{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T06:45:47Z","timestamp":1784616347496,"version":"3.55.0"},"reference-count":30,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n To evaluate effects of orthodontic treatment with aligners and conventional fixed appliances on production of speech.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n \n This was a parallel, randomized clinical trial. Patients with Angle Class I malocclusion, moderate crowding, and no speech impairment were randomly allocated to two groups: patients with orthodontic aligners (OAs; n = 20; mean age = 23.60 \u00b1 5.65 years) and those with conventional fixed appliances (n = 20; mean age = 20.56 \u00b1 4.51 years) and treated at the University of North Parana's clinic in Londrina, Brazil. Evaluation of speech production was performed semiobjectively by a speech therapist (myofunctional orofacial examination) and subjectively (self-assessment) at five time points: baseline, immediately after insertion of appliances, and subsequently at 3, 30, and 180 days after insertion. For intergroup comparison, independent\n t,<\/jats:italic>\n \u03c7\n 2<\/jats:sup>\n , Fisher exact, and Mann-Whitney tests were used; for intragroup comparison, the Friedman test was applied (\u03b1 = 5%).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In the semiobjective evaluation, patients with OAs exhibited a change in production of speech production, compared with patients with fixed appliances, immediately and 3 days after insertion of appliances (\n P<\/jats:italic>\n < .001). Thirty days after insertion, the groups were similar (\n P<\/jats:italic>\n = .487), an outcome that was unchanged at 180 days. However, in the self-assessments, patients in both groups reported significant speech difficulties immediately and 3 days after insertion of appliances, but such impairment was no longer perceived at 30 days or 180 days.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Although the speech therapist identified changes in speech production at the start of treatment in the OA group only, patient self-assessments demonstrated that orthodontic treatment, regardless of the type of appliance used, interfered with their perception of speech.<\/jats:p>\n <\/jats:sec>","DOI":"10.2319\/110620-917.1","type":"journal-article","created":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T10:50:20Z","timestamp":1622026220000},"page":"711-717","source":"Crossref","is-referenced-by-count":33,"title":["Effects of orthodontic treatment with aligners and fixed appliances on speech:"],"prefix":"10.2319","volume":"91","author":[{"given":"Paulo Eduardo","family":"Damasceno Melo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9ssica Rico","family":"Bocato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Cl\u00e1udia","family":"de Castro Ferreira Conti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen Regina","family":"Siqueira de Souza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thais Maria","family":"Freire Fernandes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcio Rodrigues","family":"de Almeida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula Vanessa","family":"Pedron Oltramari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"issue":"(suppl)","key":"i0003-3219-91-6-711-b01","series-title":"Am J Orthod Dentofacial Orthop","first-page":"S68","article-title":"Assessment of perceived orthodontic appliance attractiveness","volume":"133","author":"Ziuchkovski","year":"2008","unstructured":"Ziuchkovski\n JP,\n \n \n Fields\n HW,\n \n \n Johnston\n WM,\n \n \n Lindsey\n DT.