Scoping Review Finds Mixed-Dentition Aligners Predictable Only by Case

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Posted: July 10, 2026

Scoping Review Finds Mixed-Dentition Aligners Predictable Only by Case

Edited by Orthotown staff

A scoping review of clear aligner therapy in children ages 6 to 13 concludes that predictability in mixed dentition depends heavily on the specific indication, type of tooth movement, anatomical region, and growth stage, rather than holding uniformly across early treatment. The review was published July 4, 2026, in the Journal of the World Federation of Orthodontists.

The authors included 59 studies — 8 randomized controlled trials, 11 prospective cohorts, 38 retrospective cohorts, and 2 cross-sectional studies—most involving children ages 7 to 12. They charted performance by indication rather than issuing a single verdict on early aligner treatment.

Several patterns emerged. Transverse dentoalveolar expansion achieved with aligners fell short of what was planned, particularly in posterior regions and at gingival levels. Comparative studies suggested that rapid maxillary expansion produced greater posterior and palatal change. Mandibular advancement aligners were associated with Class II sagittal improvement, with responses varying by skeletal maturity and dentoskeletal pattern.

The review also mapped where evidence is thin. Data were limited for incisor correction, molar movement, vertical outcomes, airway, oral health, patient-reported outcomes, and smile aesthetics.

The authors concluded that clear aligners in mixed dentition show indication-dependent predictability shaped by movement type, anatomical region, and growth stage, and that clinical confidence remains constrained by a heavy reliance on retrospective evidence, heterogeneous outcome measures, and insufficient standardized reporting of post-treatment stability.

As a scoping review, the study maps the evidence base rather than grading treatment effects. It was conducted by K. Sipiyaruk, R. Chintavalakorn, and T. Nakornnoi of the Faculty of Dentistry, Mahidol University, Bangkok.

Sources:
Journal of the World Federation of Orthodontists, Clear aligner therapy for early orthodontic treatment in children aged 6-13 years: A scoping review of clinical performance and evidence gaps, July 4, 2026 (PMID 42401484): sciencedirect.com/science/article/pii/S2212443826000421


Scoping Review Finds Mixed-Dentition Aligners Predictable Only by Case

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