Unveiling the role of artificial intelligence applied to clear aligner therapy: A scoping review

Abstract

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.

Keywords: Artificial intelligence; Clear aligner; Cone-beam computed tomography; Deep learning, machine learning; Orthodontics.