Defense Date


Document Type


Degree Name

Master of Science in Dentistry



First Advisor

Dr. Bhavna Shroff

Second Advisor

Dr. Steven Lindauer

Third Advisor

Dr. Caroline Carrico

Fourth Advisor

Dr. Vincent Sawicki


Introduction: This study evaluated current trends and perspectives among orthodontists regarding clear aligner therapy in the mixed dentition (CAMD), including insights into perceived indications, compliance, oral hygiene, and other factors.

Methods: An original, 22-item survey was mailed to both a randomized, nationally representative sample of practicing orthodontic specialists (n = 800) and to a specific, randomized sub-sample of high-aligner-prescribing orthodontists (n = 200). Questions assessed respondents’ demographic information, experience with clear aligner therapy, and perceived advantages/disadvantages of CAMD compared to fixed appliance therapy (FA). Responses were compared using McNemar’s chi-squared and paired t-tests to assess CAMD versus FA.

Results: 1,000 orthodontists were surveyed, and 181 (18.1%) responded during a 12-week period. Respondents were primarily solo private practice orthodontists. None of the demographic factors showed significant associations with CAMD use. CAMD use was less common than mixed dentition FA, but the majority of respondents predicted an increase in their future CAMD use (57.9%). Among respondents utilizing CAMD, the percentage of mixed dentition cases treated with clear aligners was significantly less than the overall percentage of clear aligner cases (23.7% vs 43.8%, P < 0.0001). Significantly fewer respondents considered skeletal expansion, growth modification, sagittal correction, and habit cessation to be feasible indications for CAMD compared to FA (P < 0.0001). Perceived compliance was similar for CAMD and FA (P = 0.5841), but perceived oral hygiene was significantly better with CAMD (P < 0.0001).

Conclusions: CAMD is emerging as an increasingly appealing treatment modality for children. The majority of surveyed orthodontists reported limited indications for CAMD compared to fixed appliances, but they perceived noticeable benefits for oral hygiene with CAMD.


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Date of Submission