Abstract
The integration of clear aligner therapy into orthognathic surgery protocols has expanded rapidly in recent years, driven by advances in digital workflows, virtual surgical planning, and CAD/CAM-based appliance design. While aligners offer clear advantages in terms of esthetics, patient comfort, and digital control, their application in surgically assisted orthodontic treatment remains a subject of debate. This lecture critically examines the role of aligners in the pre-, peri-, and post-surgical phases of orthognathic treatment. Indications, limitations, and biomechanical challenges will be discussed in comparison with conventional fixed appliances, with particular emphasis on complex tooth movements, vertical control, transverse discrepancies, and surgical decompensation. The impact of aligners on interdisciplinary communication, digital treatment planning, and surgical accuracy will be highlighted. Special attention will be given to hybrid treatment concepts combining aligners with skeletal anchorage systems and auxiliary mechanics, aiming to overcome traditional limitations of aligner therapy in orthognathic cases. Clinical case examples will illustrate decision-making strategies, common pitfalls, and practical solutions for successful integration of aligners into surgical workflows. The lecture aims to provide a balanced, evidence-based assessment of whether aligners represent a true advancement in orthognathic treatment or introduce new clinical challenges that must be carefully managed.
Learning Objectives
After attending this lecture, participants will be able to:
- Evaluate the indications and limitations of clear aligner therapy in orthognathic surgery cases.
- Compare aligner-based and fixed appliance approaches in pre- and post-surgical orthodontic treatment.
- Understand biomechanical challenges associated with aligners in the surgical decompensation and finishing phases.
- Assess the role of digital workflows and virtual surgical planning when using aligners in orthognathic patients.
- Apply hybrid strategies, including skeletal anchorage and auxiliaries, to optimize outcomes in aligner-based surgical cases.
