{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T15:36:04Z","timestamp":1792337764977,"version":"4.4.0"},"reference-count":53,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,3,2]],"date-time":"2023-03-02T00:00:00Z","timestamp":1677715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: In recent years the burden of aligner treatment has been growing. However, the sole use of aligners is characterized by limitations; thus attachments are bonded to the teeth to improve aligner retention and tooth movement. Nevertheless, it is often still a challenge to clinically achieve the planned movement. Thus, the aim of this study is to discuss the evidence of the shape, placement and bonding of composite attachments. Methods: A query was carried out in six databases on 10 December 2022 using the search string (\u201corthodontics\u201d OR \u201cmalocclusion\u201d OR \u201cTooth movement techniques AND (\u201caligner*\u201d OR \u201cthermoformed splints\u201d OR \u201cinvisible splint*\u201d AND (\u201cattachment*\u201d OR \u201caccessor*\u201d OR \u201cauxill*\u201d AND \u201cposition*\u201d). Results: There were 209 potential articles identified. Finally, twenty-six articles were included. Four referred to attachment bonding, and twenty-two comprised the influence of composite attachment on movement efficacy. Quality assessment tools were used according to the study type. Conclusions: The use of attachments significantly improves the expression of orthodontic movement and aligner retention. It is possible to indicate sites on the teeth where attachments have a better effect on tooth movement and to assess which attachments facilitate movement. The research received no external funding. The PROSPERO database number is CRD42022383276.<\/jats:p>","DOI":"10.3390\/ijerph20054481","type":"journal-article","created":{"date-parts":[[2023,3,3]],"date-time":"2023-03-03T02:03:08Z","timestamp":1677808988000},"page":"4481","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":66,"title":["Attachments for the Orthodontic Aligner Treatment\u2014State of the Art\u2014A Comprehensive Systematic Review"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3446-6119","authenticated-orcid":false,"given":"Maciej","family":"Jedli\u0144ski","sequence":"first","affiliation":[{"name":"Department of Interdisciplinary Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland"},{"name":"Department of Dental and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0525-681X","authenticated-orcid":false,"given":"Marta","family":"Mazur","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland"},{"name":"Department of Dental and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8904-0153","authenticated-orcid":false,"given":"Mario","family":"Greco","sequence":"additional","affiliation":[{"name":"Department of Paediatric Dentistry, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2103-8983","authenticated-orcid":false,"given":"Joyce","family":"Belfus","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, Universidad de los Andes, Santiago 7620001, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Grocholewicz","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4374-2568","authenticated-orcid":false,"given":"Joanna","family":"Janiszewska-Olszowska","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/ocr.12431","article-title":"Evaluation of Pain Intensity in Patients Treated with Aligners and Conventional Fixed Appliances: Randomized Clinical Trial","volume":"24","author":"Casteluci","year":"2021","journal-title":"Orthod. 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