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An already powerful dental technology continues to grow in sophistication

According to Dr Carlos Colino, clear aligner technology has evolved significantly since its introduction, with advancements in materials, digitalisation and artificial intelligence making orthodontic treatment more precise, personalised and accessible. (Image: wedmoments.stock/Shutterstock)

Wed. 16 April 2025

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The technology of clear aligners has revolutionised modern orthodontics, offering an aesthetic and comfortable alternative to fixed appliances. Since its introduction in 1999, advancements in materials, digitalisation and simulation have made this technique more precise, accessible and effective. Furthermore, the evolution of aligners has helped reduce the number of in-person appointments required for treatment and encouraged the integration of remote work into orthodontic practice.

The history of aligners began in 1945 with the dental positioner created by Herald Dean Kesling. This removable device introduced the practice of achieving precise and controlled tooth movement and could be used by patients comfortably at home. In 1971, Robert John Ponitz developed transparent retainers. In 1993, John Sheridan introduced new concepts for aligner treatment, as did other leaders in this field. However, the significant breakthrough came in 1999 with the creation of Invisalign, developed by Align Technology in the US, revolutionising orthodontics with its technology and design. By 2001, Invisalign expanded into Europe and experienced exponential growth.1, 2 Today, there are many high-quality aligner brands, such as Angel Aligner, Spark and ClearCorrect.

Advancements in digitalisation and personalisation

In the 2000s, advancements in digitalisation, such as the use of CAD/CAM, allowed orthodontists to replace physical impression taking with intra-oral scanning, improving the precision and speed of producing custom aligners. The introduction of 3D printing further accelerated this process, reducing production time and the need for in-person appointments. In 2020, the South Korean company Graphy developed photopolymer resins like TC-85DAC that allow aligners to be printed directly, eliminating the need for dental models and improving treatment efficiency and personalisation.3

“The incorporation of AI, especially in aligner therapy, has been a significant change in modern orthodontics.”

Improvements in materials and biomechanical control

Initially, aligners were made from rigid plastics like PET, which, although functional, did not offer the necessary flexibility and comfort for patients. Over time, polyurethane co-polymers were adopted, providing greater elasticity and resilience and therefore allowing for more consistent and gentle forces to move teeth more precisely. Since 2010, the introduction of photopolymerisable materials allowed for even more precise personalisation and improved accuracy in 3D printing, eliminating the need for dental moulds. These materials were more resistant to wear and thus offered greater durability.

Today, aligners are made from high-strength materials that combine elasticity, biocompatibility and greater transparency, improving both the effectiveness of treatment and the patient experience. These advancements have allowed for faster, more personalised treatments in fewer visits to the orthodontist.4

The advanced digital era: Artificial intelligence and remote work

The incorporation of artificial intelligence (AI), especially in aligner therapy, has been a significant change in modern orthodontics. AI has reduced the number of physical appointments by allowing orthodontists to monitor treatment progress remotely. Orthodontists can track patients’ progress, make virtual adjustments and detect issues early, all without the need for frequent visits to the clinic. Additionally, teledentistry has allowed orthodontists to manage multiple cases remotely, optimising their time and reducing in-person visits. This approach has been especially helpful for patients with busy schedules or those living far from the clinic because they can follow their treatment from the comfort of their own homes.

The technology of aligners has transformed orthodontics, enhancing the precision and comfort of treatments. Advances in digitalisation, such as CAD/CAM technologies, including 3D printing, have allowed for faster and more accurate production of custom aligners, reducing the need for physical moulds. Materials have evolved to offer greater elasticity and strength. Moreover, the integration of AI has enabled remote monitoring, optimising treatment time and reducing in-person visits. These advancements have made orthodontic treatment more accessible and convenient for both patients and orthodontists, as well as improved treatment quality and the overall experience.

Editorial note:

This article was published in today at IDS March 28, 2025. The list of references can be found here.

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