Anterior open bites represent one of the most complex malocclusions to treat due to their multifactorial etiology and high risk of relapse. While traditionally managed with fixed appliances, extractions, temporary anchorage devices (TADs), or surgery, clear aligner therapy has emerged as an effective alternative for adult patients when biomechanics are properly applied. Anterior open bite correction with clear aligners occurs primarily through incisor extrusion, with limited and less predictable contributions from molar intrusion. This paper reviews current knowledge on anterior open bite correction with clear aligners, the predictability of relevant tooth movements, and clinical outcomes reported in the literature. It also presents a contemporary clinical protocol for managing anterior open bite with clear aligners, including setup strategies in the digital treatment plan, class-specific considerations, staging, and retention.
{"title":"Anterior open bite treatment with clear aligners in adults","authors":"Heeyeon Suh, Bella Shen Garnett, Kimberly Mahood, Heesoo Oh","doi":"10.1053/j.sodo.2025.10.006","DOIUrl":"10.1053/j.sodo.2025.10.006","url":null,"abstract":"<div><div>Anterior open bites represent one of the most complex malocclusions to treat due to their multifactorial etiology and high risk of relapse. While traditionally managed with fixed appliances, extractions, temporary anchorage devices (TADs), or surgery, clear aligner therapy has emerged as an effective alternative for adult patients when biomechanics are properly applied. Anterior open bite correction with clear aligners occurs primarily through incisor extrusion, with limited and less predictable contributions from molar intrusion. This paper reviews current knowledge on anterior open bite correction with clear aligners, the predictability of relevant tooth movements, and clinical outcomes reported in the literature. It also presents a contemporary clinical protocol for managing anterior open bite with clear aligners, including setup strategies in the digital treatment plan, class-specific considerations, staging, and retention.</div></div>","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"32 1","pages":"Pages 231-243"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The range of malocclusions treatable with aligners has expanded, yet complex cases still often require auxiliaries or skeletal anchorage to achieve predictable results. Temporary anchorage devices are often used at different stages of treatment to achieve distinct objectives, a practice that typically requires multiple appliances. This, in turn, increases treatment costs, prolongs therapy due to interruptions while awaiting new devices, and introduces additional clinical challenges. We propose and describe an alternative approach: a modular orthodontic system based on skeletal anchorage, designed to perform multiple movements within a single framework. This system allows for sequential activation of components as needed, without the need for appliance replacement. To illustrate its characteristics, advantages, and limitations, we present two clinical case reports.
{"title":"Development of modular systems with skeletal anchorage for hybrid treatment with clear aligners","authors":"Iodice Giorgio , Buono Raffaele , Segnini Cristiano , Soreca Salvatore , D’Antò Vincenzo","doi":"10.1053/j.sodo.2025.10.018","DOIUrl":"10.1053/j.sodo.2025.10.018","url":null,"abstract":"<div><div>The range of malocclusions treatable with aligners has expanded, yet complex cases still often require auxiliaries or skeletal anchorage to achieve predictable results. Temporary anchorage devices are often used at different stages of treatment to achieve distinct objectives, a practice that typically requires multiple appliances. This, in turn, increases treatment costs, prolongs therapy due to interruptions while awaiting new devices, and introduces additional clinical challenges. We propose and describe an alternative approach: a modular orthodontic system based on skeletal anchorage, designed to perform multiple movements within a single framework. This system allows for sequential activation of components as needed, without the need for appliance replacement. To illustrate its characteristics, advantages, and limitations, we present two clinical case reports.</div></div>","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"32 1","pages":"Pages 217-230"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1053/j.sodo.2025.03.004
Joshua Peh, Hannah Chong, Maurice Meade
Introduction
Interproximal reduction (IPR) is a commonly used modality in orthodontic treatment and is often integrated into digital treatment planning (DTP) processes prior initiating clear aligner therapy (CAT). Despite its apparent widespread use, existing research has primarily focused on general effects and the risks of IPR in orthodontics, with limited appraisal of its use with CAT.
