Integration of digital technologies in orthodontic treatment of children and adolescents: a prospective non-randomized comparative study on personalized therapy in the 12-18 age group.

BACKGROUND AND

OBJECTIVES

Clear aligner therapy combined with digital planning and remote monitoring is increasingly adopted in orthodontics, yet prospective comparative data in adolescents remain limited. This prospective non-randomized study compared short-term outcomes of an aligner-based digital orthodontic pathway versus conventional fixed appliances in adolescents with mild-to-moderate mandibular crowding.

MATERIALS AND

METHODS

In this prospective non-randomized comparative study, 78 adolescents (aged 12-18 years) with mild-to-moderate mandibular anterior crowding received either conventional fixed appliances or a digital pathway incorporating intraoral scanning, virtual treatment planning, clear aligners, and AI-assisted remote monitoring. Follow-up lasted 24 weeks. The primary outcome was change in Little's Irregularity Index (LII). Secondary outcomes included treatment duration, clinic visits, chair time, patient satisfaction, and caregiver satisfaction.

RESULTS

Both groups showed substantial alignment improvement. Mean LII reduction was 5.09 ± 0.57 mm in the digital group versus 4.29 ± 0.37 mm in the conventional group, with the between-group difference of 0.80 mm (95% CI, 0.59-1.02 mm), not reaching the prespecified clinical relevance threshold of 1.2 mm. The digital pathway required fewer in-office visits (2.46 vs. 4.46, p < 0.001), shorter chair time (93.1 vs. 170.8 min, p < 0.001), and shorter alignment duration (21.4 vs. 24.0 weeks, p < 0.001). Patient satisfaction (8.85 vs. 6.97, p < 0.001) and caregiver satisfaction (92.3% vs. 69.2%, p = 0.019) favored the digital pathway. Unplanned visits were numerically less frequent in the digital group (2.6% vs. 15.4%).

CONCLUSION

In this non-randomized study, the digital orthodontic pathway and conventional fixed appliances produced comparable short-term alignment outcomes in adolescents. The digital approach demonstrated advantages in treatment efficiency, resource utilization, and patient experience. These findings support the integration of digital technologies in adolescent orthodontic care, though randomized trials are needed to confirm these observations.