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Efficiency of Invisalign in contemporary orthodontic practice

From Volume 15, Issue 1, January 2022 | Pages 13-17


Cara Sandler

DCT1, Maxillofacial Surgery, Royal Sussex County Hospital, Brighton, UK

Articles by Cara Sandler

Jonathan Sandler

BDS (Hons), MSc, PhD, MOrth RCS, FDS RCPS, BDS(Hons), MSc, PhD, FDSRCPS, MOrth RCS, Consultant Orthodontist, , DOrth RCS

Consultant Orthodontist, Chesterfield Royal Hospital, Chesterfield, UK

Articles by Jonathan Sandler

Email Jonathan Sandler


The demand for clear aligners continues to grow. Their use is no longer exclusive to adults, because aligners are also now popular among younger patients as well. In the literature, there is an emphasis on cases of mild to moderate severity, which have usually been treated on a non-extraction basis, perhaps owing to the difficulty in managing space closure or a challenging tooth movement, such as derotation. The article highlights appropriate case selection in clinical orthodontic practice, and the key role that Invisalign plays.

CPD/Clinical Relevance: The reader should appreciate the potential of the Invisalign system in managing certain scenarios commonly encountered in clinical orthodontics practice.


Innovation in 3D printing and customization, and the evolution of digital dentistry has led to the development of many clear aligner systems in the last couple of decades. The Invisalign system was originally introduced in 1997 and was subsequently made available to providers in 1999, by Align Technology.1 This has dramatically changed the way we align teeth in an ever-increasing number of cases by providing a comfortable, removable, and almost invisible alternative to conventional fixed orthodontic appliances. Treatment consists of a series of clear aligners that gradually move teeth by carefully planned incremental movements into the desired correct position. This convenience and patient acceptability has led to this method of tooth movement increasingly being the primary treatment of choice for many adults and young patients in modern clinical orthodontic practice.

Although originally prescribed only for the management of mild malocclusions, the efficiency of the Invisalign approach and its clinical potency still remains a controversial point for discussion among treatment providers. The most recent evidence,2 suggests that Invisalign treatment can only be recommended for non-extraction treatment in mild to moderate crowding, among young growing patients. In contrast, it is claimed that aligners have limited efficacy and poor outcome when it comes to closing extraction spaces and/or treating adult patients.3

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