Objective
This scoping review aimed to collate and synthesise the evidence regarding the use of IPR with CAT, focusing on its applications, effects, and perceptions among clinicians and patients.
Methods
The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. On 29th August 2024, an electronic search was conducted across five databases using controlled vocabulary and free-text keywords. In addition, hand searches of key orthodontic journals, reference lists, and systematic reviews, and a search of the grey literature search was performed. Study selection, data extraction, and data synthesis were carried out using a systematic approach.
Results
Thirty-one studies, including retrospective observational studies, prospective interventional trials, and clinician surveys were collated and synthesised. The results were categorised into five groups: surveys on clinical use (six studies), patient and clinician perceptions (four studies), clinical studies on its application (six studies), effects (nine studies), and the accuracy of IPR within the context of CAT (eight studies). The findings were presented in both text and tabular formats.
Conclusions
This review highlighted the widespread use of IPR in CAT and its employment in DTP processes. Findings regarding its clinical applications, associated outcomes, and the perceptions of clinicians and patients were varied. The importance of technical precision and the need for further high-quality research to refine protocols and enhance treatment outcomes were frequently emphasized.
Registration
This review was registered in the Open Science Framework database (https://osf.io/nrkmy).
{"title":"Interproximal reduction with clear aligner therapy: A scoping review","authors":"Joshua Peh, Hannah Chong, Maurice Meade","doi":"10.1053/j.sodo.2025.03.004","DOIUrl":"10.1053/j.sodo.2025.03.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Interproximal reduction (IPR) is a commonly used modality in orthodontic treatment and is often integrated into digital treatment planning (DTP) processes prior initiating clear aligner therapy (CAT). Despite its apparent widespread use, existing research has primarily focused on general effects and the risks of IPR in orthodontics, with limited appraisal of its use with CAT.</div></div><div><h3>Objective</h3><div>This scoping review aimed to collate and synthesise the evidence regarding the use of IPR with CAT, focusing on its applications, effects, and perceptions among clinicians and patients.</div></div><div><h3>Methods</h3><div>The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. On 29th August 2024, an electronic search was conducted across five databases using controlled vocabulary and free-text keywords. In addition, hand searches of key orthodontic journals, reference lists, and systematic reviews, and a search of the grey literature search was performed. Study selection, data extraction, and data synthesis were carried out using a systematic approach.</div></div><div><h3>Results</h3><div>Thirty-one studies, including retrospective observational studies, prospective interventional trials, and clinician surveys were collated and synthesised. The results were categorised into five groups: surveys on clinical use (six studies), patient and clinician perceptions (four studies), clinical studies on its application (six studies), effects (nine studies), and the accuracy of IPR within the context of CAT (eight studies). The findings were presented in both text and tabular formats.</div></div><div><h3>Conclusions</h3><div>This review highlighted the widespread use of IPR in CAT and its employment in DTP processes. Findings regarding its clinical applications, associated outcomes, and the perceptions of clinicians and patients were varied. The importance of technical precision and the need for further high-quality research to refine protocols and enhance treatment outcomes were frequently emphasized.</div></div><div><h3>Registration</h3><div>This review was registered in the Open Science Framework database (<span><span>https://osf.io/nrkmy</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"32 1","pages":"Pages 91-103"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1053/j.sodo.2025.06.004
John C. Voudouris , John Dean Voudouris , Sundaralingam Premaraj , Thyagaseely Sheela Premaraj , Olivier Nicolay
To assist diagnosis and treatment procedures with functional, Aligner Mandibular Advancer (MA) treatment step-by-step guidelines are indicated. The latest scientific and clinical advances in Aligner MA therapy that enhance Class II correction are outlined. New guidelines are listed as twelve checklist strategies combined with the 8 supercorrection prescription recommendations from the literature, for each of 8 different orthodontic movements to place directly into the digital set-up. They are supported by several scientific evidence-based studies to control bias. Sequential steps in the checklist aim to improve skeletal changes to ensure long-term stability. The checklist includes treatment timing of non-peak, versus peak growth with a 3.36 times (1.1 to 3.7 mm/tx respectively) increase in supplemental mandibular lengthening, and patient selection criteria using FMA ≤ 26° (or CoGoMe ≤126°,Y-axis S-Gn to FH ≤ 59°). The carpal radiograph is recommended for treatment timing because CVM has been shown low reliability in several studies. The MA guideline reviews the steps to protect the TMJ, and prevent lower incisor proclination common with prior functional MA. Although most Aligner MAs do not incorporate TADs, skeletal TAD-Anchored MA (TAMA) helps maintain the lower incisors upright and maximizes the MA. Aligner MA growth modifications are assisted by supercorrecting upper and lower incisor torque for a maximum horizontal MA distance, along with other mechanotherapies. Preventing refinements or troubleshooting and clinical appliance management are reviewed. Several MA patients are presented long-term ranging from 2 to 11 years in retention.
