Effects of Orthodontic Treatment with Clear Aligners on Temporomandibular Disorders: Articular and Muscular Components: A Review of the Current Scientific Evidence
Javiera Fernandez1*, Macarena Rotman1
1Independent Researcher, Orthodontics and Dentofacial Orthopedics, Santiago, Chile.
*Corresponding Author: Javiera Fernandez, Independent Researcher. Email: javierafernandez97@gmail.com
https://doi.org/10.58624/SVOADE.2026.07.037
Received: August 20, 2026
Published: September 21, 2026
Citation: Fernandez J, Rotman M. Effects of Orthodontic Treatment with Clear Aligners on Temporomandibular Disorders: Articular and Muscular Components: A Review of the Current Scientific Evidence. SVOA Dentistry 2026, 7:5, 296-305. doi: 10.58624/SVOADE.2026.07.037
Abstract
Given the recent widespread use of clear aligners as an orthodontic alternative to fixed appliances, scientific interest has been renewed in determining whether this treatment option differentially affects one or both components of temporomandibular disorders (TMD). TMD constitute a heterogeneous group of musculoskeletal conditions that compromise the temporomandibular joint (TMJ) in its articular component— including arthralgia, disc displacements, and osteoarthrosis—and the masticatory musculature in its muscular component—including local myalgia and myofascial pain, with or without referral. The scientific evidence available on the effects of clear aligner treatment on the articular and muscular components of TMD was analyzed through a narrative literature review. Results showed that, at the articular level, the evidence indicates discrete changes in condylar position and joint spaces, of comparable or lesser magnitude than those induced by fixed appliances. At the muscular level, electromyographic evidence describes a transient and self-limiting alteration of masticatory muscle activity upon insertion of each new aligner, with no consistent evidence that aligners induce objective tooth clenching or produce a sustained modification of the sleep bruxism index. Cohort studies with clinical follow-up show an incidence of articular and muscular TMD signs and symptoms in aligner-treated patients that is equal to or lower than the baseline prevalence expected in the general population, and systematically lower than in patients treated with fixed appliances. In summary, clear aligners do not appear to constitute, per se, a relevant causal factor for either articular or muscular TMD, although their own occlusal coverage generates a transient neuromuscular effect analogous, on a smaller scale, to that of an occlusal splint. The current evidence is of low to moderate quality, and prospective, standardized studies with long-term follow-up are required to establish definitive conclusions regarding both components.
Keywords: clear aligners; temporomandibular disorders; bruxism; literature review.
