Efficacy and Efficiency of In-House Clear Aligners in Limited Orthodontic Treatment

Abstract

Objective: To evaluate the efficacy and efficiency of in-house digital software and fabrication of clear aligners. Materials and Methods: This retrospective study analysed pre-treatment, predicted and post-treatment digital scans of 61 patients (42 females, 19 males) to assess the accuracy of predicted tooth movements. Planned and final scans were superimposed using best-fit analysis in Geomagic Design X (Hexagon AB, Stockholm, Sweden). Distoincisal (DI), mesioincisal (MI) and gingival zenith (Z) landmarks were measured perpendicularly from the mid-facial aspect, with differences < 0.5 mm deemed clinically acceptable. Data were analysed using repeated-measures ANOVA with logarithmic transformation, and clinically acceptable movements were compared between groups using generalised estimating equations (GEE). Results: When evaluated individually, 91% of mandibular and 95% of maxillary landmarks showed clinically acceptable movement. When all three landmarks per tooth were below the threshold, 84% of mandibular and 88% of maxillary teeth met this criterion. At the case level, 48% of mandibular and 50% of maxillary cases achieved overall clinically acceptable movement. The greatest discrepancies were observed at the Z point on maxillary teeth (p < 0.05). Mandibular canine movements were more predictable than those of mandibular incisors (p < 0.05). Conclusion: In-house aligner planning and fabrication demonstrated effective and efficient outcomes for limited treatment cases. Tooth movement was generally more predictable in the maxilla than in the mandible, with canines showing greater predictability than incisors. Torque movements in the maxilla exhibited the lowest accuracy.