{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:27:33Z","timestamp":1788913653001,"version":"build-2803163510"},"reference-count":34,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare the efficacy of clear aligners and Z-spring (ZS) appliances in treating dental anterior crossbite (AC) during the mixed dentition period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Thirty patients (7\u201312 years) with Angle Class I occlusion and isolated pseudo-Class III AC were randomly assigned to clear aligners (Group A, n = 15) or ZS appliances (Group B, n = 15). Outcomes were evaluated based on duration, cephalometric changes, model analysis, and oral health-related quality of life (OHRQoL), assessed using the Child Oral Health Impact Profile-Short Form-19 (COHIP-SF-19).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      AC was successfully corrected in all patients. Treatment duration was significantly shorter in Group B (48.4 \u00b1 27 days) than in Group A (96.3 \u00b1 22.7 days) (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05). U1\u2013NA angle increased by 5.9\u00b0 and overjet by 4 mm in Group A; in Group B, U1\u2013NA increased by 7.7\u00b0 and overjet by 4.2 mm (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .01). Intergroup cephalometric changes (\u0394T1\u2013T0) were not significant (\n                      <jats:italic>P<\/jats:italic>\n                      &gt; .05). In Group A, incisal and gingival arch depths increased significantly (2.6 mm and 1.17 mm, respectively;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), whereas no significant changes occurred in Group B (\n                      <jats:italic>P<\/jats:italic>\n                      &gt; .05). COHIP-SF-19 scores were comparable (\n                      <jats:italic>P<\/jats:italic>\n                      &gt; .05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Clear aligners and ZS appliances were effective in treating dental AC, achieving normal overjet relationships. However, ZS appliances may cause greater tipping, whereas clear aligners facilitate tipping, alignment, and bodily movement. Treatments demonstrated comparable effects on OHRQoL of children. This study provides a foundation for future research on different appliances for managing AC in the mixed dentition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2319\/022125-154.1","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:30:44Z","timestamp":1756427444000},"page":"41-52","source":"Crossref","is-referenced-by-count":3,"title":["Effect of clear aligners and Z-spring appliance on anterior crossbite correction and quality of life in the mixed dentition: a randomized clinical trial"],"prefix":"10.2319","volume":"96","author":[{"given":"Buse Nur","family":"Gok","sequence":"first","affiliation":[{"name":"Research Assistant, Department of Pediatric Dentistry, Faculty of Dentistry, Akdeniz University, Antalya, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet Yalcin","family":"Gungor","sequence":"additional","affiliation":[{"name":"Orthodontist, Private Practice, Antalya, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ozge","family":"Erken Gungor","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Pediatric Dentistry, Faculty of Dentistry, Akdeniz University, Antalya, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"issue":"3","key":"i1945-7103-96-1-41-b01","series-title":"J Orofac Orthop","first-page":"186","article-title":"Indication for and frequency of early orthodontic therapy or interceptive measures","volume":"64","author":"Schopf","year":"2003","unstructured":"Schopf P. Indication for and frequency of early orthodontic therapy or interceptive measures. J Orofac Orthop. 2003;64(3):186\u2013200."},{"issue":"3","key":"i1945-7103-96-1-41-b02","series-title":"Eur J Orthod","first-page":"294","article-title":"Occlusal status and prevalence of occlusal malocclusion traits among 9-year-old schoolchildren","volume":"31","author":"Lux","year":"2009","unstructured":"Lux CJ,\nD\u00fccker B,\nPritsch M. Occlusal status and prevalence of occlusal malocclusion traits among 9-year-old schoolchildren. Eur J Orthod. 2009;31(3):294\u2013299."},{"issue":"9","key":"i1945-7103-96-1-41-b03","series-title":"J Can Dent Assoc (Tor)","first-page":"71","article-title":"Preventive and interceptive orthodontic treatment needs of an inner-city group of 6-and 9-year-old Canadian children","author":"Karaiskos","year":"2005","unstructured":"Karaiskos N,\nWiltshire WA,\nOdlum O. Preventive and interceptive orthodontic treatment needs of an inner-city group of 6-and 9-year-old Canadian children. J Can Dent Assoc (Tor). 2005;71(9)."