Purpose: This review systematically collects the investigations on clear aligners (CA) by finite element analysis (FEA), and summarizes the biomechanical mechanism of CA including typical side effects and reformative designs of CA and auxiliary.
Methods: Literatures on FEA biomechanical analysis of CA are searched on Web of Science and PubMed. The information of FEA methods and results, FEA-simulated orthodontic clinical scenarios are collected and discussed in categories.
Results: Twenty-nine literatures are included. FEA are conducted with ABAQUS (13/29) or Ansys (13/29), while the data presentation forms are various without clear consensus. FEA-simulated orthodontic clinical scenarios are discussed by main targeted orthodontic directions.
Conclusions: Side effects of CA treatment are essentially caused by uneven stress distribution. Auxiliaries (including attachments, power ridges, intermaxillary elastics, divots etc.) are designed to adjust orthodontic biomechanics and stress distribution to improve therapeutic efficiency. Limitations of current researches include lack of unified standard for FEA protocols and data presentation forms, and lack of long-term biomechanical analysis of CA other than its initial instantaneous effects. FEA, as an efficient way of analyzing biomechanics of CA, deserves more standardized, extensive and in-depth study. This review might provide theoretical basis and reference for optimization of future orthodontic designs.
Keywords: Biomechanics; Clear aligners; Finite element; Orthodontics; Systematic review.
© 2025. The Author(s).