Pain perception and sEMG of masticatory muscle in clear aligners vs. conventional orthodontics: A systematic review and meta-analysis

Abstract

Background: Clear aligner therapy (CAT) has gained popularity as an alternative to Conventional
Orthodontic Treatments (COT) for its potential to reduce pain and discomfort. This systematic
review and meta‑analysis aimed to compare pain perception and surface electromyography (sEMG)
in masticatory muscles between CAT and COT groups.
Materials and Methods: A comprehensive search of multiple electronic databases was conducted
to identify relevant studies. The PRISMA guidelines were employed to ensure transparency and
completeness in reporting and was registered in PROSPERO (CRD42024556800).
Results: Nine studies were considered for inclusion. The meta‑analysis revealed a nonsignificant
difference in Visual Analog Scale scores between CAT and COT groups, with a mean difference (MD)
of –2.77 (95% confidence interval [CI]: –7.25, 1.71), P = 0.23. The heterogeneity test revealed
significant heterogeneity among studies (I² = 100%). In contrast, the sEMG activity scores showed
a nonsignificant difference between CAT and COT groups (MD = –0.80, P = 0.60). In addition, the
odds ratio for patients requiring analgesics was 0.23 (95% CI: 0.08, 0.65), P = 0.005, suggesting a
significant difference between CAT and COT groups.
Conclusion: The results suggest that CAT may be associated with improved patient outcomes,
including reduced pain and discomfort, as well as lower analgesic consumption. However, the
evidence is not conclusive, and further research is needed to fully understand the differences
between CAT and COT.
Key Words: Clear aligner therapy, conventional orthodontic treatments, masticatory muscles, pain perception, surface electromyography

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Simran Neeraj Budhraja: Pubmed,Google Scholar