},{"issue":"6","key":"i1945-7103-96-1-41-b04","series-title":"Am J Orthod Dentofacial Orthop","first-page":"631","article-title":"Occurrence of malocclusion and need of orthodontic treatment in early mixed dentition","volume":"124","author":"Keski-Nisula","year":"2003","unstructured":"Keski-Nisula K,\nLehto R,\nLusa V. Occurrence of malocclusion and need of orthodontic treatment in early mixed dentition. Am J Orthod Dentofacial Orthop. 2003;124(6):631\u2013638."},{"issue":"3","key":"i1945-7103-96-1-41-b05","series-title":"J Orthod","first-page":"175","article-title":"Early correction of anterior crossbites: a systematic review","volume":"38","author":"Borrie","year":"2011","unstructured":"Borrie F,\nBearn D. Early correction of anterior crossbites: a systematic review. J Orthod. 2011;38(3):175\u2013184."},{"issue":"2","key":"i1945-7103-96-1-41-b06","series-title":"Am J Orthod Dentofacial Orthop","first-page":"160","article-title":"Anterior crossbite correction in the early deciduous dentition","volume":"102","author":"Vadiakas","year":"1992","unstructured":"Vadiakas G,\nViazis AD. Anterior crossbite correction in the early deciduous dentition. Am J Orthod Dentofacial Orthop. 1992;102(2):160\u2013162."},{"issue":"3","key":"i1945-7103-96-1-41-b07","series-title":"Cureus","first-page":"e56072","article-title":"Early interceptive correction for anterior crossbite using a removable appliance: a pediatric case study","volume":"60","author":"Almarhoumi","year":"2024","unstructured":"Almarhoumi A,\nAlwafi MM. Early interceptive correction for anterior crossbite using a removable appliance: a pediatric case study. Cureus. 2024;60(3):e56072."},{"issue":"2","key":"i1945-7103-96-1-41-b08","series-title":"Contemp Clin Dent","first-page":"223","article-title":"Management of anterior dental crossbite with removable appliances","volume":"4","author":"Ulusoy","year":"2013","unstructured":"Ulusoy A,\nBodrumlu E. Management of anterior dental crossbite with removable appliances. Contemp Clin Dent. 2013;4(2):223."},{"issue":"3","key":"i1945-7103-96-1-41-b09","series-title":"J Esthet Restor Dent","first-page":"149","article-title":"Anterior crossbite correction with a series of clear removable appliances: a case report","volume":"21","author":"Park","year":"2009","unstructured":"Park J,\nKim TW. Anterior crossbite correction with a series of clear removable appliances: a case report. J Esthet Restor Dent, 2009;21(3):149\u2013159."},{"issue":"8","key":"i1945-7103-96-1-41-b10","series-title":"J Dent Educ","first-page":"886","article-title":"Does orthodontic treatment affect patients\u2019 quality of life","volume":"72","author":"Kiyak","year":"2008","unstructured":"Kiyak HA. Does orthodontic treatment affect patients\u2019 quality of life? J Dent Educ. 2008;72(8):886\u2013894."},{"issue":"2","key":"i1945-7103-96-1-41-b11","series-title":"Int J Dent Hyg","first-page":"100","article-title":"Oral health-related quality of life in children: Part II. Effects of clinical oral health status. A systematic review","volume":"6","author":"Barbosa","year":"2008","unstructured":"Barbosa T,\nGavi\u00e3o M. Oral health-related quality of life in children: Part II. Effects of clinical oral health status. A systematic review. Int J Dent Hyg. 2008;6(2):100\u2013107."},{"issue":"2","key":"i1945-7103-96-1-41-b12","series-title":"J Pharmacol Pharmacother","first-page":"100","article-title":"CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials","volume":"1","author":"Schulz","year":"2010","unstructured":"Schulz K,\nAltman D,\nMoher D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. J Pharmacol Pharmacother. 2010;1(2):100\u2013107."},{"issue":"1","key":"i1945-7103-96-1-41-b13","series-title":"BMC Oral Health","first-page":"19","article-title":"What are patients\u2019 expectations of orthodontic treatment: a systematic review","volume":"16","author":"Yao","year":"2016","unstructured":"Yao J,\nLi DD,\nYang YQ,\nMcGrath CPJ. What are patients\u2019 expectations of orthodontic treatment: a systematic review. BMC Oral Health. 2016;16(1):19."},{"issue":"2","key":"i1945-7103-96-1-41-b14","series-title":"Eur J Orthod","first-page":"123","article-title":"Fixed versus removable orthodontic appliances to correct anterior crossbite in the mixed dentition\u2013a randomized controlled trial","volume":"37","author":"Wiedel","year":"2015","unstructured":"Wiedel AP,\nBondemark L. Fixed versus removable orthodontic appliances to correct anterior crossbite in the mixed dentition\u2013a randomized controlled trial. Eur J Orthod. 2015;37(2):123\u2013127."