\n \n \n Assessment of perceived orthodontic appliance attractiveness.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2008;\n\t\t\t\t\t133(suppl):\n\t\t\t\t\tS68\u2013\n\t\t\t\t\tS78."},{"key":"i0003-3219-91-6-711-b02","series-title":"Am J Orthod Dentofacial Orthop","first-page":"27","article-title":"How well does Invisalign work? A prospective clinical study evaluating the efficacy of tooth movement with Invisalign","volume":"135","author":"Kravitz","year":"2009","unstructured":"Kravitz\n ND,\n \n \n Kusnoto\n B,\n \n \n BeGole\n E,\n \n \n Obrez\n A,\n \n \n Agran\n B.\n \n \n How well does Invisalign work? A prospective clinical study evaluating the efficacy of tooth movement with Invisalign.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2009;\n\t\t\t\t\t135:\n\t\t\t\t\t27\u2013\n\t\t\t\t\t35."},{"key":"i0003-3219-91-6-711-b03","series-title":"Eur J Oral Sci","first-page":"105","article-title":"Lingual vs. labial fixed orthodontic appliances: systematic review and meta-analysis of treatment effects","volume":"124","author":"Papageorgiou","year":"2016","unstructured":"Papageorgiou\n SN,\n \n \n G\u00f6lz\n L,\n \n \n J\u00e4ger\n A,\n \n \n Eliades\n T,\n \n \n Bourauel\n C.\n \n \n Lingual vs. labial fixed orthodontic appliances: systematic review and meta-analysis of treatment effects.\n\t\t\t\t\tEur J Oral Sci.\n\t\t\t\t\t2016;\n\t\t\t\t\t124:\n\t\t\t\t\t105\u2013\n\t\t\t\t\t118."},{"key":"i0003-3219-91-6-711-b04","series-title":"Am J Orthod Dentofacial Orthop","first-page":"535","article-title":"Effects of retainers on the articulation of speech","volume":"110","author":"Haydar","year":"1996","unstructured":"Haydar\n B,\n \n \n Karabulut\n G,\n \n \n \u00d6zkan\n S,\n \n \n Aksoy\n A\u00dc,\n \n \n Ci\u011fer\n S.\n \n \n Effects of retainers on the articulation of speech.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t1996;\n\t\t\t\t\t110:\n\t\t\t\t\t535\u2013\n\t\t\t\t\t540."},{"key":"i0003-3219-91-6-711-b05","series-title":"Angle Orthod","first-page":"286","article-title":"Speech effects of Hawley and vacuum-formed retainers by acoustic analysis: a single-center randomized controlled trial","volume":"87","author":"Wan","year":"2017","unstructured":"Wan\n J,\n \n \n Wang\n T,\n \n \n Pei\n X,\n \n \n Wan\n Q,\n \n \n Feng\n W,\n \n \n Chen\n J.\n \n \n Speech effects of Hawley and vacuum-formed retainers by acoustic analysis: a single-center randomized controlled trial.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2017;\n\t\t\t\t\t87:\n\t\t\t\t\t286\u2013\n\t\t\t\t\t292."},{"key":"i0003-3219-91-6-711-b06","series-title":"J Orofac Orthop","first-page":"162","article-title":"Motivation, acceptance and problems of Invisalign\u00ae patients","volume":"66","author":"Nedwed","year":"2005","unstructured":"Nedwed\n V,\n \n \n Miethke\n RR.\n \n \n Motivation, acceptance and problems of Invisalign\u00ae patients.\n\t\t\t\t\tJ Orofac Orthop.\n\t\t\t\t\t2005;\n\t\t\t\t\t66:\n\t\t\t\t\t162\u2013\n\t\t\t\t\t173."},{"key":"i0003-3219-91-6-711-b07","series-title":"Int Orthod","first-page":"513","article-title":"Effects of Invisalign\u00ae treatment on speech articulation","volume":"17","author":"Pogal-Sussman-Gandia","year":"2019","unstructured":"Pogal-Sussman-Gandia\n CB,\n \n \n Tabbaa\n S,\n \n \n Al-Jewair\n T.