Class II correction using clear aligners: a scoping review
Abstract
Introduction
The increase in popularity and demand for clear aligner therapy (CAT) has resulted in the recent use of this modality to treat more complex orthodontic cases.
Aim
This scoping review aims to collate CAT treatment approaches for the correction of Class II malocclusions.
Methods
Six databases along with grey literature sources were searched using key terms related to “Class II malocclusions” and “clear aligners.” Duplicates were removed and two independent reviewers screened the titles and abstracts before data from the included full-text articles was extracted into a structured recording form. The data were summarised narratively.
Results
The search yielded 2271 studies of which 123 were suitable for full-text review and a total of 59 studies were subsequently included in the present final review. In growing individuals, a combination of CAT with or without mandibular advancement (MA) components and/or elastics was assessed. For non-growing individuals, sequential distalisation and general alignment of the arches (with or without elastics) were common treatment approaches. The benefits of CAT for Class II correction were noted to be concurrent alignment plus good incisor and vertical control. The limitations reported within growing individuals were the difficulty in adjusting to and engaging the precision wings of the MA component, and a resulting open bite (either posterior or lateral). In non-growing individuals, poor predictability and efficacy of tooth movement were noted.
Conclusions/clinical implications
Clear aligner therapy may overcome common pitfalls during Class II correction as it provides solid incisor and vertical control during therapeutic management. However, the poor predictability of tooth movement as well as a reliance on compliance may limit aligner utilisation. Further research into the predictability of CAT for the treatment of Class II malocclusions in growing populations is indicated.
© 2025 Leah M. Sidhu, Sven W.C. Jensen, Emilija D. Jensen, published by Australian Society of Orthodontists Inc.
This work is licensed under the Creative Commons Attribution 4.0 License.