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The Biosafety or Biocompability of Clear Aligner
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This review examined the biosafety of clear aligner orthodontic appliances, finding that prolonged intraoral wear can cause release of chemical leachates (including bisphenol A and residual monomers) and microplastic particulates, with potential biological effects that remain inconsistently characterized in the literature.
Clear aligners are widely used in orthodontics, which mainly relies on thermoplastic trays and resin attachments. Patients with clear aligners are instructed to wear aligners for at least 22 hours per day, so the materials experience prolonged intra-oral exposure. Thermal processing during fabrication and the oral environment may alter polymer properties and lead to the release of chemicals (e.g., bisphenol A, residual monomers, additives) and particulates (e.g., microplastics). These potential biological effects have attracted increasing attention, yet the evidence base is highly heterogeneous in materials, methods, outcomes, study types and reporting. The main aim of this study is to provide an up-to-date overview of the biological side effects of clear aligners.
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Biocompatibility and Safety of Orthodontic Clear Aligners and Thermoplastic Retainers: A Systematic In Vitro Review (2015–2025)
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This systematic review examined whether orthodontic clear aligners and retainers release harmful chemicals or microplastics in the mouth. While most products met safety standards, some materials did release detectable levels of bisphenol A and other chemicals, especially during initial wear and after aging, raising questions about long-term oral exposure.
Chemical leaching and microplastics from clear aligner materials: Current evidence and future perspectives
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This review found that orthodontic clear aligners can release microplastics and chemicals like BPA into the mouth during normal use. While most products meet current safety standards, the combination of mechanical wear, saliva, and temperature changes in the mouth accelerates material breakdown, making dental appliances an underrecognized source of daily microplastic exposure.
Microplastics and orthodontic aligners: The concerns arising from the modernization of practice through polymers and plastics
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This review highlights that clear plastic orthodontic aligners release microplastics and the chemical BPA (bisphenol A) during normal use in the mouth. The released particles can be swallowed and potentially affect the gut, respiratory system, cardiovascular system, and brain. The authors urge the orthodontic field to prioritize patient safety and develop materials that minimize microplastic release from dental devices.
Intraoral ageing of aligners and attachments: Adverse effects on clinical efficiency and release of biologically-active compounds
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This review examines how clear dental aligners and their attachments break down inside the mouth during use, releasing microplastics and chemical compounds from wear and friction. The aging process also reduces the aligners' ability to move teeth as planned. The findings raise questions about the safety of chronic microplastic exposure in the oral cavity from orthodontic appliances.
Can Clear Aligners Release Microplastics That Impact the Patient’s Overall Health? A Systematic Review
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This systematic review investigates whether clear orthodontic aligners release microplastics during use in the mouth. The findings raise concerns about a previously overlooked source of direct microplastic exposure, since millions of people wear these plastic devices against their teeth and gums for months or years at a time.
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When a large batch of papers lands in the Atlas, we read through it and send a short write-up of what stood out.