\n \n \n Effects of Invisalign\u00ae treatment on speech articulation.\n\t\t\t\t\tInt Orthod.\n\t\t\t\t\t2019;\n\t\t\t\t\t17:\n\t\t\t\t\t513\u2013\n\t\t\t\t\t518."},{"key":"i0003-3219-91-6-711-b08","series-title":"Med Princ Pract","first-page":"382","article-title":"Comparison of short-term oral impacts experienced by patients treated with Invisalign or conventional fixed orthodontic appliances","volume":"29","author":"Alajmi","year":"2020","unstructured":"Alajmi\n S,\n \n \n Shaban\n A,\n \n \n Al-Azemi\n R.\n \n \n Comparison of short-term oral impacts experienced by patients treated with Invisalign or conventional fixed orthodontic appliances.\n\t\t\t\t\tMed Princ Pract.\n\t\t\t\t\t2020;\n\t\t\t\t\t29:\n\t\t\t\t\t382\u2013\n\t\t\t\t\t388."},{"key":"i0003-3219-91-6-711-b09","series-title":"J Oral Rehabil","first-page":"744","article-title":"Validity of the \u2018protocol of oro-facial myofunctional evaluation with scores' for young and adult subjects","volume":"39","author":"Felicio","year":"2012","unstructured":"Felicio\n CM,\n \n \n Medeiros\n APM,\n \n \n Melchior\n MO.\n \n \n Validity of the \u2018protocol of oro-facial myofunctional evaluation with scores' for young and adult subjects.\n\t\t\t\t\tJ Oral Rehabil.\n\t\t\t\t\t2012;\n\t\t\t\t\t39:\n\t\t\t\t\t744\u2013\n\t\t\t\t\t753."},{"key":"i0003-3219-91-6-711-b10","series-title":"J Orofacial Myology","first-page":"38","article-title":"MBGR protocol of orofacial myofunctional evaluation with scores. International","volume":"38","author":"Marchesan","year":"2012","unstructured":"Marchesan\n IQ,\n \n \n Berretin-Felix\n G,\n \n \n Genaro\n KF.\n \n \n MBGR protocol of orofacial myofunctional evaluation with scores. International.\n\t\t\t\t\tJ Orofacial Myology.\n\t\t\t\t\t2012;\n\t\t\t\t\t38:\n\t\t\t\t\t38\u2013\n\t\t\t\t\t77."},{"key":"i0003-3219-91-6-711-b11","series-title":"Am J Orthod Dentofacial Orthop","first-page":"747","article-title":"Randomization. Part 1: sequence generation","volume":"140","author":"Pandis","year":"2011","unstructured":"Pandis\n N.\n \n \n Randomization. Part 1: sequence generation.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2011;\n\t\t\t\t\t140:\n\t\t\t\t\t747\u2013\n\t\t\t\t\t748."},{"key":"i0003-3219-91-6-711-b12","series-title":"Eur J Orthod","first-page":"29","article-title":"Speech and orthodontic appliances: a systematic literature review","volume":"40","author":"Chen","year":"2018","unstructured":"Chen\n J,\n \n \n Wan\n J,\n \n \n You\n L.\n \n \n Speech and orthodontic appliances: a systematic literature review.\n\t\t\t\t\tEur J Orthod.\n\t\t\t\t\t2018;\n\t\t\t\t\t40:\n\t\t\t\t\t29\u2013\n\t\t\t\t\t36."},{"key":"i0003-3219-91-6-711-b13","series-title":"Eur J Orthod","first-page":"724","article-title":"Adult patients' adjustability to orthodontic appliances. Part I: a comparison between labial, lingual, and Invisalign\u2122","volume":"34","author":"Shalish","year":"2012","unstructured":"Shalish\n M,\n \n \n Cooper-Kazaz\n R,\n \n \n Ivgi\n I,\n \n et al.\n \n Adult patients' adjustability to orthodontic appliances. Part I: a comparison between labial, lingual, and Invisalign\u2122.\n\t\t\t\t\tEur J Orthod.\n\t\t\t\t\t2012;\n\t\t\t\t\t34:\n\t\t\t\t\t724\u2013\n\t\t\t\t\t730."