{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T16:06:56Z","timestamp":1790093216327,"version":"4.0.1"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"International Orthodontics Foundation 2022 Elite","award":["IOFE1"],"award-info":[{"award-number":["IOFE1"]}]},{"name":"China Oral Health Foundation","award":["24H0016"],"award-info":[{"award-number":["24H0016"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare the effectiveness and efficiency of clear aligners (CA) with fixed appliances (FA) during presurgical orthodontics for combined orthodontic\u2013orthognathic treatment of skeletal Class III malocclusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>In this single-centre retrospective cohort, 95 patients (16\u201336 years) treated between 2019 and 2021 were stratified by appliance and extraction status: FA nonextraction (n = 24), FA extraction (n = 28), CA nonextraction (n = 24), and CA extraction (n = 19). The prespecified primary effectiveness outcome was maxillary incisor decompensation (\u0394U1-SN); the key efficiency outcome was recorded presurgical duration. Adjusted within-stratum CA\u2013FA contrasts used HC3 robust linear models with Benjamini\u2013Hochberg correction across the secondary-outcome family.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>CA were associated with shorter recorded duration in both strata (nonextraction \u2212143.6 days, P = .020; extraction \u2212263.0 days, P = .0005) and fewer follow-up visits (\u22128.41 and \u221213.52; both P &amp;lt; .001). A prespecified sensitivity analysis adding each CA patient\u2019s aligner delivery wait left the extraction association intact (\u2212231.7 days, P = .0023) but rendered the nonextraction association marginal (\u2212117.6 days, P = .055). CA showed greater maxillary incisor decompensation in both strata (primary outcome, raw P: nonextraction +4.63\u00b0, P = .027; extraction +4.37\u00b0, P = .044, marginal). No secondary effectiveness outcome survived correction, and a simulated surgical readiness index showed no difference.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this retrospective cohort, CA were associated with shorter recorded presurgical treatment, fewer visits and greater maxillary incisor decompensation than FA. The nonextraction duration association became marginal once the delivery wait was incorporated, whereas the extraction-stratum association was largely preserved. Prospective controlled studies are needed to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejo\/cjag069","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T11:53:56Z","timestamp":1788954836000},"source":"Crossref","is-referenced-by-count":0,"title":["Comparison of the effectiveness and efficiency of clear aligners and fixed appliances in the presurgical orthodontic treatment of skeletal Class III malocclusion: a retrospective study"],"prefix":"10.1093","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0366-0233","authenticated-orcid":false,"given":"Zhuo Ping","family":"Bai","sequence":"first","affiliation":[{"name":"Department of Orthodontics, State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University , No. 14, Section 3, Ren Min South Road, Chengdu, Sichuan 610041 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Song","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University , No. 14, Section 3, Ren Min South Road, Chengdu, Sichuan 610041 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University , No. 14, Section 3, Ren Min South Road, Chengdu, Sichuan 610041 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia Chen","family":"Huo","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University , No. 14, Section 3, Ren Min South Road, Chengdu, Sichuan 610041 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2313-6731","authenticated-orcid":false,"given":"Ujjwal","family":"Pyakurel","sequence":"additional","affiliation":[{"name":"Kantipur Dental College Teaching Hospital and Research Center , Kathmandu University, Kathmandu 44600 ,","place":["Nepal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hu","family":"Long","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University , No. 14, Section 3, Ren Min South Road, Chengdu, Sichuan 610041 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