Difficult Movements with Clear Aligners

Content

Efficacy of clear aligners in controlling orthodontic tooth movement: A

systematic review

Systematic Review by Rossini et al. in 2014 set out to

answer the following clinical research question:

"Is CAT (Clear aligner therapy) effective in controlling

the orthodontic movement in non-growing subjects?"

11 Relevant Publications were included in the study to determine the efficacy of CAT in performing intrusion, extrusion, rotation, tipping and alignment movements.

Effectiveness of Extrusion movements: 

-Anterior Extrusive movements had the lowest predictability of 30% (average 0.56mm extrusion attempted)

Effectiveness of Intrusion movements:

-High accuracy of anterior intrusion movement (Mean: ~0.72mm) comparable to traditional techniques

Effectiveness of Bodily movements:

-Upper molar distalisation had the highest predictability of 88% when 1.5mm bodily movement was prescribed

Efficacy of Rotational movements:

-Rotational movements had low predictability especially around rounded teeth (eg. canines)

Rossini et al. recommends to consider using auxillaries (IPR, attachments, elastics, TADs etc.) to improve predictability of orthodontic movements