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Aligner StainingİnvisalignNCT05213650

Cleaning Agents Impact on Invisalign Aligners: A Cross-Over Randomized Trial

A study testing non-abrasive toothpaste, abrasive toothpaste and Efferdent in people with Aligner Staining, run by Bezmialem Vakif University at 1 site in Turkey (Türkiye).

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Today, the increasing aesthetic expectations of the patients, showing its effect in the field of orthodontics, leads to the orientation towards aesthetic materials. The Invisalign system is also polyurethane for aesthetic purposes. It is a series of transparent plaques personalized to the patient's problems. Read more about this study

Who is it for?
Ages 7 to 70 yearsHealthy volunteers can take part
Conditions the study is for
Aligner Staining
What is being tested?
non-abrasive toothpaste, abrasive toothpaste and Efferdent
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
1 siteTurkey (Türkiye)
Study dates
18 Oct 2021to 1 Dec 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 7 to 70 years
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Who may be able to join

  • No active periodontal disease
  • No caries
  • No systemic disease
  • Patients who do not use any medication will be included in the study.
  • Patients who will use more than 20 transparent plates in their treatment-

Who cannot join

  • Smoking (more than 1 pack per day)
  • Patients consuming dyes such as coffee, tea, beer and red wine more than 2 times a day
  • Patients using less than 20 clear plates in their treatment

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • Banu Kılıç

    Fatih, Istanbul, 34093

Other trials in Turkey (Türkiye)

About this study

Official title: Comparative Evaluation of Cleaning Agents on Color and Roughness of Invisalign Clear Aligners: A Cross-Over Randomized Trial

Today, the increasing aesthetic expectations of the patients, showing its effect in the field of orthodontics, leads to the orientation towards aesthetic materials. The Invisalign system is also polyurethane for aesthetic purposes.

It is a series of transparent plaques personalized to the patient's problems. However, the transparent structure of the plaque increases the importance of its cleanliness.

Read more

There are many studies evaluating the removal of bacterial biofilm from plaques. However There are minimal studies evaluating the effect of the materials used for cleaning on the light transmittance, which has a significant effect on the aesthetics of the plaques.

The aim of this study is to compare 5 different agents' effects on colour change.

The work created will be divided into 5 groups according to the cleaning materials used.

One of the cleaning agents will be assigned by lot and will be used while the treatment processes are continuing.

The colour measurement will be carried out using the VITA Easyshade Compact spectrophotometer (VITA Zahnfabrik DEASYC220, Bad Sackingen, Germany). To prevent external light interference and keep the measurement head in a fixed position for each measurement, a special cubic box with a 3 mm radius entrance was created. The head of the device was firmly attached to the box lid with black tape to increase light-tightness. The colour measurement will be performed from the occlusal region of the second premolar tooth on the aligners, which will be placed on a standard white background. The colour measurement will be carried out as received and after the aligners were used in the patient's mouth for 2 weeks. Prior to measurements, the spectrophotometer will be calibrated according to the manufacturer's instructions. Each measurement will be repeated three times, and the average value will be determined. The Commision de l'Eclairage (CIE) Lab* system will be used for colour measurements. This system uses three parameters to define colour. The L* coordinate is a brightness measure that ranges from 0 (black) to 100 (white); the a* coordinate is horizontal and shows chromatic coordinates between red (+) and green (-), and the b* coordinate is also horizontal and extends in the direction of yellow (b+) and blue (b-). To determine the colour difference, a formula (Formula 1) will be used. ∆L, ∆a, and ∆b values will be calculated by subtracting the starting measurements (L0, a0, b0) from the final measurements (L1, a1, b1). The ∆E value will be calculated using these values, and the colour difference between groups will be compared.

∆E2-1 = [(∆L)2 + (+ (∆a)2 + (∆b)2]1/2= [(L1-L0)2 + (a1-a0)2 + (b1-b0)2]1/2 The formula proposed by Filho and da Silva will be used to convert ΔE values to National Bureau of Standards (NBS) values. NBS unit = ΔE* × 0.92. The ΔE values will be converted to their clinical significance using the NBS system.

According to the results of the research, the colour change of the agents used to clean Invisalign aligners will be determined.

The use of agents that have a minor effect on aesthetics can be considered ideal according to the results of the study

Read the detailed description

In recent years, following the developments in the field of orthodontics, the participation and expectations of patients in treatment have also changed. Conventional orthodontic brackets may cause aesthetic concerns in patients. The use of aesthetic materials and techniques aimed at overcoming such limitations has increased.

An orthodontic treatment system made with a material made of polyurethane was introduced for the first time in 1998 as an alternative to conventional brackets. This system uses CAD/CAM technology to produce serial plates personalized to the treatment process.

It is very important to clean these appliances for aesthetic reasons and to prevent bacteria from accumulating and becoming a focus of infection for the oral cavity. If plaques are not cleaned regularly, they can act as a reservoir for bacteria, leading to periodontal diseases, cavities and bad breath.

In the treatment of clear plaque, the patient is asked not to eat or drink anything other than water while the plaques are in the mouth. However, despite all the recommendations, patients sometimes do not comply with these and may consume coloring drinks while the plaques are in their mouths. This situation causes changes in the polymer of the material and adversely affects the aesthetics, which is the main advantage of clear aligner treatment.

Color stability of clear aligners remain critical considerations for both patients and clinicians. Despite the increasing cost, patients' desire for transparent aligners is due to the fact that these plates have almost no transparency in the mouth, so maintaining the original colour of the aligners is an important issue.

Although there are many studies in the literature evaluating the removal of bacterial biofilm after cleaning of clear plaques, there are very limited studies evaluating the Colour change of plaques.

