Alterations in the surface roughness and porosity parameters of directly printed and Invisalign aligners after 1 week of intraoral usage: An in vivo prospective investigation

•Directly printed aligners (DPAs) could present the next paradigm shift in modern orthodontics. •DPAs might have potential advantages regarding sustainability and waste reduction in the production process. •The production of DPAs is a technique-sensitive, complicated, and time-consuming process. •Intraoral service for 1 week increased the surface roughness and surface porosity of DPAs. •These effects might increase biofilm formation and bacterial adhesion. Introduction Direct printing of clear aligners could be the next paradigm shift in modern orthodontics and can potentially overcome the limitation of the indirect production method. This study investigated the effects of 1 week of intraoral usage on the surface roughness parameters of directly printed aligners (DPAs) and commercially produced Invisalign aligners compared with their unused control counterparts using confocal laser scanning microscopy. Methods The study consisted of 4 groups with 34 samples per group. Unused control aligners were allocated to the control groups (DP-Ctr and INV-Ctr). Sixty-eight patients undergoing clear aligner therapy were allocated to group DP-Clin (patients in therapy using DPAs made from TC-85 DAC resin) and group INV-Clin (patients provided with Invisalign aligners). After 1 week of intraoral usage, the aligners were retrieved from the patients in groups DP-Clin and INV-Clin. Samples were made from the buccal surface of the maxillary right central incisor of each aligner and underwent surface roughness and porosity measuring using confocal laser scanning microscopy. The arithmetic mean deviation of the profile, root mean square deviation, maximum peak height, maximum valley depth, maximum height difference among the highest peak and deepest valley, void volume, and void count were measured. Descriptive analysis and median (quantile) regression models were used for data analysis of this experiment. Results One week of intraoral usage significantly increased the surface roughness and porosity of DPAs. In contrast, a significant reduction in the surface roughness and porosity parameters of Invisalign aligners was recorded after intraoral service. Conclusions This study suggests an increase in the surface roughness and surface porosity of DPAs following 1 week of intraoral usage, which might lead to an increase in bacterial adhesion and biofilm formation in these aligners.