Micro-computed tomography evaluation of general trends in aligner thickness and gap width after thermoforming procedures involving six commercial clear aligners: An in vitro study

Objective: To assess the effects of thermoforming on aligner thickness and gap width in six aligner systems with the same nominal thickness. Methods: Six passive upper aligners of different brands were adapted to a single printed cast. Each sample was evaluated with high-resolution micro-computed tomography. To investigate aligner thickness and gap width, two-dimensional (2D) analysis was conducted assessing the effects of the following variables: tooth type (central incisor, canine, and first molar), 2D reference points, and aligner type. Data were analyzed and compared using analysis of variance and Tukey’s post-hoc tests (p < 0.05). Results: Tooth type, dental region, and aligner type affected both the gap width and aligner thickness. The aligner thickness remained moderately stable across the arch only in the F22. Conclusions: All thermoformed samples displayed smaller aligner thickness and gap width at anterior teeth and both gingival and coronal centers than at posterior teeth and occlusal surfaces.