Clear aligner orthodontic treatment: An international modified Delphi consensus study.

Introduction: This study aimed to establish a consensus, thanks to the participation of a large group of experts in the field of aligner therapy, on several of its clinical and extraclinical aspects, with particular reference to its potential and biomechanical limitations.

Methods: A Delphi study was conducted in 3 rounds. On the basis of the most recent systematic reviews in the literature, the steering committee formulated 35 questions. A group of 36 international experts agreed to participate in the survey and were asked to respond to the questions, choosing their level of agreement on a scale of 1-5 in the first round, then from 1 to 3 in the second, and finally with a yes or no response in the third, progressively narrowing the field of research. The items for which consensus (≥70%) was obtained were accepted; the others were reformulated.

Results: On the basis of the analysis of the experts' responses, 68 questions were reformulated for the second round and 28 for the third round. After 3 rounds, the study generated 47 consensus statements regarding biomechanical aspects and extraclinical factors.

Conclusions: The study, based on the modified Delphi method, collected the opinion of experts, comparing it with the scientific literature to evaluate the potential and limitations of orthodontic aligners, obtaining 47 consensus statements related to biomechanics and extraclinical factors.