periodontal status during orthodontic treatment with clear aligners while
fixed appliances have almost always been associated with increased
inflammation and mild periodontal breakdown despite preventive measures performed during treatment. There have been no reports of decalcification and only one reported case of
root resorption with clear aligners, whereas with
fixed appliances, numerous incidents of both decalcification and
root resorption have been reported. In addition, studies have also shown significantly less
pain from
soft-tissue injuries and
muscle soreness from parafunctional habits with computer-aided clear aligners. Restorative advantages include improved esthetics and comfort during treatment for better case acceptance and the ability to bleach teeth throughout treatment. Improving tooth alignment with orthodontic treatment with fixed or clear appliances increases the clinician's potential capability to perform more conservative restorative procedures, requiring less tooth structure removal and less endodontic involvement because of better tooth positions. In those cases in which
clear aligner appliances may be appropriate, less damage may occur to existing
porcelain restorations than might transpire from bonding of
fixed appliances and their removal, as well as potentially reduced
tooth wear during treatment. This article presents three case reports that demonstrate the periodontal and restorative aspects of treatment using the computer-aided clear appliances, which have either eliminated the need for certain restorative procedures or created a better periodontal and tooth position environment for performing these procedures.