The Evolution and Clinical Effectiveness of Orthodontic Appliance Designs: A Systematic Review from Pin and Tube to AI-Guided Aligners

Authors: Anshuman Mishra, Subash Chandra Nayak, Smruty Ranjan Biswal, Manisha Khandelwal, Gourav Agarwala

DOI: 10.18231/j.ijodr.11995.1831150091

Keywords: Orthodontic appliances, clear aligners, AI-guided orthodontics, self-ligating brackets, treatment efficiency, systematic review.

Abstract: Background: In the last century, there have been significant changes in orthodontic treatment methods, which have progressed from basic mechanical devices to highly complex, digitally operated systems. Increasing emphasis on digital imaging, material science, biomechanics, and patient-focused care has contributed to innovations in equipment design. Artificial Intelligence (AI)-guided aligner systems are one of the most recent innovations that have the ability to revolutionize conservative accuracy and effectiveness. Objective: The purpose of this systematic review is to widely detect the development of orthodontic tool designs, ranging from early pin and tube devices to modern AI-guided aligners, and severe treatment efficiency, patient satisfaction and their clinical effectiveness in terms of long-term results. Methods: After the PRISMA 2020 guidelines, a comprehensive electronic discovery was made in PubMed, Scopus, Embase, Web of Science, and Cochrane Library Database for studies published between 1950 and 2020. Additional manuals of orthodontic magazines and reference lists were discovered. Studies focused on the development, clinical performance, and comparative effectiveness of orthodontic devices were included. Data extraction and quality were evaluated independently by two critics, and disagreement was resolved through consent. A qualitative synthesis was performed due to variability in study design and result reporting. Results: A total of 68 clinical studies have met the inclusion criteria, including randomized controlled trials, cohort studies, comparative analyses, and systematic reviews. The reviews have highlighted a progressive improvement in aesthetic results with each gradual generation of patient comfort and equipment systems. AI-directed alignment promised initial results in terms of accuracy and low treatment time, although long-term stability data remains limited. Conclusion: The orthodontic tool design has developed to improve the continuous treatment efficiency and patient-centred results. While the AI-guided aligner systems represent a significant jump, traditional definite equipment still plays an important role in the management of complex cases. Further high-quality, long-term studies are essential to establish the durability and cost-effectiveness of AI-directed systems compared to established methods.