{"title":"Guidelines for Aligner MAs: Twelve Strategies using Supercorrection Prescriptions and TADs for Enhanced Growth Modifications in Class II correction 40-years later","authors":"John C. Voudouris , John Dean Voudouris , Sundaralingam Premaraj , Thyagaseely Sheela Premaraj , Olivier Nicolay","doi":"10.1053/j.sodo.2025.06.004","DOIUrl":"10.1053/j.sodo.2025.06.004","url":null,"abstract":"<div><div>To assist diagnosis and treatment procedures with functional, Aligner Mandibular Advancer (MA) treatment step-by-step guidelines are indicated. The latest scientific and clinical advances in Aligner MA therapy that enhance Class II correction are outlined. New guidelines are listed as twelve checklist strategies combined with the 8 supercorrection prescription recommendations from the literature, for each of 8 different orthodontic movements to place directly into the digital set-up. They are supported by several scientific evidence-based studies to control bias. Sequential steps in the checklist aim to improve skeletal changes to ensure long-term stability. The checklist includes treatment timing of non-peak, versus peak growth with a 3.36 times (1.1 to 3.7 mm/tx respectively) increase in supplemental mandibular lengthening, and patient selection criteria using FMA ≤ 26° (or CoGoMe ≤126°,Y-axis S-Gn to FH ≤ 59°). The carpal radiograph is recommended for treatment timing because CVM has been shown low reliability in several studies. The MA guideline reviews the steps to protect the TMJ, and prevent lower incisor proclination common with prior functional MA. Although most Aligner MAs do not incorporate TADs, skeletal TAD-Anchored MA (TAMA) helps maintain the lower incisors upright and maximizes the MA. Aligner MA growth modifications are assisted by supercorrecting upper and lower incisor torque for a maximum horizontal MA distance, along with other mechanotherapies. Preventing refinements or troubleshooting and clinical appliance management are reviewed. Several MA patients are presented long-term ranging from 2 to 11 years in retention.</div></div>","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"32 1","pages":"Pages 56-74"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1053/j.sodo.2024.08.005
Xiaoling Liao , Fengqiong Huang , Wuya Chen , Xiaoyan Cai , Yu Lu , Zhiying Zhou
This study compared the trends in thickness and gap width of three films commonly used in invisible orthodontic techniques on different parts of the teeth after thermoforming. Thirty pieces of three types of orthodontic thermoplastic materials, including polyethylene terephthalate (PET), polyethylene terephthalate glycol (PETG), and thermoplastic polyurethane (TPU) films, with each type consisting of 10 films, each 0.75 mm in thickness, were utilized. A total of 720 locations in the maxillary central incisors, canines, and the first molars of the resin model were localized and measured. The thermoforming films on the model were scanned using cone-beam computed tomography (CBCT), and the sectional images were analyzed by the ImageJ software. The thickness and gap width were the greatest for PET, followed by PETG, and TPU had the smallest values. In the anterior teeth, the distribution of thickness for the three films was rather consistent (P > 0.05). In the posterior teeth, there was an uneven distribution of thickness and a reduction in thickness from the crown to the cervical area (P < 0.05). The central incisors, canines, first molar mesial, and first molar distal had statistically significant differences in the gap widths of the three films (P < 0.001), and the gap widths increased from anterior to posterior teeth. The thickness distribution of the three films in the anterior teeth was more uniform and better fit for the three films compared to the posterior teeth. From a clinical point of view, the results of this study can may explain the superior controllability of clear aligners for orthodontic tooth movement in the anterior region.
