Proceed with Caution: Indications and Contraindications for Clear Aligner Treatment

Invisible orthodontics, as one of the most popular orthodontic methods today, is favored by many orthodontic patients for its aesthetic appeal, comfort, removability, and inconspicuousness. In this age of information explosion, numerous celebrities and internet influencers have praised it on various online platforms and social media, giving it an exceptionally high level of popularity.

Today, we have invited Dr. Zhou Xianghong, Director of the Department of Stomatology at Longtan Lake Outpatient Clinic, a member of the China Britain Medical and Dental Association, a member of the World Micro-implant Anchorage(WMIA), and a certified lecturer at Clickalign, to continue elucidating the indications and contraindications for clear aligner treatment.

Indications

1. 1.       Simple Case Scenarios

Cases suitable for treatment include but are not limited to:

Adult patients with sufficient clinical crown height and minor diastema closure (<4mm).

Mildly crowded dental arches (<4mm).

Treatment of 2-4mm buccal expansion.

Treatment involving rotation of incisors with sufficient space.

Cases where extraction of mandibular incisors relieves crowding or mild crossbite of individual teeth.

Mild dental crossbite cases.

Cases of mild overbite without the need for extractions.

Deep overbite cases (Ⅰ°).

2. Complex Case Scenarios

Root-controlled tooth movement (>2mm).

Moderate to severe dental arch crowding (>5mm).

Treatment with posterior distalization exceeding 4mm.

Treatment requiring intermaxillary traction.

Cases with poor periodontal conditions, accompanied by moderate to severe periodontal disease.

Adolescent cases with sufficient eruption height of dental crowns but poor compliance.

Cases of mild anterior open bite requiring anterior tooth retraction without extractions.

Cases of moderate anterior open bite requiring anterior tooth retraction with extractions.

Deep overbite cases (Ⅱ°).

Multidisciplinary treatment.

Individual posterior extrusion.

Cases Not Recommended for Clear Aligner Treatment

Severe dental arch crowding.

Insufficient clinical crown height.

Certain cases requiring tooth extraction.

Severely inclined teeth.

Complete rotation of cylindrical teeth, with obvious sagittal relationship abnormalities.

Severe periodontal disease (bone resorption to one-third of root length).

Active periodontal disease/active caries or TMJ disorders.

Root resorption/root adhesion.

Multiple posterior tooth loss (insufficient anchorage).

Patients with allergies.