How environmentally friendly is the disposal of clear aligners? A gas chromatography-mass spectrometry study

Used clear aligner trays are often indiscriminately disposed of with general plastic waste and incinerated. This study aimed to analyze the smoke composition from incinerating 2 common aligner materials: glycol-modified polyethylene terephthalate (PET-G) and polyurethane.

Each of the 2 materials in triplets was thermoformed. The thermoformed trays were shredded and subjected individually to open-fire combustion, ignited using a methane torch, in a specially designed combustion chamber. The resultant smoke was collected and analyzed using gas chromatography-mass spectrometry to study its in-depth composition.

A total of 20 peaks, corresponding to 20 compounds, were identified from each of the 2 material samples. O-xylene (21.06%) showed the maximum concentration in the PET-G sample, whereas 1,4-dimethyl-1,3-cyclohexadiene in polyurethane (18.88%). The first peak in the PET-G sample corresponded to benzene with a relative concentration of 5.18%. Four compounds were common to both samples: 1,4-dimethyl-1,3-cyclohexadiene; 1,3-cyclohexadiene, 2,3-dimethyl-; 1-hydroxymethly-4-methylenecyclohexane; and cyclohexanemethanol, 4-methylene-.

Benzene, a group 1 carcinogen, was identified in the PET-G smoke sample, whereas tetrahydrofuran, a suspected carcinogen, was found in the polyurethane sample. Some compounds were hazardous, whereas most were skin, eye, and respiratory irritants. Possible mitigation strategies include proper case selection, efficient manufacturing, direct 3-dimensional printing, and developing biodegradable materials. Clinicians can set up 'used aligner collection points' to ensure responsible disposal. Proper disposal guidelines and stringent regulations are the need of the hour.