Apical Lingual Bone Thickness Predicted Aligner Intrusion Accuracy in Pilot Study

Posted: September 3, 2026

Apical Lingual Bone Thickness Predicted Aligner Intrusion Accuracy in Pilot Study

Edited by Orthotown staff

Mandibular incisors moved far less into intrusion and far more into proclination than clear aligner treatment plans called for, and apical lingual alveolar bone thickness was independently associated with both outcomes, according to a pilot study published Aug. 27 in BMC Oral Health.

The retrospective exploratory investigation examined 23 patients and 92 mandibular incisors treated with clear aligners, comparing pretreatment cone beam computed tomography measurements of the alveolar bone with the movement actually achieved.

Mean achieved intrusion was 44%, plus or minus 38%, of planned intrusion. Mean proclination reached 124%, plus or minus 106%, of what was planned. The standard deviations approached or exceeded the mean values for both movements, indicating wide variation across the sample between planned and achieved tooth position.

Investigators measured six labial and lingual alveolar bone thickness parameters at the cervical, mid-root, and apical levels. Apical lingual bone thickness showed an independent association with both intrusion accuracy and proclination.

Gingival recession was recorded on 40.2% of the teeth and prominent root contours on 70.7%. The study was not designed to establish that aligner treatment caused those findings.

Zichao Xiang, Mingyue Yu, Lu Zhang, Yanmei Huang, and Xiaoxia Feng conducted the study.

The authors describe a limited cohort and say the findings warrant prospective validation. Receiver operating characteristic analyses produced preliminary dataset-specific patterns rather than thresholds suitable for clinical use.

Sources:
BMC Oral Health, “Apical alveolar bone thickness predicts intrusion accuracy and proclination risk of mandibular incisors in clear aligner therapy: a pilot study,” published Aug. 27, 2026:
link.springer.com/10.1186/s12903-026-09654-z
DOI:
doi.org/10.1186/s12903-026-09654-z

Apical Lingual Bone Thickness Predicted Aligner Intrusion Accuracy in Pilot Study

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