journal article·2025-08-18Open access

Comparison of the Predictability of Dentoalveolar Expansion with Different Aligner Systems in Orthodontics: A Longitudinal Clinical Study in Adult Patients

Oscar Suarez, Alfonso Alvarado-Lorenzo, Elena Calzadilla-Suárez, Giuseppe Scuzzo, Jhonny León-Valencia, Carlos Colino-Paniagua, Jose Manuel Granero-Marín, Pedro Colino-Gallardo

Applied Sciences· Volume 15· Issue 16

Abstract

Aligners represent a therapeutic option in orthodontics, offering advantages such as aesthetics, comfort, and individualized prescriptions for each patient. However, the predictability of maxillary expansion is subject to variability. The objective of this article is to evaluate the efficacy and predictability of aligners in maxillary expansion. One hundred adult patients were included in this study, divided into four groups, each assigned to a different brand of clear aligners: Angel Aligners, Invisalign, Spark, or HeySmile. Digital models were obtained at three stages: initial STL (T1), prediction (T2), and final (T3) (before the first refinement). The models were measured to obtain linear distances between canines, first bicuspids, second bicuspids, and first molars. Statistical analysis was performed using SPSS 28.0. The best predictability was obtained in the lower arch (68.900%) for second bicuspids, while the worst accuracy was for canines (39.290% in the upper arch using Invisalign). Angel aligner showed the highest percentage of predictability (60.002%) among the evaluated brands, followed by HeySmile (59.895%), Spark (59.275%), and Invisalign (57.153%). The results show that clear aligners are an effective treatment for transverse movements in both arches. However, further research is needed to improve predictability.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Orthodontics and Dentofacial Orthopedics · dental development and anomalies · Temporomandibular Joint Disorders

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Department of Dentistry, Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain

Department of Surgery, Faculty of Medicine, University of Salamanca, 37008 Salamanca, Spain

Department of Orthodontics, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168 Rome, Italy

References (44)

