Evaluation of Knowledge, Attitude and Practice amongst Indian Orthodontists Regarding Directly Printed Aligners– A Questionnaire Study

Abstract

Introduction - Clear aligner therapy has gained widespread acceptance for its esthetics, comfort, and convenience, with recent advances in 3D printing leading to the development of directly printed aligners (DPA). Compared to traditional thermoformed aligners, DPA offer improved accuracy, customization, and biomechanical efficiency, while also reducing processing time and material waste. Despite these advantages, evidence on their clinical adoption and effectiveness remains limited.

Aim – To evaluate knowledge, attitude and practice amongst Indian Orthodontists regarding   Directly Printed Aligners.

Material and Methods - A validated questionnaire was distributed via WhatsApp to IOS-registered orthodontists using systematic sampling. Based on a calculated sample size of 361, 818 orthodontists were invited, and responses were collected through Google Forms over three weeks. Reliability and validity of the questionnaire were confirmed before distribution, and only consenting participants were included for analysis.

Results - A total of 361 orthodontists participated, with 96.1% aware of the primary material used for directly printed aligners. Most respondents reported better dimensional accuracy (86.7%), faster production (100%), and improved patient comfort (73.3%) with directly printed aligners. Approximately 40% considered them more effective in tooth movement, while 46.7% felt both types were equally effective. Advantages were noted in durability (66.7%), stain resistance (60%), and customizable thickness (66.7%), though 60% found them more technique-sensitive. Despite these benefits, 80% of orthodontists still primarily use indirectly printed aligners but indicated a strong likelihood of recommending and adopting directly printed aligners in the future.

Conclusion - Orthodontists show high awareness and a positive attitude toward directly printed aligners, recognizing advantages in accuracy, production efficiency, customization, durability, and patient comfort. Although indirectly printed aligners remain more commonly used, there is strong interest in adopting directly printed aligners, indicating their potential to become the preferred choice in the future.