ArticleThe Angle orthodontist2026
A standardized protocol for clear aligner thickness measurement using a 3D-printed auxiliary device.
Article in The Angle orthodontist, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: To develop and validate a standardized protocol for clear aligner (CA) thickness measurement using a three-dimensional (3D)-printed auxiliary device to improve measurement reliability. Materials and Methods: 24 pairs of digital dental models (D0s) were included and 3D-printed into physical models (P0s), from which CAs were thermoformed using 0.75-mm polymer sheets. Measurement auxiliary devices (MADs) were designed on D0s through measurement point selection, direction determination, electronic gauge mapping, and base shaping, and then 3D-printed. Two operators measured CA thickness (40 points per CA, 48 CAs) using an electronic gauge both directly (direct measurement, D-M) and with MADs (auxiliary measurement, A-M) across three sessions. Measurement precision (repeatability and reproducibility) of D-M and A-M were analyzed using intraclass correlation coefficients (ICCs) and repeated-measures analysis of variance (ANOVA) or Friedman tests. Bland-Altman plots were used to evaluate intersession agreement. Results: A-M demonstrated superior intersession repeatability with ICC > 0.90 at all points and high intersession agreement with a narrow 95% limit of agreement (LoA) and minimal outliers. Interoperator reproducibility for A-M was also higher, with ICCs above 0.75 at all points, compared to D-M, which showed ICCs below 0.75 at almost all points. Conclusions: The 3D-printed auxiliary device-based protocol provides a precise and operator-independent method for CA thickness measurement, offering a tool for quality control and providing a foundation for future research on material advancement and design optimization to improve aligner functionality.
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