},{"issue":"9","key":"i1945-7103-96-1-41-b15","series-title":"Cureus","first-page":"e68703","article-title":"Comparative clinical outcomes in the treatment of anterior crossbite using three different appliances: a case series","volume":"16","author":"Vishnu","year":"2024","unstructured":"Vishnu G,\nRamesh R. Comparative clinical outcomes in the treatment of anterior crossbite using three different appliances: a case series. Cureus. 2024;16(9):e68703."},{"issue":"2","key":"i1945-7103-96-1-41-b16","series-title":"Angle Orthod","first-page":"144","article-title":"Comparison of two early treatment protocols for anterior dental crossbite in the mixed dentition: a randomized trial","volume":"88","author":"Miamoto","year":"2018","unstructured":"Miamoto CB,\nMarques LS,\nAbreu LG. Comparison of two early treatment protocols for anterior dental crossbite in the mixed dentition: a randomized trial. Angle Orthod. 2018;88(2):144\u2013150."},{"issue":"2","key":"i1945-7103-96-1-41-b17","series-title":"Acta Odontol Scand","first-page":"118","article-title":"Removable appliances to correct anterior crossbites in the mixed dentition: a systematic review","volume":"78","author":"Khalaf","year":"2020","unstructured":"Khalaf K,\nMando M. Removable appliances to correct anterior crossbites in the mixed dentition: a systematic review. Acta Odontol Scand. 2020;78(2):118\u2013125."},{"issue":"3","key":"i1945-7103-96-1-41-b01","series-title":"J Orofac Orthop","first-page":"186","article-title":"Indication for and frequency of early orthodontic therapy or interceptive measures","volume":"64","author":"Schopf","year":"2003","unstructured":"Schopf P. Indication for and frequency of early orthodontic therapy or interceptive measures. J Orofac Orthop. 2003;64(3):186\u2013200."},{"issue":"3","key":"i1945-7103-96-1-41-b02","series-title":"Eur J Orthod","first-page":"294","article-title":"Occlusal status and prevalence of occlusal malocclusion traits among 9-year-old schoolchildren","volume":"31","author":"Lux","year":"2009","unstructured":"Lux CJ,\nD\u00fccker B,\nPritsch M. Occlusal status and prevalence of occlusal malocclusion traits among 9-year-old schoolchildren. Eur J Orthod. 2009;31(3):294\u2013299."},{"issue":"9","key":"i1945-7103-96-1-41-b03","series-title":"J Can Dent Assoc (Tor)","first-page":"71","article-title":"Preventive and interceptive orthodontic treatment needs of an inner-city group of 6-and 9-year-old Canadian children","author":"Karaiskos","year":"2005","unstructured":"Karaiskos N,\nWiltshire WA,\nOdlum O. Preventive and interceptive orthodontic treatment needs of an inner-city group of 6-and 9-year-old Canadian children. J Can Dent Assoc (Tor). 2005;71(9)."},{"issue":"6","key":"i1945-7103-96-1-41-b04","series-title":"Am J Orthod Dentofacial Orthop","first-page":"631","article-title":"Occurrence of malocclusion and need of orthodontic treatment in early mixed dentition","volume":"124","author":"Keski-Nisula","year":"2003","unstructured":"Keski-Nisula K,\nLehto R,\nLusa V. Occurrence of malocclusion and need of orthodontic treatment in early mixed dentition. Am J Orthod Dentofacial Orthop. 2003;124(6):631\u2013638."},{"issue":"3","key":"i1945-7103-96-1-41-b05","series-title":"J Orthod","first-page":"175","article-title":"Early correction of anterior crossbites: a systematic review","volume":"38","author":"Borrie","year":"2011","unstructured":"Borrie F,\nBearn D. Early correction of anterior crossbites: a systematic review. J Orthod. 2011;38(3):175\u2013184."},{"issue":"2","key":"i1945-7103-96-1-41-b06","series-title":"Am J Orthod Dentofacial Orthop","first-page":"160","article-title":"Anterior crossbite correction in the early deciduous dentition","volume":"102","author":"Vadiakas","year":"1992","unstructured":"Vadiakas G,\nViazis AD. Anterior crossbite correction in the early deciduous dentition. Am J Orthod Dentofacial Orthop. 1992;102(2):160\u2013162."},{"issue":"3","key":"i1945-7103-96-1-41-b07","series-title":"Cureus","first-page":"e56072","article-title":"Early interceptive correction for anterior crossbite using a removable appliance: a pediatric case study","volume":"60","author":"Almarhoumi","year":"2024","unstructured":"Almarhoumi A,\nAlwafi MM. Early interceptive correction for anterior crossbite using a removable appliance: a pediatric case study. Cureus. 2024;60(3):e56072."},{"issue":"2","key":"i1945-7103-96-1-41-b08","series-title":"Contemp Clin Dent","first-page":"223","article-title":"Management of anterior dental crossbite with removable appliances","volume":"4","author":"Ulusoy","year":"2013","unstructured":"Ulusoy A,\nBodrumlu E. Management of anterior dental crossbite with removable appliances. Contemp Clin Dent. 2013;4(2):223."