A Survey of Orthodontic Clear Aligner Practices among Orthodontists in Croatia.

Objectives: The aim of this cross-sectional survey was to investigate clear aligner therapy (CAT) practices and protocols among orthodontic specialists in the Republic of Croatia. Materials and Methods: The modified version of a previously published questionnaire s was distributed online to 180 orthodontists. It included 46 open- and closed-ended questions across 11 sections, covering demographics, clinical use of CAT, aligner preferences, digital treatment planning (DTP), indications, protocols, interproximal reduction (IPR), refinements, retention, patient-reported issues, and overall perceptions. Respondents not using CAT were directed to a separate section on non-use. Results: The majority of respondents (88%) reported using CAT in clinical practice, although only 10% of their annual cases involved CAT. Adults were more common patient group (57.9%), and the main indication was mild to moderate crowding. Invisalign was the most frequently used aligner system (58.7%), primarily chosen for the quality of digital treatment planning (DTP) and sophistication of product features. Two-thirds of the respondents reported modifying the digital treatment plan, particularly by adjusting the final tooth position. Refinement was performed in 50% of the cases. IPR was included in 80% of the initial treatment plans and only 20% of the refinement phases. Finally, 52.6% of orthodontists considered CAT to be superior to conventional fixed appliance therapy. Conclusions: CAT is widely used by orthodontists in Croatia, primarily for mild cases. Nevertheless, aligners are still not perceived as producing superior outcomes compared with fixed appliances.