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Dental Arch Expansion With In-House Clear Aligners: An Exploratory Prospective Clinical Study on Torque, Vertical
Gabriel Maia Azevedo1, Raiane Machado Maia1, Arthur Siqueira Calaes de Oliveira1
1Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil.
Orthodontics & Craniofacial Research
|April 30, 2026
Summary
In-house aligners (IHA) showed effective short-term dental arch expansion, particularly in premolars, while maintaining vertical control. Canine torque control varied, with incisal-based attachments improving outcomes.
Area of Science:
- Orthodontics
- Biomaterials Engineering
- Dental Technology
Background:
- In-house aligners (IHA) offer a customizable approach to orthodontic treatment.
- Evaluating the precise tooth movement capabilities of IHAs is crucial for clinical application.
- Understanding the influence of attachment design on aligner efficacy is an ongoing area of research.
Purpose of the Study:
- To assess the short-term effectiveness of transverse dental arch expansion using IHAs.
- To compare planned versus achieved buccolingual tooth movements.
- To investigate torque control, vertical stability, and the impact of attachment variations in IHA therapy.
Main Methods:
- A prospective exploratory trial involving 21 participants (12-30 years) using six IHAs over six weeks.
- Digital models were planned using ArchForm software, and aligners were fabricated from 0.75 mm PETG sheets.
- 3D Slicer and Q3DC software were used for model registration and measurement of tooth movements (buccolingual, vertical, torque).
Main Results:
- Dental arch expansion was most effective in premolars (59% achieved), followed by canines (42%) and first molars (31%).
- Vertical tooth control was generally maintained, meeting equivalence criteria in several instances.
- Canine torque control was suboptimal, but an incisal-based slice attachment significantly improved it compared to a gingival-based attachment.
Conclusions:
- Short-term IHA therapy demonstrates variable efficacy in transverse expansion, being most successful in premolars.
- Vertical dimension control was adequately maintained during IHA treatment.
- Attachment design, specifically the positioning of slice attachments, significantly influences torque control, highlighting its importance in IHA treatment planning.
