Clear Aligners for Orthodontic Correction of Class II Malocclusions in Adult Patients Without Tooth Extraction: A Systematic Review

Objective(s) This systematic review analyzed the use of clear aligners (CAs) in adult patients with Class II malocclusion who needed orthodontic treatment. The aim was to investigate the use, effectiveness, benefits, and limitations of the CAs in orthodontic treatment in adult patients. Materials and Methods This review was conducted according to the PRISMA statement, and the protocol was registered at PROSPERO. A comprehensive search on PubMed, Scopus, and Web of Science was conducted to identify relevant papers dated from January 1, 2014, to October 25, 2024. The electronic database search identified a total of 811 articles. After eligibility, 14 records were selected for qualitative analysis. Settings and Sample Population The relevant papers, randomized clinical trials, retrospective studies, case series, and case reports, in the English language, and with full text, involving adult patients, females and males, with Class II malocclusion treated with aligners. Results/Conclusion The findings suggest that the use of CAs in Class II malocclusion is achieved with the sequential distalization of the teeth and the application of intermaxillary elastics and miniscrews. The miniscrews allow treatment with precision, control, and greater anchorage, especially in cases requiring complex tooth movements, such as distalization. The results showed, in addition to the esthetics and comfort of aligners, adequate predictability of even the most complex movements leading to the resolution of Class II malocclusion.