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Clear Aligner Attachments: A Scoping Review
Rami Boulakroune1, Junbo Wang1, Shangyou Wen1
1Department of Orthodontics, State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
This review maps evidence on clear aligner attachments, finding most research is in vitro. More clinical studies are needed to understand their real-world effectiveness and patient outcomes.
Area of Science:
- Orthodontics and Dental Technology
- Biomaterials Science
Background:
- Clear aligner therapy is a popular orthodontic treatment.
- Attachments are crucial for enhancing clear aligner efficacy.
- A comprehensive understanding of attachment research is needed.
Purpose of the Study:
- To systematically map and summarize evidence on clear aligner attachments.
- To identify key themes and research gaps in this field.
- To inform clinical practice and guide future research directions.
Main Methods:
- A scoping review was conducted following PRISMA-ScR guidelines.
- Systematic searches were performed in major databases (PubMed, Scopus, Web of Science, Embase).
- 115 studies published between 2005 and 2025 were included and data charted.
Main Results:
- In vitro studies predominated (72.1%), with most research from China and Turkey.
- Publication rates increased significantly from 2020, peaking in 2025.
- Key themes include biomechanics, bonding, materials, patient outcomes, and retention, with a focus on biomechanics and bonding.
Conclusions:
- Current evidence on clear aligner attachments is heavily reliant on in vitro data.
- Patient-reported outcomes and safety aspects remain underexplored.
- Further clinical, multicenter, and standardized research is essential to clarify attachment effectiveness and safety.
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