Evaluation of Tooth Movement Accuracy with Aligners: A Prospective Study

Background. Clear aligners treatment (CAT) is a common solution in orthodontics to treat both simple and complex malocclusions. This study aimed to evaluate the predictability of CAT, comparing the virtually planned and the achieved tooth movement at the end of stage 15, which is often the time of first refinement. Methods. Seventeen patients (mean age: 28.3 years) were enrolled in the study. Torque, tip and rotation were analyzed in 238 maxillary teeth on digital models at Pre-treatment (T0), at the end of stage 15 (T15) and at virtually planned stage 15 (T15i). Prescription, Achieved movement and performance values were calculated to compare the virtually planned and the clinical tooth position. Data were analyzed by means of Student's t test with a level of significance set at p < 0.05. Results. The largest iper-performance was the torque correction of the second molars (+2.3 degrees +/- 3.1 degrees), the greatest under-performance was the tip correction of the first molars (-2.3 degrees +/- 3.3 degrees), while rotation corrections of all the teeth showed more accurate performance. No significant differences were found between mean Prescription and mean Achieved movement for all the assessed movements (p < 0.05). Conclusions. An accurate evaluation of CAT after the 15th aligner is fundamental in order to individuate the movements that are not matching the digital set-up.