Scoping Review—The Effectiveness of Clear Aligners in the Management of Anterior Open Bite in Adult Patients

<i>Background and Objectives</i>: Anterior open-bite malocclusion remains a challenging orthodontic condition where achieving a positive overbite necessitates precise control of incisor extrusion and molar intrusion. With recent advances in clear aligner therapy—improved materials, attac...

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Main Authors: Nicolae Daniel Olteanu, Cristian Romanec, Eduard Radu Cernei, Nikolaos Karvelas, Livia Nastri, Irina Nicoleta Zetu
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/6/1113
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author Nicolae Daniel Olteanu
Cristian Romanec
Eduard Radu Cernei
Nikolaos Karvelas
Livia Nastri
Irina Nicoleta Zetu
author_facet Nicolae Daniel Olteanu
Cristian Romanec
Eduard Radu Cernei
Nikolaos Karvelas
Livia Nastri
Irina Nicoleta Zetu
author_sort Nicolae Daniel Olteanu
collection DOAJ
description <i>Background and Objectives</i>: Anterior open-bite malocclusion remains a challenging orthodontic condition where achieving a positive overbite necessitates precise control of incisor extrusion and molar intrusion. With recent advances in clear aligner therapy—improved materials, attachment techniques and digital treatment planning—the potential for non-invasive treatment has increased. This scoping review systematically maps the evidence on the efficacy of clear aligners in treating anterior open bite among adult patients, outlines treatment protocols and highlights gaps in the literature. <i>Materials and Methods</i>: A systematic search was conducted in PubMed/Medline, Embase/ScienceDirect and Clarivate/Web of Science for literature published in English between January 2000 and December 2024. Studies involving adult patients treated with clear aligners (predominantly Invisalign<sup>®</sup>) were included. A two-step screening process was applied, and data were charted according to pre-specified criteria. The review adheres to the PRISMA-ScR checklist guidelines. <i>Results</i>: From an initial pool of 802 articles, 30 met the inclusion criteria following duplicate removal and full-text screening. The evidence suggests that clear aligners can achieve measurable incisor extrusion and posterior intrusion when appropriate auxiliary techniques (e.g., attachments and mini screws) are used. However, digital treatment planning software may overestimate movement predictions, necessitating iterative refinement phases. Patient compliance, clinician expertise and technological limitations are key factors influencing outcomes. <i>Conclusions</i>: Clear aligner therapy represents a promising alternative to fixed appliances for anterior open-bite correction in adults, although challenges remain in achieving precise vertical control. Further high-quality randomized controlled trials and standardized outcome measures are needed to confirm long-term stability and efficacy.
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spelling doaj-art-b33fff652dfc4a14935e7c85ad3aa8b52025-08-20T02:20:58ZengMDPI AGMedicina1010-660X1648-91442025-06-01616111310.3390/medicina61061113Scoping Review—The Effectiveness of Clear Aligners in the Management of Anterior Open Bite in Adult PatientsNicolae Daniel Olteanu0Cristian Romanec1Eduard Radu Cernei2Nikolaos Karvelas3Livia Nastri4Irina Nicoleta Zetu5Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy from Iasi, 16 Universitatii Str., 700115 Iasi, RomaniaDepartment of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy from Iasi, 16 Universitatii Str., 700115 Iasi, RomaniaDepartment of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy from Iasi, 16 Universitatii Str., 700115 Iasi, RomaniaDepartment of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy from Iasi, 16 Universitatii Str., 700115 Iasi, RomaniaMultidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80138 Naples, ItalyDepartment of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy from Iasi, 16 Universitatii Str., 700115 Iasi, Romania<i>Background and Objectives</i>: Anterior open-bite malocclusion remains a challenging orthodontic condition where achieving a positive overbite necessitates precise control of incisor extrusion and molar intrusion. With recent advances in clear aligner therapy—improved materials, attachment techniques and digital treatment planning—the potential for non-invasive treatment has increased. This scoping review systematically maps the evidence on the efficacy of clear aligners in treating anterior open bite among adult patients, outlines treatment protocols and highlights gaps in the literature. <i>Materials and Methods</i>: A systematic search was conducted in PubMed/Medline, Embase/ScienceDirect and Clarivate/Web of Science for literature published in English between January 2000 and December 2024. Studies involving adult patients treated with clear aligners (predominantly Invisalign<sup>®</sup>) were included. A two-step screening process was applied, and data were charted according to pre-specified criteria. The review adheres to the PRISMA-ScR checklist guidelines. <i>Results</i>: From an initial pool of 802 articles, 30 met the inclusion criteria following duplicate removal and full-text screening. The evidence suggests that clear aligners can achieve measurable incisor extrusion and posterior intrusion when appropriate auxiliary techniques (e.g., attachments and mini screws) are used. However, digital treatment planning software may overestimate movement predictions, necessitating iterative refinement phases. Patient compliance, clinician expertise and technological limitations are key factors influencing outcomes. <i>Conclusions</i>: Clear aligner therapy represents a promising alternative to fixed appliances for anterior open-bite correction in adults, although challenges remain in achieving precise vertical control. Further high-quality randomized controlled trials and standardized outcome measures are needed to confirm long-term stability and efficacy.https://www.mdpi.com/1648-9144/61/6/1113clear alignerInvisalign<sup>®</sup>anterior open biteanterior extrusionposterior intrusionmalocclusion
spellingShingle Nicolae Daniel Olteanu
Cristian Romanec
Eduard Radu Cernei
Nikolaos Karvelas
Livia Nastri
Irina Nicoleta Zetu
Scoping Review—The Effectiveness of Clear Aligners in the Management of Anterior Open Bite in Adult Patients
Medicina
clear aligner
Invisalign<sup>®</sup>
anterior open bite
anterior extrusion
posterior intrusion
malocclusion
title Scoping Review—The Effectiveness of Clear Aligners in the Management of Anterior Open Bite in Adult Patients
title_full Scoping Review—The Effectiveness of Clear Aligners in the Management of Anterior Open Bite in Adult Patients
title_fullStr Scoping Review—The Effectiveness of Clear Aligners in the Management of Anterior Open Bite in Adult Patients
title_full_unstemmed Scoping Review—The Effectiveness of Clear Aligners in the Management of Anterior Open Bite in Adult Patients
title_short Scoping Review—The Effectiveness of Clear Aligners in the Management of Anterior Open Bite in Adult Patients
title_sort scoping review the effectiveness of clear aligners in the management of anterior open bite in adult patients
topic clear aligner
Invisalign<sup>®</sup>
anterior open bite
anterior extrusion
posterior intrusion
malocclusion
url https://www.mdpi.com/1648-9144/61/6/1113
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