{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T12:07:53Z","timestamp":1788782873196,"version":"build-2803163510"},"reference-count":39,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthod Craniofacial Res"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Considering the orthodontic needs of individuals with disabilities and the potential impact of such treatments on both quality of life (QoL) and anxiety, this study aims to assess the effects of using clear aligner therapy (Invisalign) on QoL and anxiety levels in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      Fourteen patients with malocclusion and disabilities were enrolled. Initial orthodontic examinations were performed, and questionnaires were administered to assess QoL and anxiety using the WHOQoL\u2010BREF and the State\u2013Trait Anxiety Inventory (STAI\u2010T), respectively, with assessments completed at baseline (T0), three months (T1), and six months (T2) after the start of therapy. The maximum sampling error was evaluated using Pearson's Coefficient of Variation. The normality of the sample distributions was assessed using the Shapiro\u2013Wilk test. For within\u2010group comparisons across the three time points, Friedman's nonparametric test for paired samples was employed, with a post hoc 2\u2010to\u20102 Pairwise Comparison test. The correlation between QoL and anxiety levels was evaluated with Spearman's rank correlation coefficient (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A statistically significant decrease was observed in the Environment domain at T2 compared to T0 and T1 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0126), as well as a significant increase in the Overall Quality of Life domain from T1 to T2 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0145). The correlation analysis revealed significant associations among the domains of the WHOQoL\u2010BREF and STAI\u2010T.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An improvement in the overall quality of life among children and adolescents with disabilities was observed during clear aligner therapy; nonetheless, further controlled studies are needed to confirm this association.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ocr.70178","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T11:15:27Z","timestamp":1788779727000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of Clear Aligner Therapy on Quality of Life and Anxiety Levels: An Exploratory Study in Patients With Disabilities"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9568-5520","authenticated-orcid":false,"given":"Kelly Regina","family":"Micheletti\u2010Cerqueira","sequence":"first","affiliation":[{"name":"Department of Orthodontics School of Dental Medicine, University at Buffalo  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciana Tiemi","family":"Inagaki\u2010Nomura","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine and Pediatric Dentistry State University of Londrina  Londrina Paran\u00e1 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana Emi","family":"Nagata","sequence":"additional","affiliation":[{"name":"Department of Dentistry Northern Parana State University  Jacarezinho Paran\u00e1 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Eduardo","family":"de Oliveira Lima","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine and Pediatric Dentistry State University of Londrina  Londrina Paran\u00e1 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro Marcelo","family":"Tondelli","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine and Pediatric Dentistry State University of Londrina  Londrina Paran\u00e1 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariane","family":"de Ara\u00fajo Fonseca Figueiredo","sequence":"additional","affiliation":[{"name":"Former Undergraduate Student Positivo University  Londrina Paran\u00e1 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8914-702X","authenticated-orcid":false,"given":"Jo\u00e3o Armando","family":"Brancher","sequence":"additional","affiliation":[{"name":"School of Health Sciences Positivo University  Curitiba Paran\u00e1 Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"e_1_2_13_2_1","first-page":"105","volume-title":"Community\u2010Based Rehabilitation: CBR Guidelines","author":"World Health Organization","year":"2010"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1754\u20104505.2010.00136.x"},{"issue":"4","key":"e_1_2_13_4_1","first-page":"295","article-title":"Effects of Premature Loss of Deciduous Molars","volume":"54","author":"Northway W. 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