ClearCorrect® aligners demonstrated clinically acceptable predictability of dental expansion in children with mixed dentition, achieving improvements in anterior crowding and midline diastemas, while also maintaining stable oral health status, and without compromising physiological root development.
Objective:This prospective clinical study evaluated the predictability of dental movement and oral health outcomes in children with mixed dentition treated with clear aligners. Methods: Orthodontic treatment was delivered using ClearCorrect® aligners. Standardized clinical documentation was obtained at pre-treatment (T1) and immediately post treatment (T2). Digital models were used to measure changes in arch perimeter, transverse dental movement at the cusp and gingival levels of the intercanine, first and second primary molars, and first permanent molars, as well as changes in dental spacing. Oral hygiene was assessed using the Simplified Visual Plaque Index and Modified Sulcus Bleeding Index. Root development was evaluated by crown-to-root ratio (C/R) and Nolla stages. Descriptive statistics were used to summarize outcomes. Results: Twenty children (7 Female, 13 Male; mean age, 8.5 ± 1.0 years) completed treatment with excellent compliance. The mean treatment duration was 9.6 ± 2.0 months. Predictability of arch perimeter increase was 32% in the upper arch and 58% in the lower arch. Transverse expansion predictability ranged from 42–54% at the gingival level and 51 65% at the cusp level, in the upper arch, and 42–58% and 46–95%, respectively, in the lower arch. Significant reductions in anterior crowding and midline diastemas were observed. Periodontal health remained stable, and root development progressed normally. Conclusion: ClearCorrect® aligners demonstrated clinically acceptable predictability of dental expansion in children with mixed dentition, achieving improvements in anterior crowding and midline diastemas, while also maintaining stable oral health status, and without compromising physiological root development.
Daniel Neves, Desire Cassilha Neves, Giselle Machado Gurek et al.· Journal of Orofacial Innovat...· 0 citations
Background: The aim of this study was to evaluate gingival margin modifications during and after orthodontic treatment with Clear Aligners in paediatric patients. Secondary objectives included assessing the relationship between gingival changes and different types of tooth movement and evaluating the stability of these changes after treatment completion. Methods: A total of 50 patients (26 f, 24 m, mean age: 7.6 ± 1.1 years) in mixed dentition were enrolled. Inclusion criteria were good general health, plaque and gingival indices below 20%, good compliance with aligners, and no prior orthodontic treatment. Patients with periodontal issues, medications influencing gingival response, or with poor expected compliance were excluded. Patients were treated using Clear Aligners and attachments to facilitate specific tooth movements (expansion, intrusion, and rotational corrections). Measurements were performed at four time points: before treatment (T0), after 6 months (T1), at the end of treatment (T2), and 12 months post-treatment (T3). At each time point, intraoral scans, clinical photographs, and periodontal measurements were recorded. Results: A statistically significant increase in gingival margin height was observed from baseline to T1 (+0.29 mm), T2 (+0.44 mm), and T3 (+0.39 mm). Mean Changes between T0 and T3 were +0.39 ± 0.22 (p ≤ 0.001). A total of 60% of patients demonstrated a coronal migration of the gingival margin. Gingival Index showed a non-significant increase at T1, followed by normalization at T2 (p = 0.481) and T3 (p = 0.637). Plaque Index (PI) remained stable throughout the observation period. Expansion was associated with the greatest gingival change (+0.52 mm), followed by intrusion (+0.45 mm). Conclusions: Clear aligner treatment in mixed dentition appears to produce favourable and stable gingival margin modifications, with minimal adverse periodontal effects when properly monitored.
Marco Clementini, C. Pavoni, F. Gazzani et al.· Applied Sciences· 0 citations
This exploratory study aimed to evaluate the expansion effects of a customized elastodontic appliance (CEA) on maxillary and mandibular arches in mixed dentition children using cone-beam computed tomography (CBCT), and to clarify whether these effects are dental, dentoalveolar, or skeletal.
This retrospective study included 31 mixed dentition children (mean age 8.3 ± 1.2 years) who underwent CEA treatment for 8.2 ± 1.3 months. Pre- and post-treatment CBCT images were used to measure width changes at three levels: cusp, alveolar bone, and apical basal bone. Paired t-tests were used for comparisons.
Significant increases were observed at cusp and alveolar levels. At the cusp level, maxillary inter-canine width increased by 2.97 mm ± 1.31 mm (95% CI: 2.49–3.45,
P
< 0.001), and mandibular inter-canine width by 2.39 mm ± 1.32 mm (95% CI: 1.91–2.87,
P
< 0.001). Maxillary second primary molar buccal cusp width increased by 1.67 mm
±
0.85 mm (95% CI: 1.36–1.98,
P
< 0.001), and mandibular counterpart by 1.26 mm
±
1.11 mm (95% CI: 0.85–1.67,
P
< 0.001). At the alveolar bone level, maxillary alveolar crest width increased by 1.39 mm ± 1.09 mm (95% CI: 0.99–1.79,
P
< 0.001), whereas mandibular alveolar crest width showed a minimal increase of 0.38 mm ± 0.75 mm (95% CI: 0.10–0.66,
P
= 0.008). No significant changes were observed in apical basal bone width in either arch.
The findings suggest that CEA may expand maxillary and mandibular arches in mixed dentition children with maxillary transverse deficiency. The maxillary expansion effect primarily involves dental movement and adaptive dentoalveolar change, without significant deep basal bone changes. In the mandible, significant dental expansion was observed at the cusp level, while the alveolar bone changes were minimal and should be interpreted cautiously. These findings provide preliminary CBCT-based evidence for the transverse expansion effects of CEA in mixed dentition children.
Not applicable. This is a retrospective, anonymous observational study without prospective intervention or a clinical trial protocol.
Orthodontically induced external root resorption (OIERR) is a recognized adverse effect of orthodontic treatment. Limited literature exists that reported on volumetric root changes in anterior open bite patients treated with clear aligners. This study aimed to evaluate three-dimensional volumetric changes in anterior teeth roots using cone-beam computed tomography (CBCT) in open-bite patients treated with clear aligners. Fifty CBCT scans [pre-treatment (T1) and post-treatment (T2)] obtained from 25 adult patients (11 males,14 females; mean age: 32.67 ± 10.67 years) with anterior open bite (1–4 mm) treated using clear aligners were retrospectively analyzed. Semi-automated segmentation of the twelve anterior teeth was performed using Blue Sky Plan software, followed by three-dimensional superimposition in 3-matic software. A reference line at the cementoenamel junction was used to trim the crown, and root volumes were measured at both time points. Percentage changes in root volume between pre-treatment and post-treatment were calculated. The level of significance was set at p ≤ 0.05. Skeletal and dental parameters were assessed before and after treatment. The reproducibility of the measurements was assessed using the intraclass correlation coefficient (ICC). Both intra-examiner and inter-examiner reliability were excellent (ICC: 0.90–0.94 and 0.92–0.96, respectively; p < 0.001). All anterior teeth demonstrated significant reduction in root volume. Maxillary canines showed the greatest percentage decrease (− 6.33 ± 2.58%), followed by the central (− 5.91 ± 4.93%) and lateral incisors (− 5.50 ± 3.24%). Mandibular canines again showed the largest reduction (− 6.75 ± 2.33%), followed by lateral (− 5.58 ± 3.20%) and central incisors (− 4.86 ± 2.54%). Males exhibited significantly greater root volume reduction across all anterior teeth (p < 0.05), while no significant correlation was found with age. Patients with anterior open bite who were treated with clear aligners showed mild root volume reduction in all anterior teeth with canines being most affected. This reduction is generally considered to be clinically insignificant. Male patients showed greater volumetric reduction, whereas age and magnitude of incisor movement were not significantly correlated with root volume changes.
Dina Elfouly, Esraa A Elnadoury, Tarek El-Bialy· BMC Oral Health· 0 citations
Background: Orthodontic appliances influence plaque accumulation and periodontal health. Fixed orthodontic appliances often hinder effective oral hygiene, whereas clear aligners are removable and may facilitate better plaque control.Aim: To compare periodontal health outcomes in patients undergoing orthodontic treatment with fixed appliances and clear aligners.Materials and Methods: A cross‑sectional questionnaire‑based study (16 questions) was conducted over 6–9 months among 364 orthodontic patients. Participants were categorized into two groups: fixed appliance therapy (n=227) and clear aligner therapy (n=137). Parameters assessed included gingival bleeding, gingival swelling, halitosis, gingival recession, oral hygiene compliance, and patient‑perceived gum health outcomes. Data were analyzed using descriptive statistics and Chi‑square test using SPSS version 25.0. A p‑value <0.05 was considered statistically significant.Results: Among the participants, 227 (62.4%) were treated with fixed appliances and 137 (37.6%) with clear aligners. Patients treated with fixed appliances reported significantly higher gingival bleeding, swelling, halitosis, and gingival recession. Oral hygiene compliance and perceived improvement in gum health were higher among aligner patients.Conclusion: Clear aligner therapy demonstrated comparatively better periodontal health outcomes than fixed orthodontic appliances, possibly due to improved accessibility for oral hygiene maintenance.Keywords: Clear aligners, Fixed orthodontic appliances, Periodontal health, Orthodontic treatment, Oral hygiene
Sumedha Srivastava, Veena Kalburgi, Jitendra Jasutkar et al.· University Journal of Dental...· 0 citations
To evaluate the predictability of orthodontic tooth movement using different clear aligner brands through a
secondary-data synthesis of published clinical evidence available up to 2025. A secondary-data-based comparative
clinical evidence study was conducted using published clinical studies and systematic reviews that evaluated
planned versus achieved orthodontic tooth movement with clear aligners. The main multi-brand dataset was
extracted from a 2025 longitudinal clinical study comparing Angel Aligners, Invisalign, Spark, and HeySmile in
adult patients requiring dentoalveolar expansion. Additional movement-specific data were extracted from published
studies on Invisalign and other clear aligner systems. Predictability was defined as the percentage of clinically
achieved movement relative to planned digital movement.
In the 2025 multi-brand adult expansion study, Angel Aligner showed the highest overall predictability at 60.002%,
followed by HeySmile 59.895%, Spark 59.275%, and Invisalign 57.153%. Lower-arch expansion was more
predictable than upper-arch expansion. Tooth-group analysis showed the highest predictability for second bicuspids,
followed by first bicuspids, first molars, and canines. Earlier Invisalign evidence reported mean overall tooth
movement accuracy of 41% in 2009 and approximately 50% in 2020. Extrusion, canine rotation, premolar
derotation, torque, and mandibular incisor intrusion were among the least predictable movements, whereas molar
distalization and selected transverse expansion movements showed comparatively higher predictability.
Clear aligner predictability remains moderate and varies according to aligner brand, arch, tooth group, and
movement type. Brand-level differences were observed for dentoalveolar expansion, although the evidence is
stronger for Invisalign than for newer aligner systems. Clinicians should apply overcorrection, optimized
attachments, careful staging, auxiliaries, and refinement planning for less predictable movements.
Shwetali B Jadhav, Vrushank Prabhuraj Panure, M. Jadhav et al.· International Journal of Dru...· 0 citations
