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Kravitz ND, Kusnoto B et al. Am J Orthod Dentofacial Orthop 2009; 135: 27–35

'The Invisalign system uses CAD/CAM stereolithographic technology' to construct from a single impression, a series of polyurethane aligners. However, 'many orthodontists report that 70-80% of patients' receiving Invisalign, require midcourse correction or other adjunctive treatment. The aim of this study was to determine, using ToothMeasure software, if treatment of 37 patients with Anterior Invisalign, resulted in the predicted tooth positions. The posterior teeth formed the fixed reference points. 'The most accurate movement was lingual constriction' whereas the least was extrusion of the central incisors. Correcting rotations of canine teeth were less effective than those of other teeth, particularly if the desired rotational movements were greater than 15°. The authors acknowledge the limitations of this study.