},{"key":"i0003-3219-91-6-711-b14","series-title":"Am J Orthod Dentofacial Orthop","first-page":"302.e1","article-title":"A comparison of treatment impacts between Invisalign aligner and fixed appliance therapy during the first week of treatment","volume":"131","author":"Miller","year":"2007","unstructured":"Miller\n KB,\n \n \n McGorray\n SP,\n \n \n Womack\n R,\n \n et al.\n \n A comparison of treatment impacts between Invisalign aligner and fixed appliance therapy during the first week of treatment.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2007;\n\t\t\t\t\t131:\n\t\t\t\t\t302.e1\u2013\n\t\t\t\t\te9."},{"key":"i0003-3219-91-6-711-b15","series-title":"Angle Orthod","first-page":"519","article-title":"Speech performance and oral impairments with lingual and labial orthodontic appliances in the first stage of fixed treatment A randomized controlled trial","volume":"83","author":"Khattab","year":"2013","unstructured":"Khattab\n TZ,\n \n \n Farah\n H,\n \n \n Al-Sabbagh\n R,\n \n \n Hajeer\n MY,\n \n \n Haj-Hamed\n Y.\n \n \n Speech performance and oral impairments with lingual and labial orthodontic appliances in the first stage of fixed treatment A randomized controlled trial.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2013;\n\t\t\t\t\t83:\n\t\t\t\t\t519\u2013\n\t\t\t\t\t526."},{"issue":"(suppl)","key":"i0003-3219-91-6-711-b01","series-title":"Am J Orthod Dentofacial Orthop","first-page":"S68","article-title":"Assessment of perceived orthodontic appliance attractiveness","volume":"133","author":"Ziuchkovski","year":"2008","unstructured":"Ziuchkovski\n JP,\n \n \n Fields\n HW,\n \n \n Johnston\n WM,\n \n \n Lindsey\n DT.\n \n \n Assessment of perceived orthodontic appliance attractiveness.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2008;\n\t\t\t\t\t133(suppl):\n\t\t\t\t\tS68\u2013\n\t\t\t\t\tS78."},{"key":"i0003-3219-91-6-711-b02","series-title":"Am J Orthod Dentofacial Orthop","first-page":"27","article-title":"How well does Invisalign work? 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A prospective clinical study evaluating the efficacy of tooth movement with Invisalign.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2009;\n\t\t\t\t\t135:\n\t\t\t\t\t27\u2013\n\t\t\t\t\t35."},{"key":"i0003-3219-91-6-711-b03","series-title":"Eur J Oral Sci","first-page":"105","article-title":"Lingual vs. labial fixed orthodontic appliances: systematic review and meta-analysis of treatment effects","volume":"124","author":"Papageorgiou","year":"2016","unstructured":"Papageorgiou\n SN,\n \n \n G\u00f6lz\n L,\n \n \n J\u00e4ger\n A,\n \n \n Eliades\n T,\n \n \n Bourauel\n C.\n \n \n Lingual vs. labial fixed orthodontic appliances: systematic review and meta-analysis of treatment effects.\n\t\t\t\t\tEur J Oral Sci.\n\t\t\t\t\t2016;\n\t\t\t\t\t124:\n\t\t\t\t\t105\u2013\n\t\t\t\t\t118."},{"key":"i0003-3219-91-6-711-b04","series-title":"Am J Orthod Dentofacial Orthop","first-page":"535","article-title":"Effects of retainers on the articulation of speech","volume":"110","author":"Haydar","year":"1996","unstructured":"Haydar\n B,\n \n \n Karabulut\n G,\n \n \n \u00d6zkan\n S,\n \n \n Aksoy\n A\u00dc,\n \n \n Ci\u011fer\n S.\n \n \n Effects of retainers on the articulation of speech.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t1996;\n\t\t\t\t\t110:\n\t\t\t\t\t535\u2013\n\t\t\t\t\t540."