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Is the use of clear aligners a real critical change in oral health prevention and treatment?

ABSTRACT
The introduction, in the late years of the last century, of clear aligners therapy (CAT) has drastically changed the approach' perspective to orthodontic treatment. Both patients and clinicians' expectations appear to be addressed with clear aligner therapy achieving an aesthetic appearance and fewer side effects, mainly due to the difficult maintenance of proper oral hygiene in the conventional fixed approach. Research has partially confirmed these key points of CAT but similarly revealed several limitations to the overall benefit of this treatment. Both the aforementioned key points of the CAT are currently under discussion: the aesthetic appearance is not uniform, due to the presence in some cases of extensive need for attachments, and the better periodontal conditions are certainly present in the CAT but mainly limited to the short term. This critical review of the state of the art clarifies the gray areas, such as to inform the researcher with the aim of elaborating an adequate study design in order to evaluate the advantages and limitations of this orthodontic approach.