Non-Cochrane · intervention · PM42675477
Clear aligner therapy for adult anterior open bite: a systematic review, descriptive evidence map, and certainty appraisal of reported dentoskeletal changes.
Huang Xinqi, Lei Mengling, Liao Juntong, et al. · BMC oral health · 2026 · PubMed · doi:10.1186/s12903-026-09379-z
Findings
Population Adults or predominantly adults with anterior open bite
2 findings
| Clear aligner therapy | Before treatment (single-arm change) | Overbite increase (mm) Completed treatment · Extended sensitivity analysis | MD 2.89 [2.21, 3.57] Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness 7 studies · 322 participants |
| Clear aligner therapy | Before treatment (single-arm change) | Overbite increase (mm) Completed treatment · Primary exploratory analysis | MD 3.07 [2.46, 3.69] Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness 5 studies · 206 participants |
Included primary studies 10
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Chamberland 2024 Noninvasive conservative management of anterior open bite treated with TADs versus clear aligner therapy. PMID:38556610 | 2024 | 1 other review | Overbite increase (mm) | not extracted yet |
| Garnett 2019 Cephalometric comparison of adult anterior open bite treatment using clear aligners and fixed appliances. PMID:30280928 | 2019 | 1 other review | Overbite increase (mm) | not extracted yet |
| Harris 2020 Evaluation of open bite closure using clear aligners: a retrospective study. PMID:32830306 | 2020 | 1 other review | Overbite increase (mm) | not extracted yet |
| Moshiri 2017 Cephalometric evaluation of adult anterior open bite non-extraction treatment with Invisalign. PMID:29160342 | 2017 | 1 other review | PM42675477-P1-O2 | not extracted yet |
| Steele 2022 A comparative assessment of the dentoskeletal effects of clear aligners vs miniplate-supported posterior intrusion with fixed appliances… PMID:35339320 | 2022 | 1 other review | not stated | not extracted yet |
| Suh 2022 Treatment of anterior open bites using non-extraction clear aligner therapy in adult patients. PMID:35527369 | 2022 | 1 other review | Overbite increase (mm) | not extracted yet |
| Withayanukonkij 2023 Root resorption during maxillary molar intrusion with clear aligners: a randomized controlled trial. PMID:37922387 | 2023 | 1 other review | not stated | not extracted yet |
| Arwa 2025 Cone beam computed tomography analysis of anterior open bite management using clear aligners: a single-arm retrospective study. PMID:40646026 | 2025 | this review only | Overbite increase (mm) | not extracted yet |
| Burashed 2023 The efficacy of anterior open bite closure when using Invisalign's optimized extrusion versus conventional attachments. PMID:37164825 | 2023 | this review only | PM42675477-P1-O2 | not extracted yet |
| Karalikkattil 2024 Effectiveness of Invisalign Treatment on Open Bite Correction. PMID:38595389 | 2024 | 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 question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adult or predominantly adult patients with anterior open bite | Adult or predominantly adult anterior open bite (n=421 aligner-treated participants) |
| Intervention | Clear aligner therapy as the primary orthodontic modality | Clear aligner therapy, mainly Invisalign (10 studies) |
| Comparison | No comparator, fixed appliances, skeletal anchorage-assisted posterior intrusion, or other modalities when the aligner arm was separable | None (single-arm), fixed appliances, miniplate- or TAD-supported posterior intrusion, conventional attachments |
| Outcomes | Overbite change, incisor extrusion or inclination, molar intrusion or posterior vertical change, mandibular plane angle, autorotation, treatment duration, stability, adverse effects | Overbite increase (7 studies pooled, n=322); descriptive dentoskeletal changes |
| Study designs | RCTs, nonrandomized clinical studies, retrospective cohorts, comparative studies | 1 RCT, 9 nonrandomized studies (mostly retrospective) |
| Timing | Studies published January 2010 to April 2026 | Treatment durations 14 to 29 months; one RCT 6 months |
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 | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | No | No | yes |
| 7List of excluded studies with reasonscritical | Yes | Partial Yes | no |
| 8Included studies described in detail | Partial Yes | Yes | no |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: Yes | RCT: Yes · NRSI: Yes | yes |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: N/A · NRSI: No | RCT: N/A · NRSI: Yes | no |
| 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 | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Low | no |