Clear aligners: between clinical inertia and dormant disruption

Area of Science:

• Biomaterials Science
• Orthodontics
• Dental Materials

Background:

• Clear aligner therapy has seen rapid growth but faces limitations in clinical efficiency, biomechanical predictability, and enamel preservation.
• Current attachments, bonding protocols, and aligner materials restrict advancements despite increased research and market proliferation.

Purpose of the Study:

• To review potential biomedical innovations for clear aligner therapy.
• To provide a roadmap for translating new technologies into clinical practice.
• To address limitations in force delivery, attachment debonding, and material design.

Main Methods:

• Literature review focusing on recent advancements in dental adhesives and material science.
• Analysis of prepolymerized attachment materials, non-etch bonding strategies, and novel polymer technologies.
• Evaluation of strategies for reversible adhesion and enamel preservation.

Main Results:

• Potential advances include prepolymerized attachments, non-etch bonding, debond-on-demand adhesives, and biomimetic materials.
• Nondissipative energy polymers offer possibilities for improved force delivery.
• Strategies focus on minimizing stress relaxation and enabling on-demand adhesion.

Conclusions:

• Translating biomedical innovations can significantly enhance clear aligner therapy performance and predictability.
• Focus on enamel preservation, controlled adhesion, and material innovation is crucial.
• Future developments should aim for reversible adhesion and improved biomechanical control.