Comparative Evaluation of Patient-Performed Cleaning Methods on the Integrity of Clear Orthodontic Aligners: A Randomized Clinical Trial

Abstract

Introduction: Clear aligner therapy offers an aesthetic and removable alternative to conventional orthodontic appliances. However, aligners are continuously exposed to the oral environment and may undergo changes in surface characteristics, colour and biological contamination during clinical use. Appropriate cleaning is therefore important for maintaining aligner integrity and hygiene. The present study evaluated the effects of commonly used patient-performed cleaning methods on clear orthodontic aligners.  Aim: To compare the effects of five cleaning methods on the surface roughness, colour change and ATP bioluminescence of clear orthodontic aligners following 14 days of intraoral use.  Materials and Methods: An in-vivo comparative study was conducted among 60 participants, randomly allocated into five groups of 12 each: soap solution, Orodox cleansing tablets, Toothsi cleaning foam, water (control), and baking soda paste. Each aligner was used for 14 days and cleaned daily according to the assigned protocol. Surface roughness was evaluated using a surface profilometer and expressed as Ra (µm). Colour change was assessed using a spectrophotometer and expressed as ΔE. Biological contamination was assessed using an ATP bioluminometer and expressed as relative light units (RLU). Data were analysed using IBM SPSS Statistics. One-way ANOVA followed by Tukey's HSD post-hoc test was used for surface roughness and colour change. Since the homogeneity of variance assumption was violated for ATP, Welch's ANOVA followed by Games–Howell post-hoc analysis was performed. A p-value <0.05 was considered statistically significant.