In the light of this information, the aim of this research is to evaluate the colour change of transparent plaques, which is a polyurethane material, using 5 different cleaning methods. The cleaning methods to be used for this; toothpaste, whitening toothpaste, Corega Pro Guard \& Retainer cleaning tablet, Efferdent antibacterial cleaning tablet and liquid soap.

Being tested
non-abrasive toothpaste, abrasive toothpaste, Efferdent, Cleaning Crystals

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • non-abrasive toothpasteOther

    Also called cleaning agent

    Aligners should be cleaned at least once a day, but twice is preferred to prevent them from changing color or having a bad odor. They should be treated just like teeth and cleaned often, especially after eating and drinking.Usually, dentists advise their patients to clean their plaques with only liquid soap, toothbrush and water. Non-abrasive toothpaste will be used as intervention to aligner cleaning during invisalign treatment.

  • abrasive toothpasteOther

    Also called cleaning agent

    Aligners should be cleaned at least once a day, but twice is preferred to prevent them from changing color or having a bad odor. They should be treated just like teeth and cleaned often, especially after eating and drinking.Usually, dentists advise their patients to clean their plaques with only liquid soap, toothbrush and water. Abrasive toothpaste will be used as intervention to aligner cleaning during invisalign treatment.

  • EfferdentOther

    Also called cleaning agent

    Aligners should be cleaned at least once a day, but twice is preferred to prevent them from changing color or having a bad odor. They should be treated just like teeth and cleaned often, especially after eating and drinking.Usually, dentists advise their patients to clean their plaques with only liquid soap, toothbrush and water.The Efferdent tablet will be used once a week as an intervention to aligner cleaning during invisalign treatment.

  • Cleaning CrystalsOther

    Also called cleaning agent

    Aligners should be cleaned at least once a day, but twice is preferred to prevent them from changing color or having a bad odor. They should be treated just like teeth and cleaned often, especially after eating and drinking.Usually, dentists advise their patients to clean their plaques with only liquid soap, toothbrush and water. Invisalign Cleaning Crystals will be used once a week as an intervention to aligner cleaning during invisalign treatment.

Study groups in NCT05213650
Study groupRoleWhat they receive
Invisalign control patients (liquid soap)No interventionPatients who clean their plaques only with liquid soap and toothbrush
Invisalign non-abrasive toothpaste patientsExperimentalPatients who clean their plaque with non-abrasive toothpaste and toothbrush
Receives: Other: non-abrasive toothpaste
Invisalign abrasive toothpaste patientsExperimentalPatients who clean their plaque with abrasive toothpaste and toothbrush
Receives: Other: abrasive toothpaste
Invisalign Efferdent patientsExperimentalPatients who clean their plaques with liquid soap and use Efferdent antibacterial cleaning tablet once a week
Receives: Other: Efferdent
Invisalign Cleaning Crystals patientsExperimentalPatients who clean their plaques with liquid soap and use Invisalign Cleaning Crystals tablet once a week
Receives: Other: Cleaning Crystals

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Colour change (Delta E)_control

    Delta E of 12 clear aligners of patients who clean their plaques only with liquid soap and a toothbrush

    Measured: 2 week

  2. Colour change (Delta E)_Invisalign non-abrasive toothpaste patients

    Delta E of 12 clear aligners of patients who clean their plaques with non-abrasive toothpaste and toothbrush

    Measured: 2 week

  3. Colour change (Delta E)_ Invisalign abrasive toothpaste patients

    lDelta E of 12 clear aligners of patients who clean their plaque with abrasive toothpaste and toothbrush

    Measured: 2 week

  4. Colour change (Delta E) Invisalign Efferdent patients

    Delta E of 12 clear aligners of patients who clean their plaques with liquid soap and use Efferdent antibacterial cleaning tablet once a week

    Measured: 2 week

  5. Colour change (Delta E) Invisalign Cleaning Crystals patients

    Delta E of 12 clear aligners of patients who clean their plaques with liquid soap and use Invisalign Cleaning Crystals tablet once a week

    Measured: 2 week

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 Jan 2022
  2. Study start18 Oct 2021
  3. Primary completion1 Dec 2022
  4. Study completion1 Dec 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Diagnosis
Allocation
Randomised
Intervention model
Parallel groups
Model description
controlled clinical trial
Masking
Single blind
Who is masked
Participant
Enrolment
20 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05213650
Sponsor's protocol ID
BezmialemVU invisalign
Acronym
İnvisalign
Status last verified
Jul 2023
First submitted
17 Jan 2022
Last updated
27 Jul 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Papadimitriou A, Mousoulea S, Gkantidis N, Kloukos D. Clinical effectiveness of Invisalign(R) orthodontic treatment: a systematic review. Prog Orthod. 2018 Sep 28;19(1):37. doi: 10.1186/s40510-018-0235-z.

    PubMed 30264270
  • Kravitz ND, Kusnoto B, BeGole E, Obrez A, Agran B. How well does Invisalign work? A prospective clinical study evaluating the efficacy of tooth movement with Invisalign. Am J Orthod Dentofacial Orthop. 2009 Jan;135(1):27-35. doi: 10.1016/j.ajodo.2007.05.018.

    PubMed 19121497
  • Kilic B, Canpolat S, Ozturk M. Comparative evaluation of the effect of different cleaning agents on colour and surface roughness of Invisalign clear aligners: a cross-over randomized controlled trial. BMC Oral Health. 2025 Nov 4;25(1):1745. doi: 10.1186/s12903-025-06928-w.

    PubMed 41188779

Questions about this trial

What is this clinical trial studying?

A study testing non-abrasive toothpaste, abrasive toothpaste and Efferdent in people with Aligner Staining, run by Bezmialem Vakif University at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 27 Jul 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Colour change (Delta E)_control (time frame: 2 week). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05213650, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Jul 2023.

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