Figure 7: The 9-year-old is shown post-treatment. discUssiOn The cases presented demonstrate the potential utility of clear aligners during the mixed dentition stage. One of the most significant advantages of early intervention is the opportunity to influence arch development while growth remains active. During the ages of approxi-mately 6 to 10 years, the midpalatal suture is often still patent, allowing favorable adaptation of the developing dentition and supporting structures. Historically, removable expansion appliances have relied heavily on patient compliance. Clear aligners maintain this same principle while providing improved esthetics, oral hygiene, comfort, and digital treatment planning. Compliance remains the primary determi-nant of success. Patients in this case series were instructed to wear aligners 22 hours per day, contribut-ing to favorable outcomes. Clear aligners appear particularly useful for dentoalveolar expansion, arch perimeter development, correction of minor crossbites, alignment, and space management. They may help reduce the risk of impaction, facilitate eruption guidance, and potentially decrease future treatment complexity. However, severe Figure 8: Case 3 focused on another 9-year-old female patient. orthodontics.com Summer 2026 23
Journal of the American Orthodontic Society Summer 2026: Page 23
