Prediction accuracy of tooth movement in digital treatment planning with aligners: A systematic review

Aim: To evaluate the accuracy of common tooth movements performed with clear aligners and to summarize patient-centered outcomes.

Materials and Methods: A comprehensive search of PubMed, PubMed Central (PMC), Scopus, MDPI, and BMC Oral Health was conducted to identify Englishlanguage articles published between 1 January 2020 and 31 March 2025. The search strategy combined keywords and Medical Subject Headings (MeSH) terms, including "clear aligner", "Invisalign", "aligner accuracy", "tooth movement predictability", "distalisation", "rotation", "expansion", "intrusion", "torque", "overbite correction", "space closure", "quality of life", and "patient satisfaction". Reference lists of the included articles were screened manually to identify additional eligible studies.

Conclusions: Distalization and rotation are predictably expressed with clear aligners, whereas transverse expansion, tipping/torque, overbite reduction, and particularly intrusion remain less reliable. Treatment planning should anticipate under-expression, incorporate overcorrections, use attachments and auxiliaries judiciously, and ensure robust patient education to enhance compliance and satisfaction.