Clear Aligner Therapy in Adults With Stage II-IV Periodontitis: A Narrative Review

Area of Science:

• Dentistry
• Orthodontics
• Periodontology

Background:

• Stage II-IV periodontitis often causes pathologic tooth migration and occlusal instability, necessitating interdisciplinary care.
• Adults with periodontitis are increasingly seeking clear aligner therapy (CAT), but its role in periodontal treatment is not well-defined.

Purpose of the Study:

• To review existing clinical evidence on the use of CAT in adults with stage II-IV periodontitis.
• To outline principles for managing these cases through interdisciplinary care.

Main Methods:

• A narrative review of clinical studies was performed using major scientific databases.
• Included studies focused on adults with periodontitis or a stable reduced periodontium treated with CAT within an interdisciplinary framework.

Main Results:

• Nine studies (case reports, series, pilot study) met the criteria, involving patients with stage II-IV periodontitis.
• CAT was initiated after periodontal infection control and supportive periodontal care (SPC).
• In stable patients, CAT improved occlusal relationships and pathologic tooth migration without compromising periodontal health; fixed appliances showed no superiority.

Conclusions:

• Clear aligner therapy is a viable orthodontic option for adults with stage II-IV periodontitis when integrated into a structured interdisciplinary protocol.
• Further high-quality prospective studies are needed to validate these findings.