},{"issue":"3","key":"i1945-7103-96-1-41-b09","series-title":"J Esthet Restor Dent","first-page":"149","article-title":"Anterior crossbite correction with a series of clear removable appliances: a case report","volume":"21","author":"Park","year":"2009","unstructured":"Park J,\nKim TW. Anterior crossbite correction with a series of clear removable appliances: a case report. J Esthet Restor Dent, 2009;21(3):149\u2013159."},{"issue":"8","key":"i1945-7103-96-1-41-b10","series-title":"J Dent Educ","first-page":"886","article-title":"Does orthodontic treatment affect patients\u2019 quality of life","volume":"72","author":"Kiyak","year":"2008","unstructured":"Kiyak HA. Does orthodontic treatment affect patients\u2019 quality of life? J Dent Educ. 2008;72(8):886\u2013894."},{"issue":"2","key":"i1945-7103-96-1-41-b11","series-title":"Int J Dent Hyg","first-page":"100","article-title":"Oral health-related quality of life in children: Part II. Effects of clinical oral health status. A systematic review","volume":"6","author":"Barbosa","year":"2008","unstructured":"Barbosa T,\nGavi\u00e3o M. Oral health-related quality of life in children: Part II. Effects of clinical oral health status. A systematic review. Int J Dent Hyg. 2008;6(2):100\u2013107."},{"issue":"2","key":"i1945-7103-96-1-41-b12","series-title":"J Pharmacol Pharmacother","first-page":"100","article-title":"CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials","volume":"1","author":"Schulz","year":"2010","unstructured":"Schulz K,\nAltman D,\nMoher D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. J Pharmacol Pharmacother. 2010;1(2):100\u2013107."},{"issue":"1","key":"i1945-7103-96-1-41-b13","series-title":"BMC Oral Health","first-page":"19","article-title":"What are patients\u2019 expectations of orthodontic treatment: a systematic review","volume":"16","author":"Yao","year":"2016","unstructured":"Yao J,\nLi DD,\nYang YQ,\nMcGrath CPJ. What are patients\u2019 expectations of orthodontic treatment: a systematic review. BMC Oral Health. 2016;16(1):19."},{"issue":"2","key":"i1945-7103-96-1-41-b14","series-title":"Eur J Orthod","first-page":"123","article-title":"Fixed versus removable orthodontic appliances to correct anterior crossbite in the mixed dentition\u2013a randomized controlled trial","volume":"37","author":"Wiedel","year":"2015","unstructured":"Wiedel AP,\nBondemark L. Fixed versus removable orthodontic appliances to correct anterior crossbite in the mixed dentition\u2013a randomized controlled trial. Eur J Orthod. 2015;37(2):123\u2013127."},{"issue":"9","key":"i1945-7103-96-1-41-b15","series-title":"Cureus","first-page":"e68703","article-title":"Comparative clinical outcomes in the treatment of anterior crossbite using three different appliances: a case series","volume":"16","author":"Vishnu","year":"2024","unstructured":"Vishnu G,\nRamesh R. Comparative clinical outcomes in the treatment of anterior crossbite using three different appliances: a case series. Cureus. 2024;16(9):e68703."},{"issue":"2","key":"i1945-7103-96-1-41-b16","series-title":"Angle Orthod","first-page":"144","article-title":"Comparison of two early treatment protocols for anterior dental crossbite in the mixed dentition: a randomized trial","volume":"88","author":"Miamoto","year":"2018","unstructured":"Miamoto CB,\nMarques LS,\nAbreu LG. Comparison of two early treatment protocols for anterior dental crossbite in the mixed dentition: a randomized trial. Angle Orthod. 2018;88(2):144\u2013150."},{"issue":"2","key":"i1945-7103-96-1-41-b17","series-title":"Acta Odontol Scand","first-page":"118","article-title":"Removable appliances to correct anterior crossbites in the mixed dentition: a systematic review","volume":"78","author":"Khalaf","year":"2020","unstructured":"Khalaf K,\nMando M. Removable appliances to correct anterior crossbites in the mixed dentition: a systematic review. Acta Odontol Scand. 2020;78(2):118\u2013125."}],"container-title":["The Angle Orthodontist"],"original-title":[],"link":[{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/view\/journals\/angl\/96\/1\/article-p41.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/downloadpdf\/journals\/angl\/96\/1\/article-p41.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/downloadpdf\/journals\/angl\/96\/1\/article-p41.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T14:15:09Z","timestamp":1780064109000},"score":1,"resource":{"primary":{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/view\/journals\/angl\/96\/1\/article-p41.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":34,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.2319\/022125-154.1","relation":{},"ISSN":["1945-7103","0003-3219"],"issn-type":[{"value":"1945-7103","type":"electronic"},{"value":"0003-3219","type":"print"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}