Comparative Assessment of Set-Up Procedures Between Clear Aligners and Lingual Appliances: A Review

Kyung-A Kim

Department of Orthodontics, Kyung Hee University College of Dentistry, Seoul, Korea.

Clear aligners and lingual appliances represent two prominent esthetic orthodontic treatment modalities, each relying on distinct biomechanical principles and set-up philosophies. While both systems utilize digital treatment planning, their approaches to force delivery, control of tooth movement, and overcorrection differ substantially. Clear aligner therapy is based on staged digital set-ups that generate sequential tooth movements through a series of removable aligners, with treatment efficacy heavily dependent on patient compliance and preprogrammed overcorrection. In contrast, lingual appliances employ fixed brackets positioned on the lingual surfaces, allowing continuous force application and real-time biomechanical control through wire adjustments, with overcorrection primarily incorporated at the bracket positioning and archwire design stages. This review comparatively evaluates clear aligners and lingual appliances with a particular focus on set-up procedures across different treatment stages, biomechanical characteristics, strategies for overcorrection, and clinical treatment outcomes. Available evidence suggests that while clear aligners offer advantages in comfort and esthetics for mild to moderate malocclusions, lingual appliances provide superior control for complex movements and greater predictability in challenging cases. Understanding the strengths and limitations of each set-up approach is essential for optimizing treatment outcomes and selecting appropriate esthetic orthodontic modalities.

Key words: Clear aligners, Lingual orthodontics, Set-up procedure, Overcorrection, Digital orthodontics

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