Non-Cochrane · intervention · PM42499039
Predictability of maxillary transverse changes with Invisalign in adults: A systematic review and meta-analysis.
XiangGang Hou, Jia Qin, Jie Yang, et al. · Medicine · 2026 · PubMed · doi:10.1097/md.0000000000049772
Findings
Population Adults with malocclusion requiring maxillary transverse expansion
15 findings
| Invisalign clear aligner treatment (including attachments) | Maxillary transverse expansion predicted by ClinCheck software | Maxillary 1st intermolar width: predictability of expansion (%) Retrospective clinical studies; aligner treatment in adults · Measurement landmark: overall (inverse-variance model) | Predictability (%) 73 [67, 79] GRADE not reported 6 studies |
| Invisalign clear aligner treatment (including attachments) | Maxillary transverse expansion predicted by ClinCheck software | Maxillary 1st interpremolar width: predictability of expansion (%) Retrospective clinical studies; aligner treatment in adults · Measurement software: Geomagic | Predictability (%) 80.70 [73.61, 87.78] GRADE not reported 3 studies |
| Invisalign clear aligner treatment (including attachments) | Maxillary transverse expansion predicted by ClinCheck software | Maxillary 1st interpremolar width: predictability of expansion (%) End of aligner treatment (follow-up varied by study) · Retrospective clinical studies; aligner treatment in adults | Predictability (%) 80.73 [73.78, 87.68] High 6 studies · 218 participants |
| Invisalign clear aligner treatment (including attachments) | Maxillary transverse expansion predicted by ClinCheck software | Maxillary 1st intermolar width: predictability of expansion (%) Retrospective clinical studies; aligner treatment in adults · Measurement software: Geomagic | Predictability (%) 75.12 [67.30, 82.93] GRADE not reported 3 studies |
| Invisalign clear aligner treatment (including attachments) | Maxillary transverse expansion predicted by ClinCheck software | Maxillary 1st intermolar width: predictability of expansion (%) Retrospective clinical studies; aligner treatment in adults · Measurement landmark: palatal cusp tip | Predictability (%) 75 [66, 84] GRADE not reported 2 studies |
| Invisalign clear aligner treatment (including attachments) | Maxillary transverse expansion predicted by ClinCheck software | Maxillary 1st intermolar width: predictability of expansion (%) End of aligner treatment (follow-up varied by study) · Retrospective clinical studies; aligner treatment in adults | Predictability (%) 71.57 [62.41, 80.73] Moderate Downgraded: risk of bias, inconsistency 6 studies · 191 participants |
| Invisalign clear aligner treatment (including attachments) | Maxillary transverse expansion predicted by ClinCheck software | Maxillary 2nd interpremolar width: predictability of expansion (%) End of aligner treatment (follow-up varied by study) · Retrospective clinical studies; aligner treatment in adults | Predictability (%) 78.74 [70.41, 87.08] Moderate Downgraded: risk of bias, inconsistency 6 studies · 210 participants |
| Invisalign clear aligner treatment (including attachments) | Maxillary transverse expansion predicted by ClinCheck software | Maxillary 1st intermolar width: predictability of expansion (%) Retrospective clinical studies; aligner treatment in adults · Study country: developed countries | Predictability (%) 77.22 [70.34, 84.10] GRADE not reported 4 studies |
| Invisalign clear aligner treatment (including attachments) | Maxillary transverse expansion predicted by ClinCheck software | Maxillary 2nd interpremolar width: predictability of expansion (%) Retrospective clinical studies; aligner treatment in adults · Measurement software: Geomagic | Predictability (%) 78.06 [70.61, 85.51] GRADE not reported 3 studies |
| Invisalign clear aligner treatment (including attachments) | Maxillary transverse expansion predicted by ClinCheck software | Maxillary 1st intermolar width: predictability of expansion (%) Retrospective clinical studies; aligner treatment in adults · Study country: developing countries | Predictability (%) 58.53 [45.20, 71.86] GRADE not reported 2 studies |
| Invisalign clear aligner treatment (including attachments) | Maxillary transverse expansion predicted by ClinCheck software | Maxillary 1st intermolar width: predictability of expansion (%) Retrospective clinical studies; aligner treatment in adults · Measurement landmark: buccal cusp tip | Predictability (%) 78 [69, 87] GRADE not reported 3 studies |
