Efficacy of clear aligners in producing molar distalization: Systematic review

Abstract

Objectives: The aim of this review is to systematically analyze the efficacy of molar distalization using clear aligners in non-growing Class II patients. Materials and Methods: A complete search across the electronic database through PubMed, Cochrane, Google scholar, LILACS, and manual search of orthodontic journals were done till 2019. Studies were selected on the basis of PRISMA guidelines. Results: A total of four articles were included in this review. The amount of molar distalization reported was 2–3 mm. Conclusion: Out of the four studies included. In all the studies a significant amount of distalization was reported. Three retrospective studies concluded that distalization with aligners is the most effective of all tooth movements. One study concluded that aligners effectively achieved distalization with an efficacy of 87%, other two studies concluded that aligners effectively distalized the molars with good control over vertical dimension and mesiodistal tipping.

Anchorage Loss Evaluation during Maxillary Molars Distalization Performed by Clear Aligners: A Retrospective Study on 3D Digital Casts

“…Regarding the CAT efficacy in achieving the distalization movement, our results agreed with those of previous studies [1,17,18,24,34,40,41], showing a significant improvement in the sagittal position of first molars, with an average distalization movement of 2.5 mm.…”

“…According to the other studies presented in the literature [1,17,18,24,34,40,41], also in our research, no statistically significant movements were detected at the premolar level. Slight differences were found at the level of the second premolars, attributable to the start of distal movements, as required by the protocol, but nonetheless not significant.…”

“…Recent studies [18,34] evaluated the accuracy of upper-molar bodily distal movement with aligners. Verma and George [34], in their systematic review, reported a significant amount of distalization of nearly 2-3 mm in all the selected studies and suggested this complex movement could be performed using CAT with good control over vertical craniofacial parameters, mesio-distal angulation of molars, and anchorage loss.…”

Three-Dimensional Force Characterizations in Maxillary Molar Distalization: A Finite Element Study

“…Even though treatment with a clear aligner is shorter than that with braces, some studies have indicated that the clear aligner may not provide enough occlusion contacts, torque control, and retention [11]. In addition, Verma and George reported the duration of sequential molar distalization with aligners to be excessively long (21 ± 3 months) [12]. The clear aligners can be combined with various types of auxiliaries prior to aligner treatment, such as the Carriere ® Motion 3D (CM3D) by Henry Schein Orthodontics ® (Carlsbad, CA, USA) appliance, to enhance the correction forces [13] and minimize the occupation of the oral cavity, which improves patient comfort and speech compared with conventional appliances such as braces [14].…”