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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.
The clinical application of aligners is accompanied by the ageing of the polymer appliances and the attachments used, which may result in inefficiency in reaching the predicted range of tooth movement, and release of compounds and microplastics in the oral cavity as a result of the friction, wear and attrition of the aligner and composite attachment. The purpose of this review is to present the mechanism and effects of in vivo ageing; describe the hydrolytic degradation of aligners and enzymatic degradation of composite attachments; examine the ageing pattern of aligners in vivo, under actual clinical scenarios; and identify a link to the discrepancy between predicted and actual clinical outcome. Lastly, strategies to deal with three potentially critical issues associated with the use of aligners, namely the necessity of weekly renewal, the dissimilar mechanical properties of aligner and attachment resulting in wear and plastic deformation of the aligner, and the development of integuments and biofilms with microbial colonization of the appliance, are discussed.
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This review summarizes existing research on clear plastic orthodontic aligners, worn in the mouth, and whether they release chemicals and tiny plastic particles as they wear down. Lab studies found that aligner surfaces can develop roughness and tiny cracks, sometimes releasing chemicals and microplastics, but most evidence comes from lab models rather than real-world use in people.
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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.
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Researchers tested three popular brands of clear orthodontic aligners under simulated chewing conditions and found that all released microplastic particles during use. Since patients wear aligners for extended periods each day, this represents a direct and ongoing source of microplastic ingestion, raising questions about the cumulative exposure from dental devices that are growing in popularity.
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.
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