ArticleEuropean journal of orthodontics2026
Environmental impact of orthodontic treatment: a simplified fast-track comparative life-cycle impact assessment of self-ligating metal brackets and clear aligners.
Article in European journal of orthodontics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
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Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveSustainability is a prominent topic in modern-day society, with a trend toward reducing environmental impact. The growing amount of plastics and the release of greenhouse gases during waste management raise concerns. This study compares the environmental burden of clear aligners- and self-ligating metal brackets (fixed appliances) to identify the production phase where improvements could best reduce impact.
methodsA simplified fast-track life cycle impact assessment (LCIA) was performed for four illustrative patient cases (two aligner, two fixed appliances). Data were derived from the Industrial Design & Engineering Materials open access database (Idemat, 2024) and manufacturer specifications. Environmental indicators were carbon footprint (kg CO2-eq), cumulative energy demand [megajoules (MJ)], and total ReCiPe score [Points (Pt)].
resultsClear aligners show a higher environmental impact in all categories. Mean carbon footprint for clear aligners ranged from 20.58 to 24.75 kg CO2 and 0.22 kg CO2 in fixed appliance treatment. The Total ReCiPe ranges 0.54-0.66 Pt) for clear aligners compared with 0.01 Pt in treatment with self-ligating metal brackets. These results should be interpreted cautiously, as they may overestimate true magnitudes. LIMITATIONS: This study used a simplified LCIA, incorporating assumptions substantiated by research whenever possible.
conclusionsWithin the limitations of a small sample size and a simplified model, fixed appliance treatment showed a lower environmental impact than clear aligners. The results are exploratory and require validation through larger, clinically based studies incorporating sensitivity analyses and multi-source datasets. The "materials" phase seems a key contributor, stimulating environmentally conscious decision making.
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