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Related Experiment Video

Updated: Apr 19, 2026

Author Spotlight: 3D Movement Assessment of Maxillary Posterior Teeth in Clear Aligner Treatment
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Accuracy of Mandibular Dentition Distalisation With Invisalign in Class III Malocclusion: A Pilot Study Using CBCT

Hsin-Yu Wang1,2, Jui-Sheng Sun3,4, Chang-Yu Ku1

  • 1School of Dentistry, College of Medicine, National Taiwan University, Taipei City, Taiwan.

Orthodontics & Craniofacial Research
|April 18, 2026
PubMed
Summary

Invisalign treatment shows limited efficacy for distalizing mandibular teeth in Class III malocclusion without skeletal anchorage. Miniscrews improve accuracy, while elastics cause unwanted tooth and jaw movements.

Keywords:
CBCT analysisInvisalign treatmentclass III malocclusion

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Area of Science:

  • Orthodontics and Dental Imaging
  • Biomaterials and Biomechanics

Background:

  • Class III malocclusion presents complex treatment challenges.
  • Accurate assessment of tooth movement is crucial for effective orthodontic treatment.
  • Digital models and cone beam computed tomography (CBCT) offer advanced diagnostic capabilities.

Purpose of the Study:

  • To precisely analyze Invisalign treatment outcomes in Class III malocclusion using integrated digital models and CBCT.
  • To evaluate the three-dimensional tooth movement and skeletal changes during Invisalign treatment.
  • To compare the efficacy of Class III elastics versus miniscrew anchorage for mandibular distalization.

Main Methods:

  • Integration of pretreatment and posttreatment digital dental models with maxillofacial CBCT scans.
  • Voxel-based registration on stable cranial base structures for superimposition.
  • Assessment of maxillary and mandibular tooth movement and positional changes using registered CBCT images and virtual planning models.

Main Results:

  • Distal movement accuracy for mandibular first molars ranged from 26.72% to 33.87% with elastics, improving to 39.28%-44.66% with miniscrews.
  • Miniscrew anchorage resulted in significantly more distal movement (2.02-2.29 mm) compared to elastics (0.62-0.80 mm).
  • Class III elastics caused maxillary incisor proclination and significant condyle head displacement, unlike miniscrew anchorage.

Conclusions:

  • Invisalign treatment efficacy for mandibular distalization is limited, particularly without skeletal anchorage.
  • Miniscrew anchorage enhances treatment predictability and minimizes unwanted skeletal changes.
  • Class III elastics may lead to undesirable side effects in Class III malocclusion treatment.