The Effectiveness of Clear Aligners in Orthognathic Surgery: Pre- and Postoperative Phases—A Scoping Review

Clear aligners are increasingly used as an alternative to fixed appliances in orthognathic surgery, particularly for skeletal Class III malocclusions. This scoping review aimed to evaluate the effectiveness of clear aligners in the pre- and postoperative phases of surgical treatment and was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Electronic searches were conducted in PubMed, Scopus, Embase, Web of Science, Cochrane Library, and OpenGrey. Data extraction considered study design, country, sample characteristics, surgical protocol, orthodontic biomechanics, use of auxiliaries, and cephalometric outcomes. Seven studies published between 2020 and 2024 were included. They involved 120 adult patients treated with Invisalign® combined with Le Fort I osteotomy and bilateral sagittal split osteotomy. All studies reported skeletal improvements, particularly in ANB angle and Wits appraisal, with maintenance of vertical dimensions. Clear aligners facilitated presurgical dental decompensation, torque control, and postsurgical occlusal refinement, with auxiliaries and digital tools enhancing predictability. Despite variability in protocols and limited long-term follow-up, outcomes were comparable to those achieved with fixed appliances. Current evidence supports the clinical viability of integrating clear aligners into orthognathic surgery, although standardized protocols and further high-quality prospective studies are needed to confirm long-term stability.