Efficiency, Efficacy, Periodontal & Occlusal Outcomes for Aligners Versus Fixed Orthodontic Appliances in Crowded Incisor Treatment

The study is a randomized controlled trial aimed at comparing the efficiency, efficacy, periodontal and occlusal outcomes between two orthodontic treatment options: clear aligners and traditional fixed braces for patients with moderate crowding in the lower incisors.

Pre-treatment diagnostic records including clinical examination, intraoral scans, intraoral and extraoral photographs will be obtained for each participant.

To ensure that participants in both groups have similar levels of crowding severity and comparable dental health characteristics at the start of the study, randomization will be conducted in blocks. A total of forty participants (20 in each group) will be selected according to specific criteria designed to maintain this uniformity across both treatment groups.This study follows a parallel-group design and the participants will be randomly allocated into one of the two groups included in the study:

Intervention Groups:

* Group A - Fixed Labial Braces (Master Series®, American Orthodontics): In the traditional braces group, fixed metal brackets will be bonded to the lower teeth, and archwires will be used in a specific sequence designed to bring the teeth into alignment over time. * Group B - Clear Aligners (EON Aligner): The clear aligner group will receive custom-fitted aligners created using a digital model of each participant's teeth. These aligners are removable, requiring patient adherence to wearing them for at least 22 hours daily.

Primary Outcomes:

1. Total alignment time 2. Clinical measures of periodontal status 3. Occlusal contact distribution 4. Efficacy of clear aligners Vs fixed appliances in alignment of lower anterior teeth

Secondary Outcomes:

1. Total number of scheduled routine appointments and additional emergency visits 2. Missed appointment rate 3. Number of refinements 4. Bracket/ attachment failure rate 5. Chair-side Time 6. Treatment Efficiency Index 7. BANA (Microbial-enzymatic N-benzoyl-DL-arginine-2-napthylamide) Score 8. Immunological Assay using ELISA 9. Patient's occlusal comfort level 10. Changes in mandibular incisor inclination 11. Changes in the mandibular arch form

Data will be analyzed using SPSS (Statistical Package for the Social Sciences) software, with statistical tests appropriate to the variable types (e.g., Mann-Whitney for group comparisons and Wilcoxon Signed-Rank test for time-related variables).

• Total number of scheduled routine appointments and additional emergency visits [Срок оценки: Through alignment, an average of 6 months]
• Missed appointment rate [Срок оценки: Through alignment, an average of 6 months]
• Number of refinements [Срок оценки: Through alignment, an average of 6 months]
• Bracket/ attachment failure rate [Срок оценки: Through alignment, an average of 6 months]
• Chair side time [Срок оценки: Through alignment, an average of 6 months]
• Treatment Efficiency Index [Срок оценки: Through alignment, an average of 6 months]
• BANA (Microbial-enzymatic N-benzoyl-DL-arginine-2-napthylamide) Score [Срок оценки: Baseline, after 3 months, and after 6 months]
• Immunological Assay using ELISA [Срок оценки: Baseline, after 3 months, and after 6 months]
• Patient's occlusal comfort level [Срок оценки: Baseline, and after an average of 6 months, and after treatment an average of 1 year]
• Changes in mandibular incisor inclination [Срок оценки: Baseline, and after an average of 6 months]
• Changes in the mandibular arch form [Срок оценки: Baseline, and after an average of 6 months]