},{"key":"i0003-3219-91-6-711-b05","series-title":"Angle Orthod","first-page":"286","article-title":"Speech effects of Hawley and vacuum-formed retainers by acoustic analysis: a single-center randomized controlled trial","volume":"87","author":"Wan","year":"2017","unstructured":"Wan\n J,\n \n \n Wang\n T,\n \n \n Pei\n X,\n \n \n Wan\n Q,\n \n \n Feng\n W,\n \n \n Chen\n J.\n \n \n Speech effects of Hawley and vacuum-formed retainers by acoustic analysis: a single-center randomized controlled trial.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2017;\n\t\t\t\t\t87:\n\t\t\t\t\t286\u2013\n\t\t\t\t\t292."},{"key":"i0003-3219-91-6-711-b06","series-title":"J Orofac Orthop","first-page":"162","article-title":"Motivation, acceptance and problems of Invisalign\u00ae patients","volume":"66","author":"Nedwed","year":"2005","unstructured":"Nedwed\n V,\n \n \n Miethke\n RR.\n \n \n Motivation, acceptance and problems of Invisalign\u00ae patients.\n\t\t\t\t\tJ Orofac Orthop.\n\t\t\t\t\t2005;\n\t\t\t\t\t66:\n\t\t\t\t\t162\u2013\n\t\t\t\t\t173."},{"key":"i0003-3219-91-6-711-b07","series-title":"Int Orthod","first-page":"513","article-title":"Effects of Invisalign\u00ae treatment on speech articulation","volume":"17","author":"Pogal-Sussman-Gandia","year":"2019","unstructured":"Pogal-Sussman-Gandia\n CB,\n \n \n Tabbaa\n S,\n \n \n Al-Jewair\n T.\n \n \n Effects of Invisalign\u00ae treatment on speech articulation.\n\t\t\t\t\tInt Orthod.\n\t\t\t\t\t2019;\n\t\t\t\t\t17:\n\t\t\t\t\t513\u2013\n\t\t\t\t\t518."},{"key":"i0003-3219-91-6-711-b08","series-title":"Med Princ Pract","first-page":"382","article-title":"Comparison of short-term oral impacts experienced by patients treated with Invisalign or conventional fixed orthodontic appliances","volume":"29","author":"Alajmi","year":"2020","unstructured":"Alajmi\n S,\n \n \n Shaban\n A,\n \n \n Al-Azemi\n R.\n \n \n Comparison of short-term oral impacts experienced by patients treated with Invisalign or conventional fixed orthodontic appliances.\n\t\t\t\t\tMed Princ Pract.\n\t\t\t\t\t2020;\n\t\t\t\t\t29:\n\t\t\t\t\t382\u2013\n\t\t\t\t\t388."},{"key":"i0003-3219-91-6-711-b09","series-title":"J Oral Rehabil","first-page":"744","article-title":"Validity of the \u2018protocol of oro-facial myofunctional evaluation with scores' for young and adult subjects","volume":"39","author":"Felicio","year":"2012","unstructured":"Felicio\n CM,\n \n \n Medeiros\n APM,\n \n \n Melchior\n MO.\n \n \n Validity of the \u2018protocol of oro-facial myofunctional evaluation with scores' for young and adult subjects.\n\t\t\t\t\tJ Oral Rehabil.\n\t\t\t\t\t2012;\n\t\t\t\t\t39:\n\t\t\t\t\t744\u2013\n\t\t\t\t\t753."},{"key":"i0003-3219-91-6-711-b10","series-title":"J Orofacial Myology","first-page":"38","article-title":"MBGR protocol of orofacial myofunctional evaluation with scores. International","volume":"38","author":"Marchesan","year":"2012","unstructured":"Marchesan\n IQ,\n \n \n Berretin-Felix\n G,\n \n \n Genaro\n KF.\n \n \n MBGR protocol of orofacial myofunctional evaluation with scores. International.\n\t\t\t\t\tJ Orofacial Myology.\n\t\t\t\t\t2012;\n\t\t\t\t\t38:\n\t\t\t\t\t38\u2013\n\t\t\t\t\t77."},{"key":"i0003-3219-91-6-711-b11","series-title":"Am J Orthod Dentofacial Orthop","first-page":"747","article-title":"Randomization. Part 1: sequence generation","volume":"140","author":"Pandis","year":"2011","unstructured":"Pandis\n N.\n \n \n Randomization. Part 1: sequence generation.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2011;\n\t\t\t\t\t140:\n\t\t\t\t\t747\u2013\n\t\t\t\t\t748."