Post-surgical Orthodontic Management Using Clear Aligners: A Systematic Review of Stability, Efficiency, and Patient Outcomes

Clear aligner therapy has gained increasing attention as an alternative to fixed appliances in surgical-orthodontic treatment, particularly during the critical post-surgical phase. This systematic review evaluated the effectiveness of clear aligners in post-surgical orthodontic management, focusing on skeletal and dental stability, treatment efficiency, and patient-centered outcomes. A comprehensive search of PubMed, ScienceDirect, Google Scholar, and the Cochrane Library identified 10 eligible studies involving 258 patients. Owing to substantial heterogeneity in surgical procedures, aligner protocols, outcome measures, and follow-up durations, a meta-analysis was not feasible; therefore, findings were synthesized narratively. Across the included studies, skeletal and dental stability achieved with clear aligners was comparable to outcomes achieved with fixed appliances, with no significant differences in short-term relapse. Several studies reported improved treatment efficiency, including reduced overall treatment duration in surgery-first protocols and fewer clinical appointments during pre-surgical preparation. Patient-centered outcomes consistently favored clear aligners, with randomized trials demonstrating better periodontal health, reduced discomfort, and improved quality of life compared with fixed appliances. Perioperative outcomes were similar between groups, indicating the safety of incorporating aligners into orthognathic workflows. Despite promising results, the evidence remains limited by heterogeneity and a lack of long-term, controlled studies. Clear aligners represent an effective and patient-friendly alternative in post-surgical orthodontic management, offering comparable clinical outcomes with potential advantages in comfort, efficiency, and periodontal health.