Aligner systems are increasingly used to treat simple malocclusions as well as more complex cases requiring multi-directional dental movements. Mesialization of lateral teeth is one of the most challenging movements from a biomechanical standpoint. As the process may lead to undesirable mesial inclination of dental crowns, it is crucial that the biomechanics of clear aligner treatment be appropriately planned.

Aim

The aim of this paper is to present the possibility of mesialization of lateral teeth in the course of clear aligner therapy on the basis of a series of three clinical cases.

Material and methods

Three adult patients treated with the Spark™ aligner system were included in the study. Patient documentation included intraoral photographs, X-rays (pantomography and lateral cephalometric imaging), and digital visualizations of the planned treatment, including superimpositions of teeth illustrating the planned orthodontic movements.

Results

Clinical studies suggest that the effectiveness of mesiodistal movements in aligner therapy varies and depends on a number of factors. For this reason, various biomechanical strategies are increasingly used to make dental movements more predictable, including overcorrection in digital setup or the use of additional anchorage elements. Improved dental relationships and stable occlusion were achieved in all patients. The control of mesialization movements was facilitated by the use of mesial root tip (MRT) overcorrection and, in one case, additional skeletal anchorage.

Conclusions

Mesialization of the lateral teeth in clear aligner therapy is possible with proper planning of treatment biomechanics and individual adjustment of the therapeutic strategy to the particular clinical situation.