A survey of clear aligner practices among orthodontists in India: A questionnaire study

Abstract

Objective: This study aimed to assess the clinical opinions and treatment practices of Indian orthodontists regarding clear aligner therapy. It focused on aligner material preferences, clinical protocols, treatment planning, and comparisons with conventional fixed appliance therapy. Materials and Methods: A structured electronic questionnaire comprising 17 multiple-choice questions was distributed to 450 members of the Indian Orthodontic Society. The survey explored diverse aspects including case selection criteria, digital treatment planning, aligner usage frequency, patient compliance issues, and retention strategies. The responses were collected over a three-month period and analyzed using automated tools via Google Forms. Results: A total of 300 orthodontists responded, yielding a response rate of 66.6%. Among the respondents, 70.7% reported treating between 0-30 clear aligner cases annually. A significant majority expressed discomfort in treating complex malocclusions with aligners, including severe cases (98%) and crossbites (86.7%). Patient-reported concerns included speech difficulties (66.7%) and halitosis (60.3%). More than half of the clinicians indicated that over 50% of their aligner cases required refinement stages. Notably, 84.3% of orthodontists disapproved of do-it-yourself (DIY) aligner systems. Despite the growing interest in aligner therapy, 63% still preferred traditional fixed orthodontic appliances. Conclusion: The survey highlights considerable variability in the adoption and application of clear aligner therapy among Indian orthodontists. While aligners are gaining popularity for their aesthetic and comfort advantages, fixed orthodontic appliances remain the preferred modality for most practitioners, particularly for complex cases. These findings underscore the need for standardized guidelines and further clinical research to support the expanding use of clear aligner systems in routine practice.