CLINICAL INDICATIONS AND EFFECTIVE APPROACHES FOR CLEAR ALIGNER TREATMENT IN GROWING PATIENTS

Ege Berber1 Hande Pamukçu2

1Başkent University, Faculty of Dentistry, Department of Orthodontics, Ankara, Türkiye
2Başkent University, Faculty of Dentistry, Department of Orthodontics, Ankara, Türkiye

Berber E, Pamukçu H. Clinical Indications and Effective Approaches for Clear Aligner Treatment in Growing Patients. In: Hancıoğlu Kırcelli B, editor. What We Know About Clear Aligners 1st ed. Ankara: Türkiye Klinikleri; 2025. p.105-114.

ABSTRACT

The goal of Phase I orthodontic treatment is to intercept and correct malocclusions early, prior to the eruption of permanent teeth, thus minimizing the need for future treatment and reducing overall treatment duration. Clear aligners can serve as an alternative to conventional methods in early orthodontic treatment when cases are selected appropriately. Clear aligner treatment provides notable advantages, including enhanced aesthetics, patient comfort, and improved oral hygiene, making it particularly suitable for young patients who may struggle with conventional orthodontic appliances. Clear aligners can effectively address most malocclusions, also support guided development and expansion of the dental arches. In addition, clear aligners also provide a valuable treatment alternative for patients requiring functional therapy. Furthermore, the transparent and removable characteristics of aligners allow patients in the growth phase to maintain normal dietary habits without restrictions, making them easier to incorporate into daily routines. By solving malocclusions during the growth phase, aligner treatment can contribute to improved facial aesthetics and functional outcomes, thereby reducing the need for extensive treatment in permanent dentition.

Keywords: Orthodontic appliances-removable; Orthodontic appliances-functional; Palatal expansion technique; Orthodontics