},{"key":"i0003-3219-91-6-711-b12","series-title":"Eur J Orthod","first-page":"29","article-title":"Speech and orthodontic appliances: a systematic literature review","volume":"40","author":"Chen","year":"2018","unstructured":"Chen\n J,\n \n \n Wan\n J,\n \n \n You\n L.\n \n \n Speech and orthodontic appliances: a systematic literature review.\n\t\t\t\t\tEur J Orthod.\n\t\t\t\t\t2018;\n\t\t\t\t\t40:\n\t\t\t\t\t29\u2013\n\t\t\t\t\t36."},{"key":"i0003-3219-91-6-711-b13","series-title":"Eur J Orthod","first-page":"724","article-title":"Adult patients' adjustability to orthodontic appliances. Part I: a comparison between labial, lingual, and Invisalign\u2122","volume":"34","author":"Shalish","year":"2012","unstructured":"Shalish\n M,\n \n \n Cooper-Kazaz\n R,\n \n \n Ivgi\n I,\n \n et al.\n \n Adult patients' adjustability to orthodontic appliances. Part I: a comparison between labial, lingual, and Invisalign\u2122.\n\t\t\t\t\tEur J Orthod.\n\t\t\t\t\t2012;\n\t\t\t\t\t34:\n\t\t\t\t\t724\u2013\n\t\t\t\t\t730."},{"key":"i0003-3219-91-6-711-b14","series-title":"Am J Orthod Dentofacial Orthop","first-page":"302.e1","article-title":"A comparison of treatment impacts between Invisalign aligner and fixed appliance therapy during the first week of treatment","volume":"131","author":"Miller","year":"2007","unstructured":"Miller\n KB,\n \n \n McGorray\n SP,\n \n \n Womack\n R,\n \n et al.\n \n A comparison of treatment impacts between Invisalign aligner and fixed appliance therapy during the first week of treatment.\n\t\t\t\t\tAm J Orthod Dentofacial Orthop.\n\t\t\t\t\t2007;\n\t\t\t\t\t131:\n\t\t\t\t\t302.e1\u2013\n\t\t\t\t\te9."},{"key":"i0003-3219-91-6-711-b15","series-title":"Angle Orthod","first-page":"519","article-title":"Speech performance and oral impairments with lingual and labial orthodontic appliances in the first stage of fixed treatment A randomized controlled trial","volume":"83","author":"Khattab","year":"2013","unstructured":"Khattab\n TZ,\n \n \n Farah\n H,\n \n \n Al-Sabbagh\n R,\n \n \n Hajeer\n MY,\n \n \n Haj-Hamed\n Y.\n \n \n Speech performance and oral impairments with lingual and labial orthodontic appliances in the first stage of fixed treatment A randomized controlled trial.\n\t\t\t\t\tAngle Orthod.\n\t\t\t\t\t2013;\n\t\t\t\t\t83:\n\t\t\t\t\t519\u2013\n\t\t\t\t\t526."}],"container-title":["The Angle Orthodontist"],"original-title":[],"link":[{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/view\/journals\/angl\/91\/6\/article-p711.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/angle-orthodontist\/article-pdf\/91\/6\/711\/2936664\/i0003-3219-91-6-711.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/downloadpdf\/journals\/angl\/91\/6\/article-p711.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/downloadpdf\/journals\/angl\/91\/6\/article-p711.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T13:16:20Z","timestamp":1780060580000},"score":1,"resource":{"primary":{"URL":"https:\/\/angle-orthodontist.kglmeridian.com\/view\/journals\/angl\/91\/6\/article-p711.xml"}},"subtitle":["A randomized clinical trial"],"short-title":[],"issued":{"date-parts":[[2021,11]]},"references-count":30,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.2319\/110620-917.1","relation":{},"ISSN":["0003-3219"],"issn-type":[{"value":"0003-3219","type":"print"}],"subject":[],"published":{"date-parts":[[2021,11]]}}}