Clear Aligners in Surgical Orthodontics: Enhancing Outcomes and Facilitating Recovery

Clear aligners have transformed the landscape of orthodontics offering patients an invisible and comfortable way to straighten their teeth. However, their role extends beyond traditional tooth movements. Clear aligners are increasingly being integrated into surgical orthodontics ranging from minor procedures to complex jaw corrections.

This blog explores how clear aligners contribute to surgical orthodontics before, during, and after procedures. While this application falls outside the original intended use of aligners as they are primarily indicated for the treatment of tooth malocclusions they can still potentially aid in surgical orthodontic workflows.

Pre-Surgical Preparation

Clear aligners can be effectively used to prepare the dentition and arches for different surgical procedures including:

• Orthognathic Surgery: Ensuring teeth are in the proper position before jaw repositioning (1).
• Impacted Tooth Exposure: Commonly with canines, it involves creating space for surgical access and guided eruption. (2)
• Surgical extractions and site development: Moving teeth to create space for implants.(3)

In Surgical Class II cases, clear aligners offer several specific pre-surgical advantages:

• Aesthetics & Comfort
  
  
  • Nearly invisible, which improves patient confidence.
    
    
  • No wires or brackets, reducing soft tissue irritation.(7)
    
    
  • Removable, which helps maintain better oral hygiene.
    
    
• Better Orthodontic Preparation
  
  
  • More predictable incisor uprighting.(8)
    
    
  • Better controlled expansion with reduced molar tipping.(9)
    
    
• Seamless Integration with Virtual Surgical Planning (VSP)
  
  
  • Aligners can be digitally mapped to synchronize with planned surgical movements.
    
    
  • Post-surgical aligners can be pre-manufactured for immediate use, supporting quicker transition to the recovery phase.
    

With clear aligners, doctors can benefit from digital treatment planning allowing them to better visualize their surgical goals and the teeth movements needed to achieve them.

Surgical Integration 

While clear aligners are typically removed during surgical procedures, their role remains significant to the overall treatment plan. Their design can be adapted to complement various surgical interventions enhancing treatment efficiency and outcomes.

Integration with Temporary Anchorage Devices (TADs)

‍ Temporary Anchorage Devices (TADs) are small screws placed in the bone to provide stable anchorage points for orthodontic tooth movement. When combined with clear aligners, TADs can help with complex movements that might be challenging with clear aligners alone. (2)

Support in Periodontal and Restorative Procedures

Clear aligners can be effectively integrated into periodontal and restorative treatments. For example: For patients with periodontal issues, aligners can offer a minimally invasive option which allows for better oral hygiene compared to fixed appliances. Also, they can help with tooth repositioning in preparation for restorative procedures, such as implant placement or crown lengthening, by guiding soft tissue and bone remodeling through controlled movements (4)

Post-Surgical Recovery and Stabilization

After surgery, maintaining results is crucial, clear aligners can offer several advantages:

Faster Recovery and Greater Comfort

• With no brackets or wires, aligners cause less irritation to swollen or healing soft tissues.(10)
  
  
• Patients often experience easier adaptation in speech and chewing compared to traditional braces.(10)
  
  More Precise Post-Surgical Finishing Movements
  

• Aligners enable controlled fine-tuning of bite alignment, tooth torque, and vertical positioning.
  
  
• This helps minimize unwanted post-surgical changes—such as excessive incisor proclination—which can occur with less precise systems⁶.
  

Lower Risk of Relapse and Root Resorption

• Aligners apply gentler, more controlled forces, which can reduce the risk of root resorption.(11)
• They also help maintain occlusal stability more effectively during the retention phase compared to fixed appliances⁵.
• Refinement capabilities: they can give room for small adjustments without the need for fixed appliances.(6)
• Improved hygiene: Removable and easy to clean, clear aligners can be an optimal option to help patients maintain oral hygiene especially during recovery. (1)

In addition to these clinical benefits, patients generally appreciate the continued comfort and aesthetics of aligners during the healing phase, which may enhance compliance and overall satisfaction.

Conclusion

Clear aligners are more than just a cosmetic preference, they are proving to be powerful when integrated with surgical orthodontics. By contributing to preparation, integration and recovery, they help provide precise surgical outcomes and a smoother patient experience.