Referanslar

  1. Kim TW, Öztürk Ortan Y. Clear aligner appliances: fabrication and clinical application. Turk J Orthod. 2009;22(3):256-66.
  2. Joffe L. Invisalign®: Early experiences. J Orthod. 2003;30(4):348-352. [Crossref]  [PubMed]
  3. Blevins R. Phase I orthodontic treatment using Invisalign First. J Clin Orthod. 2019;53(2):73-83.
  4. Staderini E, Patini R, Meuli S, Camodeca A, Guglielmi F, Gallenzi P. Indication of clear aligners in the early treatment of anterior crossbite: a case series. Dental Press J Orthod. 2020;25(4):33-43. [Crossref]  [PubMed]  [PMC]
  5. Lione R, Lombardo EC, Paoloni V, Meuli S, Pavoni,C, Cozza P. Upper arch dimensional changes with clear aligners in the early mixed dentition: A prospective study. J Orofac Orthop. 2023;84(1):33-40. [Crossref]  [PubMed]
  6. Levrini L, Carganico A, Abbate L. Maxillary expansion with clear aligners in the mixed dentition: A preliminary study with Invisalign® First system. Eur J Paediatr Dent. 2021;22(2):125-128. [Crossref]  [PubMed]
  7. Favero R, Volpato A, Favero L. Managing early orthodontic treatment with clear aligners. J Clin Orthod. 2018;52(12):701709.
  8. Palma S, Zafra JL. Aligner Techniques in Orthodontics. 1st ed. United States of America: John Wiley & Sons; 2021. p. 250-275. [Crossref]  [PubMed]
  9. Pamukçu H, Özsoy S, Aksoy PC, Polat Özsoy Ö. Evaluation of maxillary dimensional changes in the mixed dentition: clear aligners vs acrylic expanders. Angle Orthod. 2024;94(4):392-399. [Crossref]  [PubMed]  [PMC]
  10. Gonçalves A, Ayache S, Monteiro F, Silva FS, Pinho T. Efficiency of Invisalign First® to promote expansion movement in mixed dentition: a retrospective study and systematic review. Eur J Paediatr Dent. 2023;9;24(2):112-123. [Crossref]  [PubMed]
  11. Wang J, Bukhari A, Tai SK, Zou B. Dimensional changes in the palate associated with Invisalign First System: a pilot study. Angle Orthod. 2023;93(5):524-530. [Crossref]  [PubMed]  [PMC]
  12. Lu L, Zhang L, Li C, Yi F, Lei L, Lu Y. Treatment effects after maxillary expansion using invisalign first system vs. acrylic splint expander in mixed dentition: a prospective cohort study. BMC Oral Health. 2023;23(1):598. [Crossref]  [PubMed]  [PMC]
  13. Lombardo EC, Paoloni V, Fanelli S, Pavoni C, Gazzani F, Cozza P. Evaluation of the Upper Arch Morphological Changes after Two Different Protocols of Expansion in Early Mixed Dentition: Rapid Maxillary Expansion and Invisalign® First System Life. 2022;12(9):1323. [Crossref]  [PubMed]  [PMC]
  14. He J, Hu L, Yuan Y, et al. Comparison between clear aligners and twin-block in treating class II malocclusion in children: a retrospective study. J Clin Pediatr Dent.2024;48(5):125-130. [Crossref]  [PubMed]
  15. Lombardo EC, Lione R, Franchi L, et al. Dentoskeletal effects of clear aligner vs twin block-a short-term study of functional appliances. J Orofac Orthop. 2024;85(5):317-326. [Crossref]  [PubMed]  [PMC]
  16. Ravera S, Castroflorio T, Galati F, et al. Short term dentoskeletal effects of mandibular advancement clear aligners in Class II growing patients. A prospective controlled study according to STROBE Guidelines. Eur J Paediatr Dent. 2021;22(2):119-124. [Crossref]  [PubMed]
  17. Zybutz T, Drummond R, Lekic M, Brownlee M. Investigation and comparison of patient experiences with removable functional appliances. Angle Orthod. 2021;91(4):490-495. [Crossref]  [PubMed]  [PMC]
  18. Sabouni W, Hansa I, Al Ali SM, Adel SM, Vaid N. Invisalign treatment with mandibular advancement: A retrospective cohort cephalometric appraisal. J Clin ImagingSci. 2022;12:42. [Crossref]  [PubMed]
  19. Hosseini HR, Ngan P, Tai SK, Andrews LJ 2nd, Xiang J. A comparison of skeletal and dental changes in patients with a Class II relationship treated with clear aligner mandibular advancement and Herbst appliance followed by comprehensive orthodontic treatment. Am J Orthod Dentofacial Orthop. 2024;165(2):205-219. [Crossref]  [PubMed]
  20. Wu Y, Yu Q, Xia Y, et al. Does mandibular advancement with clear aligners have the same skeletal and dentoalveolar effects as traditional functional appliances?. BMC Oral Health. 2023;23(1):65. [Crossref]  [PubMed]  [PMC]
  21. Gurgel ML, de Oliveira Ruellas AC, Bianchi J, et al. Clear aligner mandibular advancement in growing patients with Class II malocclusion. AJO DO Clin Companion. 2023;3(2):93-109. [Crossref]  [PubMed]  [PMC]
  22. Caruso S, Nota A, Caruso S, Severino M, Gatto R, Meuli S, et al. Mandibular advancement with clear aligners in the treatment of skeletal Class II. A retrospective controlled study. Eur J Paediatr Dent. 2021;22(1):26-30. [Crossref]  [PubMed]  [PMC]
  23. Yue Z, Yi Z, Liu X, et al. Comparison of invisalign mandibular advancement and twin-block on upper airway and hyoid bone position improvements for skeletal class II children: a retrospective study. BMC Oral Health. 2023;23(1):661. [Crossref]  [PubMed]  [PMC]
  24. Uzuner FD, Sipahi D. Şeffaf plaklarla molar distalizasyonu. Turkiye Klinikleri Orthodontics-Special Topics. 2022;8(1):57-63.
  25. Liu X, Cheng Y, Qin W, et al. Effects of upper-molar distalization using clear aligners in combination with Class II elastics: a three-dimensional finite element analysis. BMC Oral Health. 2022;22(1):546. [Crossref]  [PubMed]  [PMC]
  26. Rossini G, Parrini S, Deregibus A, Castroflorio T. Controlling orthodontic tooth movement with clear aligners. J Aligner Orthod. 2017;1(1):7-20. [Crossref]  [PubMed]  [PMC]
  27. Caruso S, Nota A, Ehsani S, Maddalone E, Ojima K, Tecco S. Impact of molar teeth distalization with clear aligners on occlusal vertical dimension: a retrospective study. BMC Oral Health. 2019;19(1):182. [Crossref]  [PubMed]  [PMC]
  28. Saif BS, Pan F, Mou Q, Han M, Bu W, Zhao J, et al. Efficiency evaluation of maxillary molar distalization using Invisalign based on palatal rugae registration. Am J Orthod Dentofacial Orthop. 2022;161(4):e372-e379. [Crossref]  [PubMed]
  29. Taffarel IA, Gasparello GG, Mota-Júnior SL, Pithon MM, Taffarel IP, Meira TM, Tanaka OM. Distalization of maxillary molars with Invisalign aligners in nonextraction patients with Class II malocclusion. Am J Orthod Dentofacial Orthop. 2022;162(4):e176-e182. [Crossref]  [PubMed]
  30. Elfouly D, El-Harouni NM, Ismail HA, El-Bialy T, Ghoneima A. Tip, torque and rotation of maxillary molars during distalization using Invisalign: a CBCT study. BMC Oral Health. 2024;24(1):797. [Crossref]  [PubMed]  [PMC]