Clear Aligner Treatment in China: a Cross-sectional Survey of Clinical Practice among Dental Practitioners.

Abstract

Objective: To investigate the clinical application of clear aligner therapy (CAT) among Chinese dental practitioners, focusing on case selection, treatment strategies, aligner change intervals and recall schedules, and compare CAT with fixed appliances in clinical decision making.

Methods: A nationwide online cross-sectional survey of licensed dental practitioners in China was conducted from June to November 2024. A structured questionnaire collected information on demographics, CAT case selection, treatment strategies and clinical management practices. Descriptive statistics were conducted.

Results: CAT was the choice of 87.74% of respondents (n = 1,066), mainly driven by patient demand and expected compliance (88.84%). The high cost was identified as the main hindrance. CAT was most commonly prescribed to adult patients, especially those aged 26 to 30 years. For dental crowding, clinicians more often preferred arch expansion or molar distalisation over interproximal enamel reduction or extraction. In extraction cases, four-premolar extraction was the most common pattern. Rotation and root control were perceived to be the most difficult tooth movements. Most respondents reported aligner changes every 7 to 14 days (n = 608 [57.04%], every 7 to 10 days; n = 389 [36.49%], every 10 to 14 days). Recall visits were typically every 6 to 12 weeks (n = 389 [36.49%], every 6 to 8 weeks; n = 355 [33.30%], every 8 to 12 weeks).

Conclusion: CAT has been widely adopted by Chinese dental practitioners, especially for the treatment of adult patients with mild to moderate malocclusion. Standard clinical protocols most often require aligner changes at 7- to 10-day intervals and patient recall visits at 6 to 8 weeks.