Show source-provided references
1. The Evolution of Orthodontic Treatment: From Braces to Aligners
2. Aligner biomechanics: Where we are now and where we are heading for?
3. Predictability of orthodontic tooth movement with aligners: Effect of treatment design10.1186/s40510-023-00499-8 ↗
4. Predictability of the deep overbite correction using clear aligners10.1016/j.ajodo.2022.07.019 ↗
5. Lou, T., and Mair, A. (2020). An Historical Overview of Clear Aligner Therapy the Evolution of Clear Aligners, Oral Health Group.
6. Assessment of clear aligner accuracy of 2 clear aligners systems10.1016/j.ajodo.2023.05.028 ↗
7. Orthognathic surgery and aligners. A comparative assessment of periodontal health and quality of life in postsurgical orthodontic treatment with aligners versus traditional fixed appliances: A randomized controlled trial
8. Kurnaz, M., and Dayan, E. (2025). Comparison of the effects of maxillary expansion applying rapid maxillary expanders or clear aligners in mixed dentition: A 3D finite element study. J. Orofac. Orthop., 86.10.1007/s00056-025-00590-1 ↗
9. The predictability of the mandibular curve of Wilson, buccolingual crown inclination, and transverse expansion expression with Invisalign treatment10.1016/j.ajodo.2021.09.020 ↗
10. Mario, P., de Villagomez, S., Federica, P., Cremonini, F., Salvatore, R., and Lombardo, L. (2024). Evaluation of tooth movement accuracy with the F22 aligner system: A retrospective study. Appl. Sci., 14.10.3390/app14041641 ↗
11. D’Antò, V., Rongo, R., Casaburo, S., Martina, S., Petrucci, P., Keraj, K., and Valletta, R. (2024). Predictability of tooth rotations in patients treated with clear aligners. Sci. Rep., 14.10.1038/s41598-024-61594-2 ↗
12. How well does Invisalign ClinCheck predict actual results: A prospective study10.1111/ocr.12752 ↗
13. Rocha, A., Gonçalves, M., Oliveira, A., Azevedo, R., and Pinho, T. (2023). Efficiency and Predictability of Coronal Maxillary Expansion Repercussion with the Aligners System: A Retrospective Study. Dent. J., 11.10.3390/dj11110258 ↗
14. Gallucio, G., De Stefano, A., and Horodynski, M. (2023). Efficacy and Accuracy of Maxillary Arch Expansion with Clear Aligner Treatment. Int. J. Environ. Res. Public Health, 5.10.3390/ijerph20054634 ↗
15. Efficacy of clear aligners vs rapid palatal expanders on palatal volume and surface area in mixed dentition patients: A randomized controlled trial10.1016/j.ajodo.2024.04.006 ↗
16. Is efficacy of miniscrew-assisted rapid palatal expansion in mid to late adolescents and young adults related to craniofacial sutures opening? A systematic review and meta-analysis
17. Loberto, S., Pavoni, C., Fanelli, S., Lugli, L., Cozza, P., and Lione, R. (2024). Predictability of expansion movements performed by clear aligners in mixed dentition in both arches: A retrospective study on digital casts. BMC Oral Health, 24.10.1186/s12903-024-04435-y ↗
18. Effectiveness and predictability of treatment with clear orthodontic aligners: A scoping review10.1016/j.ortho.2023.100755 ↗
19. Predictability of maxillary dentoalveolar expansion with clear aligners in patients with mixed dentition10.4041/kjod24.082 ↗
20. D’Antò, V., Valletta, R., Di Mauro, L., Riccitiello, F., Kirlis, R., and Rongo, R. (2023). The Predictability of Transverse Changes in Patients Treated with Clear Aligners. Materials, 16.10.3390/ma16051910 ↗
21. The predictability of transverse changes with Invisalign10.2319/122115-875.1 ↗
22. How well does Invisalign work? A prospective clinical study evaluating the efficacy of tooth movement with Invisalign10.1016/j.ajodo.2007.05.018 ↗
23. Has Invisalign improved? A prospective follow-up study on the efficacy of tooth movement with Invisalign10.1016/j.ajodo.2019.12.015 ↗
24. The predictability of expansion with invisalign: A retrospective cohort study10.1016/j.ajodo.2021.07.032 ↗
25. Invisalign, an innovative invisible orthodontic appliance to correct malocclusions: Advantages and limitations10.12968/denu.2012.39.4.254 ↗
26. Digital model in orthodontics: Is it really necessary for every treatment procedure? A scoping review
27. Alvarado, A., Antonio, L., Curto, A., Garcovich, D., and Criado, L. (2024). Reproducibility and reliability of dental arch measurements: Comparing of manual, digital, and app-based methods. BMC Oral Health, 24.10.1186/s12903-024-05392-2 ↗
28. Predicted overbite and overjet changes with the invisalign appliance: A validation study10.2319/041323-269.1 ↗
29. Factors affecting expansion predictability of clear aligner treatment10.1007/s00784-025-06328-y ↗
30. How effective is the Invisalign® system in expansion movement with Ex30′ aligners?10.1007/s00784-016-1908-y ↗
31. Inchingolo, A., Ceci, S., Coloccia, G., Azzollini, D., Malcangi, G., Mancini, A., Inchingolo, F., Trerotoli, P., Dipalma, G., and Patano, A. (2023). Predictability and Effectiveness of Nuvola® Aligners in Dentoalveolar Transverse Changes: A Retrospective Study. Biomedicines, 11.10.3390/biomedicines11051366 ↗
32. Li, N., Wang, C., Yang, M., Chen, D., Tang, M., Li, D., Qiu, S., Chen, Q., and Feng, Y. (2024). Effects of different tooth movement patterns and aligner thicknesses on maxillary arch expansion with clear aligners: A three-dimensional finite element study. Front. Bioeng. Biotechnol., 12.10.3389/fbioe.2024.1424319 ↗
33. Macrì, M., Medori, S., and Festa, F. (2025). Evaluation of Maxillary Dentoalveolar Expansion with Clear Aligners: A Retrospective CBCT Study. Diagnostics, 15.10.3390/diagnostics15131586 ↗
34. Efficiency of upper arch expansion with the Invisalign system10.2319/022719-151.1 ↗
35. Ma, S., and Wang, Y. (2023). Clinical outcomes of arch expansion with Invisalign: A systematic review. BMC Oral Health, 23.10.1186/s12903-023-03302-6 ↗
36. Is maxillary arch expansion with Invisalign® efficient and predictable? A systematic review10.1016/j.ortho.2023.100750 ↗
37. Putrino, A., Barbato, E., and Galluccio, G. (2021). Clear aligners: Between evolution and efficiency—A scoping review. Int. J. Environ. Res. Public Health, 18.10.3390/ijerph18062870 ↗
38. Accuracy of clear aligners: A retrospective study of patients who needed refinement10.1016/j.ajodo.2017.11.028 ↗
39. Maxillary arch development with Invisalign system10.2319/080520-687.1 ↗
40. Efficacy and predictability of maxillary and mandibular expansion with the Invisalign® system10.4317/jced.58315 ↗
41. Effectiveness of dental arch expansion in the orthodontic treatment with clear aligners: A scoping review10.1093/ejo/cjae059 ↗
42. Morales-Burruezo, I., Gandía-Franco, J., Cobo, J., Vela-Hernández, A., and Bellot-Arcís, C. (2020). Arch expansion with the Invisalign system: Efficacy and predictability. PLoS ONE, 15.10.1371/journal.pone.0242979 ↗
43. Santucci, V., Rossouw, P., Michelogiannakis, D., El-Baily, T., and Feng, C. (2023). Assessment of Posterior Dentoalveolar Expansion with Invisalign in Adult Patients. Int. J. Environ. Res. Public Health, 20.10.3390/ijerph20054318 ↗
44. Efficiency and predictability of maxillary expansion with Invisalign® system