{"title":"The thickness and gap width of aligners made of three types of thermoforming materials: An in-vitro study","authors":"Xiaoling Liao , Fengqiong Huang , Wuya Chen , Xiaoyan Cai , Yu Lu , Zhiying Zhou","doi":"10.1053/j.sodo.2024.08.005","DOIUrl":"10.1053/j.sodo.2024.08.005","url":null,"abstract":"<div><div>This study compared the trends in thickness and gap width of three films commonly used in invisible orthodontic techniques on different parts of the teeth after thermoforming. Thirty pieces of three types of orthodontic thermoplastic materials, including polyethylene terephthalate (PET), polyethylene terephthalate glycol (PETG), and thermoplastic polyurethane (TPU) films, with each type consisting of 10 films, each 0.75 mm in thickness, were utilized. A total of 720 locations in the maxillary central incisors, canines, and the first molars of the resin model were localized and measured. The thermoforming films on the model were scanned using cone-beam computed tomography (CBCT), and the sectional images were analyzed by the ImageJ software. The thickness and gap width were the greatest for PET, followed by PETG, and TPU had the smallest values. In the anterior teeth, the distribution of thickness for the three films was rather consistent (<em>P</em> > 0.05). In the posterior teeth, there was an uneven distribution of thickness and a reduction in thickness from the crown to the cervical area (<em>P</em> < 0.05). The central incisors, canines, first molar mesial, and first molar distal had statistically significant differences in the gap widths of the three films (<em>P</em> < 0.001), and the gap widths increased from anterior to posterior teeth. The thickness distribution of the three films in the anterior teeth was more uniform and better fit for the three films compared to the posterior teeth. From a clinical point of view, the results of this study can may explain the superior controllability of clear aligners for orthodontic tooth movement in the anterior region.</div></div>","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"32 1","pages":"Pages 261-268"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1053/j.sodo.2025.02.007
Igor Lavrin , Sarah Lawrence
Clear aligner therapy offers an aesthetic alternative to traditional braces and, when combined with orthognathic surgery, enhances treatment outcomes for complex skeletal cases. This paper outlines the authors’ protocols for integrating aligners with surgery and presents three case reviews using different aligner systems. The cases demonstrate the role of aligners in pre-surgical decompensation, intra-operative management, and post-surgical finishing.
{"title":"Clear aligner treatment with orthognathic surgery","authors":"Igor Lavrin , Sarah Lawrence","doi":"10.1053/j.sodo.2025.02.007","DOIUrl":"10.1053/j.sodo.2025.02.007","url":null,"abstract":"<div><div>Clear aligner therapy offers an aesthetic alternative to traditional braces and, when combined with orthognathic surgery, enhances treatment outcomes for complex skeletal cases. This paper outlines the authors’ protocols for integrating aligners with surgery and presents three case reviews using different aligner systems. The cases demonstrate the role of aligners in pre-surgical decompensation, intra-operative management, and post-surgical finishing.</div></div>","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"32 1","pages":"Pages 148-164"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The popularity of clear aligner treatment (CAT) has been on the rise. Improving treatment satisfaction with CAT requires an in-depth understanding of the patient's perspectives. Nowadays, patients use social media to share authentic treatment experiences. This study aimed to explore the content of CAT-related Instagram posts before, during, and after CAT.
Materials and methods
This study used mixed quantitative and qualitative methods. A social media monitoring software, AwarioTM, was used to collect Instagram CAT-related posts over 4 weeks and categorize them as positive, negative, and neutral ones. Three investigators manually reviewed this categorization. The sentiments of posts before, during, and after treatment were compared using Chi-square tests. Qualitative analysis of post content was carried out to extract themes relevant to patient experiences.
