Assessing the environmental impact of clear aligner therapy: a scoping review.

Abstract

Objective: To evaluate the environmental impact and sustainability-related practices of clear aligner therapy (CAT), focusing on environmental impact, economic implications, waste management, recycling practices, manufacturing processes, and aligner materials. It further explores the alignment of clear aligner practices with Sustainable Development Goals (SDG's) 3,9,12 and 13.

Methodology: A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. The review was guided by the Population-Concept-Context (PCC) framework. A comprehensive literature search was performed across five electronic databases (PubMed Central, Google Scholar, Scopus, Web of Science, and EBSCOhost) for studies published between January 2014 and December 2024. Studies evaluating the environmental sustainability of clear aligner therapy, including materials, manufacturing processes, waste management, recycling practices, and carbon emissions, were included.

Results: Thirteen studies met the inclusion criteria. The evidence indicates that clear aligner therapy contributes to plastic waste, microplastic generation, and greenhouse gas emissions throughout its life cycle. The included studies reported biodegradable materials, direct three-dimensional (3D) printing technologies (SDG-9), recycling initiatives (SDG 12), and circular economy approaches as potential strategies to reduce environmental impacts (SDG 3 & 13). However, the implementation of these strategies remains constrained by limited recycling infrastructure, economic considerations, and insufficient high-quality evidence.

Conclusion: Available evidence suggests that innovations in material selection, circular economy approaches, optimized manufacturing processes, and enhanced recycling programs may reduce the environmental burden associated with clear aligner therapy. Nevertheless, further high-quality environmental assessment studies are required to support the development of more sustainable orthodontic practices aligned with SDGs 3, 9, 12, and 13.