Posterior Open Bite and Posterior Occlusal-Contact Changes During Clear Aligner Therapy: Implications for Sports Dentistry and Physically Active Patients - A Structured Narrative Review
DOI:
https://doi.org/10.12775/QS.2026.75.75902Keywords
clear aligners, posterior open bite, posterior occlusal contacts, sports dentistry, athlets mouthguards, dental trauma, occlusal settlingAbstract
Background. Posterior open bite (POB) and reduced posterior occlusal contact have been reported during clear aligner therapy (CAT), but these outcomes are not equivalent and their clinical relevance remains uncertain.
Aim. To critically summarize clinical evidence on posterior occlusion during and after CAT and integrate implications for sports dentistry.
Review approach. PubMed/MEDLINE and Web of Science Core Collection were searched through 1 September 2026, with citation tracking; a supplementary sports-dentistry search addressed mouthguards, dental trauma, athletes, occlusion, and performance.
Results. Posterior-contact reductions were frequently reported during or immediately after CAT, whereas CAT-versus-fixed comparisons were inconsistent. Planned contacts were often more favorable than achieved contacts, and partial settling was observed. Sports literature supports mouthguards for injury prevention and identifies appliance-related wearability issues, but direct evidence in clear-aligner athletes is lacking. No evidence established that CAT-associated contact changes impair athletic performance.
Conclusions. Posterior-contact reduction during CAT should not be equated with clinically significant POB or an aligner-specific causal effect. In athletes, management should separately address posterior occlusion, mouthguard compatibility, oral-injury prevention, and sport participation.
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