Results
A total of 2015 posts were included in the analysis, including posts before (n=422), during (n=1503), and after (n=90) CAT. The majority of posts (90%) before CAT were positive in sentiment analysis. In contrast, there were more negative than positive posts during CAT (54.8% and 45.2% respectively). Among notable sources of negative sentiments there were pain, unfavorable esthetic appearance of attachments, and sleep difficulties. While 60% of post-treatment posts contained positive sentiments about treatment outcomes and the patient-clinician relationship, 40% were negative and focused on the length of treatment being longer than expected.
Conclusions
High expectations among the public are prevalent before using CAT. Discrepant negative sentiments are revealed during treatment due to pain, attachments, sleep difficulties, and other factors. Patients reflect negatively on the treatment duration after the treatment is concluded. Clinicians should focus on these patient perceptions when counseling them before and during CAT.
{"title":"Instagram and clear aligner therapy: A content analysis of patient perspectives","authors":"Vincenzo Grassia , Fabrizia d'Apuzzo , Reem A. Alansari , Abdolreza Jamilian , Babak Sayahpour , Samar M. Adel , Ludovica Nucci","doi":"10.1053/j.sodo.2024.05.009","DOIUrl":"10.1053/j.sodo.2024.05.009","url":null,"abstract":"<div><h3>Background</h3><div>The popularity of clear aligner treatment (CAT) has been on the rise. Improving treatment satisfaction with CAT requires an in-depth understanding of the patient's perspectives. Nowadays, patients use social media to share authentic treatment experiences. This study aimed to explore the content of CAT-related Instagram posts before, during, and after CAT.</div></div><div><h3>Materials and methods</h3><div>This study used mixed quantitative and qualitative methods. A social media monitoring software, Awario<sup>TM</sup>, was used to collect Instagram CAT-related posts over 4 weeks and categorize them as positive, negative, and neutral ones. Three investigators manually reviewed this categorization<em>.</em> The sentiments of posts before, during, and after treatment were compared using Chi-square tests<em>.</em> Qualitative analysis of post content was carried out to extract themes relevant to patient experiences.</div></div><div><h3>Results</h3><div>A total of 2015 posts were included in the analysis, including posts before (n=422), during (n=1503), and after (n=90) CAT. The majority of posts (90%) before CAT were positive in sentiment analysis. In contrast, there were more negative than positive posts during CAT (54.8% and 45.2% respectively). Among notable sources of negative sentiments there were pain, unfavorable esthetic appearance of attachments, and sleep difficulties. While 60% of post-treatment posts contained positive sentiments about treatment outcomes and the patient-clinician relationship, 40% were negative and focused on the length of treatment being longer than expected.</div></div><div><h3>Conclusions</h3><div>High expectations among the public are prevalent before using CAT. Discrepant negative sentiments are revealed during treatment due to pain, attachments, sleep difficulties, and other factors. Patients reflect negatively on the treatment duration after the treatment is concluded. Clinicians should focus on these patient perceptions when counseling them before and during CAT.</div></div>","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"32 1","pages":"Pages 85-90"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141130880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1053/j.sodo.2025.02.005
Daniel Sim, Mauro Farella
Clear aligner therapy (CAT) has become a popular alternative to fixed orthodontic appliances. However, persistent methodological issues challenge the evaluation of its effectiveness.
Most studies rely on small-scale, non-randomised, retrospective designs, raising concerns about selection bias and limited external validity. Other methodological shortcomings, including unclear treatment endpoints, inadequate adjustments for confounding variables, and a lack of long-term outcomes, further complicate comparisons with fixed appliances.
While CAT demonstrates potential advantages in maintaining oral hygiene, reducing plaque accumulation, and preventing white spot lesions, its effectiveness in achieving complex tooth movements, such as rotations and root torque, remains quite limited. Although CAT appears to be effective for mild to moderate malocclusions, fixed appliances may still achieve better outcomes in more complex cases.
Until future research addresses these methodological gaps and establishes a stronger evidence base, clinicians are advised to prescribe CAT cautiously, especially for complex treatments.
