# Efficacy and Efficiency of In‐House Clear Aligners in Limited Orthodontic Treatment

**Authors:** Michael C. Kessler, Joon Han, George J. Eckert, Lana Helms, Jay A. Hughes, Phillip Wong, Carolina Frota, Vinicius Dutra, Hakan Turkkahraman, R. Scott Conley

PMC · DOI: 10.1111/ocr.70066 · 2025-11-24

## TL;DR

This study evaluates how well in-house clear aligners work for limited orthodontic treatments by analyzing tooth movement accuracy in patients.

## Contribution

The study introduces a new method for assessing the accuracy of in-house clear aligner treatments using digital scans and statistical analysis.

## Key findings

- 91% of mandibular and 95% of maxillary landmarks showed clinically acceptable tooth movement.
- Mandibular canines were more predictable than incisors in movement accuracy.
- Maxillary torque movements had the lowest accuracy among all tooth movements.

## Abstract

To evaluate the efficacy and efficiency of in‐house digital software and fabrication of clear aligners.

This retrospective study analysed pre‐treatment, predicted and post‐treatment digital scans of 61 patients (42 females, 19 males) to assess the accuracy of predicted tooth movements. Planned and final scans were superimposed using best‐fit analysis in Geomagic Design X (Hexagon AB, Stockholm, Sweden). Distoincisal (DI), mesioincisal (MI) and gingival zenith (Z) landmarks were measured perpendicularly from the mid‐facial aspect, with differences < 0.5 mm deemed clinically acceptable. Data were analysed using repeated‐measures ANOVA with logarithmic transformation, and clinically acceptable movements were compared between groups using generalised estimating equations (GEE).

When evaluated individually, 91% of mandibular and 95% of maxillary landmarks showed clinically acceptable movement. When all three landmarks per tooth were below the threshold, 84% of mandibular and 88% of maxillary teeth met this criterion. At the case level, 48% of mandibular and 50% of maxillary cases achieved overall clinically acceptable movement. The greatest discrepancies were observed at the Z point on maxillary teeth (p < 0.05). Mandibular canine movements were more predictable than those of mandibular incisors (p < 0.05).

In‐house aligner planning and fabrication demonstrated effective and efficient outcomes for limited treatment cases. Tooth movement was generally more predictable in the maxilla than in the mandible, with canines showing greater predictability than incisors. Torque movements in the maxilla exhibited the lowest accuracy.

## Full-text entities

- **Species:** Canis lupus familiaris (dog, subspecies) [taxon 9615], Homo sapiens (human, species) [taxon 9606]

## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12779182/full.md

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Source: https://tomesphere.com/paper/PMC12779182