Clear aligners: between clinical inertia and dormant disruption

Clear aligner therapy has expanded rapidly over the past two decades; yet clinical efficiency, biomechanical predictability, and long-term enamel preservation remain limited by the current generation of attachments, bonding protocols, and aligner materials. Despite increasing publications and the proliferation of aligner companies, fundamental innovations in force delivery, attachment debonding, and material design have lagged clinical demand. This review highlights potential advances in prepolymerized attachment materials, nonetch bonding strategies, debond-on-demand and biomimetic adhesives, and nondissipative energy polymers, providing a roadmap for translating biomedical innovations into clinical aligner practice. Emphasis is placed on strategies that preserve enamel, minimize stress relaxation, and enable reversible or on-demand adhesion, addressing gaps that have constrained aligner therapy performance and predictability.