Maxillary arch development with clear aligners: A comprehensive scoping review

Area of Science:

• Orthodontics
• Dental Biomaterials
• Craniofacial Development

Background:

• Increasing demand for esthetic, removable orthodontic alternatives.
• Clear aligner therapy (CAT) is increasingly used for managing maxillary arch expansion and crossbites.
• Evaluation of CAT's efficacy in transverse maxillary development is crucial.

Purpose of the Study:

• To evaluate the efficacy and limitations of clear aligner therapy (CAT), specifically Invisalign, in the transverse development of the maxillary arch.
• Assess the predictability and outcomes of CAT for maxillary expansion.
• Identify areas for improvement in CAT protocols for transverse dimension management.

Main Methods:

• A comprehensive literature search was conducted across multiple databases (PubMed, Scopus, Web of Science, etc.) for English-language studies.
• Keywords included "maxillary arch development," "CAT," and "Invisalign" for studies published between 2020 and 2024.
• Eight studies were included following PRISMA guidelines from 3,190 initial records.

Main Results:

• Clear aligners achieve maxillary expansion primarily through buccal tipping of posterior teeth.
• Bodily movement and predictability of expansion outcomes, especially at the root or gingival level, remain limited.
• Expansion efficiency varied, with some studies reporting high success at the cusp width but discrepancies between planned and achieved results.

Conclusions:

• Clear aligners offer moderate effectiveness for maxillary arch expansion, mainly through dental tipping in mild to moderate cases.
• CAT is less predictable for achieving bodily movement or substantial skeletal changes.
• High-quality, controlled trials are necessary to validate findings and optimize treatment protocols for transverse maxillary development.