Efficacy of Clear Aligners in Controlling Tooth Movement - Overcoming the Limitations of Aligners in Orthodontics

AIM: To investigate the effectiveness of clear aligners in orthodontic treatments, focusing on rotations, vertical adjustments, and three-dimensional changes. METHODS: A systematic review of the PubMed database was conducted using keywords related to clear aligners and orthodontic tooth movements. The search, limited to English-language articles published between 2009 and 2024, for subjects aged 19 and older, yielded 58 articles. After applying strict inclusion and exclusion criteria, 15 relevant articles were selected. RESULTS: Rotational corrections for canines and premolars varied in accuracy, with distal rotations being more challenging. Rotations over 15° significantly reduced maxillary canine correction accuracy. Vertical movements showed higher accuracy in incisor extrusion and molar intrusion, being more effective at closing bites. No significant difference was found between Invisalign optimized and conventional attachments. Aligners supported mesiodistal and buccolingual movements and dental arch expansion, though these often involved tipping. CONCLUSION: Clear aligners are effective for various orthodontic tooth movements, despite variability in predictability and outcomes. Improving results involves optimising attachment designs, frequent aligner changes, and personalised treatment plans. Clear aligners remain a promising orthodontic alternative, with ongoing research aimed at enhancing precision.