Emerging insights and new developments in clear aligner therapy: A review of the literature

Abstract

Aggressive promotion by stakeholders and increased public awareness for alternative esthetic orthodontic treatment options have popularized the demand for clear aligner therapy (CAT). Patient demand is driven by appearance, comfort, convenience, and less complicated oral hygiene control. CAT is an important treatment alternative to conventional fixed appliances and a viable alternative for mild-to-moderate malocclusions in nonextraction, nongrowing patients. CAT is less effective and predictable than conventional fixed appliances for complex orthodontic tooth movements and malocclusions. However, the introduction of improved software, aligner materials, and auxiliary devices has enhanced the scope of malocclusions that may be treated. Managing complex tooth movements during CAT requires auxiliaries, overcorrections, and refinements to improve the predictability, effectiveness, and stability of treatment outcomes. The main predictors of treatment outcome are proper patient selection, patient complexity, treatment planning, compliance, clinician experience, and regular monitoring. Currently, there are no evidence-based clinical guidelines for CAT. Aligner technology and therapy are continuously evolving and improving. This literature review aimed to assess and summarize current scientific knowledge and evidence relating to CAT.