article · Journal of Dentistry
Artificial intelligence is increasingly being explored to support clear aligner therapy, spanning stages such as tooth segmentation, digital model registration, treatment setup, and remote patient monitoring. A review of forty-one studies indicates that artificial intelligence can perform tooth segmentation with ninety-eight per cent accuracy, merge cone beam computed tomography with intraoral scan data, support digital measurements, and predict treatment outcomes. At the same time, an evaluation of thirteen commercial aligner software programmes available up to March 2024 revealed that only one platform demonstrated full automation across the orthodontic digital workflow. None of these commercial tools were directly evaluated within the academic studies reviewed. Overall, while artificial intelligence demonstrates high technical performance across specific tasks, full workflow automation remains rare in currently available clinical software.
Clear aligner therapy relies heavily on digital workflows, from initial scanning to treatment planning and remote tracking. Integrating artificial intelligence can potentially improve the efficiency, accuracy, and predictability of orthodontic care. However, a noticeable gap remains between academic research algorithms and the actual validation of commercially available software tools used by clinicians.
This work directly concerns orthodontic software developers and practicing orthodontists. While thirteen commercial programmes already exist on the market, showing near-market or active commercial status, true end-to-end automation remains largely unrealised, with only one tool reaching full automation. The gap between published academic artificial intelligence models and evaluated market software indicates clear commercial opportunities to validate and integrate high-accuracy algorithms into commercial digital planning suites.
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OBJECTIVES: To conduct a scoping review on the application of artificial intelligence (AI) in clear aligner therapy and to assess the extent of AI integration and automation in orthodontic software currently available to orthodontists. DATA AND SOURCES: A systematic electronic literature search was performed in the following databases: PubMed, Embase, Web of Science, Cochrane Library, and Scopus. Also, grey literature resources up to March 2024 were reviewed. English-language studies on potential AI applications for clear aligner therapy were included based on an independent evaluation by two reviewers. An assessment of the automation steps in orthodontic software available on the market up to March 2024 was also conducted. STUDY SELECTION AND RESULTS: Out of 708 studies, 41 were included. Sixteen articles focused on tooth segmentation, four on registration of digital models, 13 on digital setup, and eight on remote monitoring. Moreover, 13 aligner software programs were identified and assessed for their level of automation. Only one software demonstrated complete automation of the steps involved in the orthodontic digital workflow. CONCLUSIONS: None of the 13 identified aligner software programs were evaluated in the 41 included studies. However, AI-based tooth segmentation achieved 98 % accuracy, while AI effectively merged CBCT and IOS data, supported digital measurements, predicted treatment outcomes, and showed potential for remote monitoring. CLINICAL SIGNIFICANCE: AI applications in clear aligner therapy are on the rise. This scoping review enables orthodontists to identify AI-based solutions in orthodontic planning and understand its implications, which can potentially enhance treatment efficiency, accuracy, and predictability.
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DOI: 10.1016/j.jdent.2025.105564
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