{"title":"Methodological issues in current clear aligner research","authors":"Daniel Sim, Mauro Farella","doi":"10.1053/j.sodo.2025.02.005","DOIUrl":"10.1053/j.sodo.2025.02.005","url":null,"abstract":"<div><div>Clear aligner therapy (CAT) has become a popular alternative to fixed orthodontic appliances. However, persistent methodological issues challenge the evaluation of its effectiveness.</div><div>Most studies rely on small-scale, non-randomised, retrospective designs, raising concerns about selection bias and limited external validity. Other methodological shortcomings, including unclear treatment endpoints, inadequate adjustments for confounding variables, and a lack of long-term outcomes, further complicate comparisons with fixed appliances.</div><div>While CAT demonstrates potential advantages in maintaining oral hygiene, reducing plaque accumulation, and preventing white spot lesions, its effectiveness in achieving complex tooth movements, such as rotations and root torque, remains quite limited. Although CAT appears to be effective for mild to moderate malocclusions, fixed appliances may still achieve better outcomes in more complex cases.</div><div>Until future research addresses these methodological gaps and establishes a stronger evidence base, clinicians are advised to prescribe CAT cautiously, especially for complex treatments.</div></div>","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"32 1","pages":"Pages 10-21"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01DOI: 10.1053/j.sodo.2025.09.010
Mohamad Al Husini , Bhadrinath Srinivasan
Clear aligner therapy has become a notable treatment method in orthodontics, as patients widely accept it due to its superior aesthetic appeal. They differ from conventional fixed appliances by exerting a push force, not a pull one, to move teeth, making it biomechanically unique. Despite their widespread use, the predictability of outcomes with clear aligners, particularly for difficult tooth movements (uprighting and distalization of posterior teeth), is lower than that of fixed appliances. During uprighting of molars, difficulties may arise due to the anatomical complexity of the tooth, the biomechanical requirements for controlled root movement, anchorage needs, and limitations in appliance design. Distalization poses challenges like anchorage demands, risk of tipping instead of bodily movement, space limitations, appliance dependence, and unwanted reciprocal effects. Auxiliaries like Temporary Anchorage Devices (TADs)provide stable anchorage, prevent reciprocal tooth movements, and help accomplish complex tooth movements. Integration of TADs into clear aligner therapy will effectively improve the predictability of complex tooth movements. This paper uses different case examples to demonstrate the use of temporary anchorage devices and clear aligners to handle complex tooth movements like uprighting and distalization of posterior teeth.
{"title":"Optimizing complex tooth movements with clear aligners: The role of temporary anchorage devices in molar uprighting and distalization – a case series","authors":"Mohamad Al Husini , Bhadrinath Srinivasan","doi":"10.1053/j.sodo.2025.09.010","DOIUrl":"10.1053/j.sodo.2025.09.010","url":null,"abstract":"<div><div>Clear aligner therapy has become a notable treatment method in orthodontics, as patients widely accept it due to its superior aesthetic appeal. They differ from conventional fixed appliances by exerting a push force, not a pull one, to move teeth, making it biomechanically unique. Despite their widespread use, the predictability of outcomes with clear aligners, particularly for difficult tooth movements (uprighting and distalization of posterior teeth), is lower than that of fixed appliances. During uprighting of molars, difficulties may arise due to the anatomical complexity of the tooth, the biomechanical requirements for controlled root movement, anchorage needs, and limitations in appliance design. Distalization poses challenges like anchorage demands, risk of tipping instead of bodily movement, space limitations, appliance dependence, and unwanted reciprocal effects. Auxiliaries like Temporary Anchorage Devices (TADs)provide stable anchorage, prevent reciprocal tooth movements, and help accomplish complex tooth movements. Integration of TADs into clear aligner therapy will effectively improve the predictability of complex tooth movements. This paper uses different case examples to demonstrate the use of temporary anchorage devices and clear aligners to handle complex tooth movements like uprighting and distalization of posterior teeth.</div></div>","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"32 1","pages":"Pages 203-216"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号