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Author Spotlight: 3D Movement Assessment of Maxillary Posterior Teeth in Clear Aligner Treatment
Published on: February 23, 2024
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Indications and limits of clear aligner therapy: an international modified Delphi consensus study
Vincenzo D'Antò1, Giorgio Oliva2, Michele Nieri3
1University of Naples Federico II, Naples, Italy. vincenzo.danto@gmail.com.
Progress in Orthodontics
|August 5, 2025
Summary
Experts reached consensus on clear aligner therapy (CAT) efficacy for mild malocclusions and improved quality of life. Gaps remain in understanding root resorption, relapse, and skeletal effects, necessitating further research in clear aligner treatments.
Area of Science:
- Orthodontics
- Dental Technology
Background:
- Clear aligner therapy (CAT) is increasingly utilized in orthodontics.
- Expert consensus is needed to define its optimal application and identify research gaps.
Purpose of the Study:
- To achieve expert agreement on essential aspects of clear aligner therapy (CAT).
- To identify areas requiring further scientific investigation in CAT.
Main Methods:
- A modified Delphi method was employed with 23 international orthodontic experts.
- Experts evaluated 25 statements across six key CAT areas over three rounds using a 5-point Likert scale.
- Statements lacking consensus were revised, merged, split, or removed by a steering committee.
Main Results:
- Twenty-two of 25 statements achieved expert consensus.
- Agreement was reached on CAT efficacy for mild crowding and open bites, biomechanical limits, improved quality of life, and oral hygiene.
- Experts supported CAT for periodontal patients needing tipping movements and favored palatal expanders over aligners for growing patients.
Conclusions:
- Broad expert agreement was achieved on many CAT aspects.
- Significant evidence gaps exist regarding root resorption, orthodontic relapse, treatment duration, skeletal growth effects, and managing periodontally compromised patients.
- Further research is warranted to address these identified limitations in the literature.
