[Discussion on the application of clear aligner treatment in multidisciplinary complex cases]

Clear aligner treatment has evolved over the last 20 years. It has transformed from a simple tool for tooth alignment to an essential component of multidisciplinary oral treatment. It has shown significant advantages in the orthodontic treatment of periodontal disease, the orthodontic treatment of temporomandibular joint disorder (TMD), integrated approaches with dental implant restoration, and the combined treatment of orthodontics and orthognathic surgery. The objective of orthodontic treatment for periodontal disease is to enhance health and stability. Commencement of clear aligner treatment is advised after the management of periodontal inflammation. The principle of applying gentle and gradual force must be adhered to. The extent of tooth movement should be reduced. The coverage of the aligner should be minimized. The time between aligner replacements should be extended. The objective of orthodontic treatment for TMD is to achieve occlusal-joint coordination, eliminate occlusal trauma, stabilize joint function, align the teeth, and improve occlusion. Clear aligner intervention is only suitable for stable TMD. Emphasis is placed on collaborative multidisciplinary management. Informed consent for orthodontic treatment of patients with TMD is crucial. The goal of combined orthodontic and restorative treatment is to integrate space and aesthetics. The digital design of clear aligners can optimize spacing, expand the area for dental implants, intrude over-erupted opposing teeth, upright tilted abutment teeth, ensure optimal gingival distance and mesiodistal diameter for dental implants, and when combined with smile design, it can significantly improve the pink and white aesthetic score. Precise orthodontic-surgical coordination is achieved for the combined treatment of severe skeletal malocclusion via orthodontics and orthognathic surgery. The digital design of clear aligners facilitates the alignment of the upper and lower dental arches more effectively compared with fixed orthodontic treatment. It effectively reduces chairside operation time and significantly improves treatment efficiency. At present, the application of clear aligners in multidisciplinary fields remains limited, and high-quality studies are lacking. We anticipate further high-quality research in the future to enhance our understanding of clear aligner treatment. This will facilitate the exact and rapid completion of clear aligner therapy for patients, resulting in aesthetically pleasing smiles.