Damascus, Syria: Clear aligners' efficiency and effectiveness have been extensively studied in mild and moderate malocclusion conditions. However, less emphasis has been paid to evaluating clear aligners in more complex malocclusion situations. A team from Damascus University's dental school conducted a study that will add to the small body of literature on the efficacy of in-office clear aligners against conventional fixed appliances in more complicated occlusion cases.

Clear aligners: Past and Present
Kesling pioneered transparent thermoplastic appliances to move teeth in the early 1940s. Clear aligners have seen tremendous growth since the late 1990s, with the introduction of computer-aided design (CAD)/computer-aided manufacturing (CAM) technology and the Invisalign system by Align Technology, Inc.
Recently, the availability of orthodontic treatment planning software in dental clinics, along with three-dimensional (3D) scanners and a wide range of validated 3D validated printers and printing materials, has encouraged clinicians to manufacture their patients' aligners in-house, i. e., without the need to communicate with CA providers.
Clear aligners have provided patients seeking orthodontic treatment with a highly cosmetic and comfortable alternative to traditional braces, and are thus increasing in popularity, particularly among young adults seeking to fix their smile without the use of braces. Over the last 20 years, clear aligner technology has evolved and is constantly being improved to provide the most predictable tooth movements possible.
Only two prior Randomized Controlled Trials have investigated the CA's effectiveness in the treatment of complicated patients, including premolar extraction, and both employed aligners provided by Invisalign.
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