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Clear aligner orthodontic treatment: An international modified Delphi consensus study.

Niki Arveda1, Marta Calza1, Tommaso Castroflorio2

  • 1Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy.

American Journal of Orthodontics and Dentofacial Orthopedics : Official Publication of the American Association of Orthodontists, Its Constituent Societies, and the American Board of Orthodontics
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This study established expert consensus on the potential and limitations of orthodontic aligner therapy. Forty-seven consensus statements were generated on biomechanical aspects and extraclinical factors.

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Area of Science:

  • Orthodontics
  • Biomaterials Science
  • Dental Technology

Background:

  • Expert consensus is crucial for understanding the clinical and extraclinical aspects of aligner therapy.
  • Identifying the potential and biomechanical limitations of aligners requires broad expert input.

Purpose of the Study:

  • To achieve expert consensus on the clinical and extraclinical aspects of orthodontic aligner therapy.
  • To evaluate the potential and biomechanical limitations of current aligner systems.

Main Methods:

  • A modified Delphi study involving 36 international experts was conducted over three rounds.
  • Experts responded to 35 initial questions, with iterative refinement and consensus-building (≥70% agreement).
  • The process involved progressive narrowing of research fields through scaled and binary responses.

Main Results:

  • The study generated 47 consensus statements after three rounds of expert evaluation.
  • Significant reformulation of questions occurred across rounds (68 in round 2, 28 in round 3).
  • Consensus was reached on key biomechanical aspects and extraclinical factors relevant to aligner therapy.

Conclusions:

  • The modified Delphi method successfully synthesized expert opinions on orthodontic aligners.
  • Forty-seven consensus statements provide valuable insights into the biomechanics and extraclinical considerations of aligner therapy.
  • This consensus aids in understanding the capabilities and constraints of modern orthodontic aligners.