A 3D comparison of planned versus achieved anterior tooth position in clear aligner treatment

This study has compared the predicted anterior teeth alignment with the actual clinical results after the first set of aligners without refinement using digital intraoral scans and Clincheck digital models for evaluation. The sample included 40 adult individuals, with an average age of 27.8 years, treated with clear aligners for mild to moderate crowding. Initial and final intra-oral scans, along with predicted final digital models, were used for assessment. Four specific orthodontic tooth movements, vertical movement (including both intrusion and extrusion as linear displacements), along with three angular movements: mesiodistal rotation, mesiodistal crown tipping, and buccolingual crown tipping of 480 upper and lower anterior teeth, were examined to evaluate the efficiency of clear aligners in achieving the desired predicted outcome. Anterior teeth showed significant differences between the predicted and actual variables in all four different types of tooth movement (P < 0.05). The overall mean accuracy of anterior teeth alignment was found to be (50.3%). The mean accuracy of anterior teeth alignment was (47.6%) and (53%) for the upper and lower dentition, respectively. In upper dentition, the highest accuracy was attained during distal tipping (64.85%) and mesial rotational movement (63.32%), whereas intrusion movement demonstrated lower predictability (23.1%). In the lower dentition, the highest accuracy was observed during lingual tipping (75.52%) and labial tipping movement (66.51%). Anterior teeth alignment did not achieve the planned outcome as predicted using the first set of aligners. Concerns remain with specific movements, particularly the intrusion of upper incisors. Therefore, additional refinements are recommended to achieve the desired outcome.