| Invisalign clear aligner treatment (including attachments) | Maxillary transverse expansion predicted by ClinCheck software | Maxillary intercanine width: predictability of expansion (%) End of aligner treatment (follow-up varied by study) · Retrospective clinical studies; aligner treatment in adults | Predictability (%) 72.01 [59.67, 84.35] Low Downgraded: inconsistency, publication bias 6 studies · 194 participants |
| Invisalign clear aligner treatment (including attachments) | Maxillary transverse expansion predicted by ClinCheck software | Maxillary intercanine width: predictability of expansion (%) Retrospective clinical studies; aligner treatment in adults · Measurement software: Geomagic | Predictability (%) 82.42 [75.86, 88.98] GRADE not reported 3 studies |
| Invisalign clear aligner treatment (including attachments) | Maxillary transverse expansion predicted by ClinCheck software | Maxillary 1st intermolar width: predictability of expansion (%) Retrospective clinical studies; aligner treatment in adults · Study country: overall (inverse-variance model) | Predictability (%) 73.29 [67.17, 79.40] GRADE not reported 6 studies |
| Invisalign clear aligner treatment (including attachments) | Maxillary transverse expansion predicted by ClinCheck software | Maxillary transverse expansion predictability, four regions combined (Geomagic studies) Retrospective clinical studies; aligner treatment in adults · Measurement software: Geomagic, all four regions combined | Predictability (%) 79.42 [75.83, 83.01] GRADE not reported 3 studies |
Included primary studies 6
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Houle 2017 The predictability of transverse changes with Invisalign. PMID:27304231 | 2017 | 1 other review | not stated | not extracted yet |
| Lione 2021 Maxillary arch development with Invisalign system. PMID:33570617 | 2021 | 1 other review | not stated | not extracted yet |
| Tien 2023 The predictability of expansion with Invisalign: A retrospective cohort study. PMID:36195544 | 2023 | 1 other review | not stated | not extracted yet |
| Zhou 2020 Efficiency of upper arch expansion with the Invisalign system. PMID:31368778 | 2020 | 1 other review | not stated | not extracted yet |
| Bowman 2023 Evaluation of the predicted vs. achieved occlusal outcomes with the Invisalign® appliance: A retrospective investigation of adult patients. PMID:36868001 | 2023 | this review only | not stated | not extracted yet |
| Zhao 2017 [Maxillary expansion efficiency with clear aligner and its possible influencing factors]. PMID:29972918 | 2017 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
| Review | Shared studies | Jaccard |
|---|---|---|
| Predicting transversal dental arch expansion outcomes with Invisalign aligners in permanent dentition: a systematic review and… (2026) | 4 | 0.10 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients with malocclusion requiring maxillary transverse expansion; excluded cleft lip/palate or craniofacial syndromes | Adults (18 years or older) treated with Invisalign for malocclusion requiring maxillary transverse expansion (n=233) |
| Intervention | Invisalign treatment including attachments; excluded additional auxiliary devices, extraction, surgery | Invisalign aligners with attachments (6 retrospective studies) |
| Comparison | Maxillary transverse expansion predicted using ClinCheck software | ClinCheck-predicted expansion |
| Outcomes | Percentage of achieved maxillary transverse expansion relative to ClinCheck-predicted expansion | Predictability at canine (72.01%), 1st premolar (80.73%), 2nd premolar (78.74%), 1st molar (71.57%) |
| Study designs | RCTs, controlled clinical trials, single-arm clinical trials, cohort and other non-randomized clinical studies | Retrospective non-randomized studies (n=6) |
| Timing | Not specified | Not specified |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | No | No | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | No | No | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: N/A · NRSI: Yes | RCT: N/A · NRSI: Yes | yes |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: N/A · NRSI: Yes | RCT: N/A · NRSI: Yes | yes |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |