{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:17:23Z","timestamp":1788862643480,"version":"build-2803163510"},"reference-count":68,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Materials"],"abstract":"<jats:p>Clear orthodontic aligners are removable polymer devices worn about 22 h a day for 12 to 24 months, increasingly by children. A growing in vitro literature shows that thermoformed and 3D-printed aligners shed micro- and nanoplastics and co-release elemental or organic constituents under oral, gastric and mechanical conditions, yet aligner-derived particle burden and systemic dose in wearers have not been measured. This review sets aligner-derived release against the wider human micro- and nanoplastic record and evaluates saliva as a biomonitoring matrix. Directly printed devices release more and larger microplastics under mechanical stress, whereas thermoformed materials show acid-related degradation, with Sb\/Sn release and nanometre-scale particles reported in a single, not yet replicated in vitro study. Particles below 5 microns, especially below 1 micron, are plausible translocation candidates, but translocation of aligner-derived particles has not been demonstrated. In vitro work reports macrophage and oxidative responses, whereas detections in blood, placenta and atheroma are not source-specific and remain associative. The EU amalgam phase-out does not regulate aligners but highlights a substitution question, because device and chemicals law addresses intentionally added microplastics, not wear-generated secondary particles. ICP-MS for antimony and tin, with Raman, micro-FTIR and electron microscopy, forms a plausible analytical toolbox. We propose harmonised release testing and validated salivary biomonitoring, prioritising children, to characterise source-proximal exposure before use expands.<\/jats:p>","DOI":"10.3390\/ma19183816","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:00:04Z","timestamp":1788861604000},"page":"3816","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clear Aligners as a Prescribed Source of Unmeasured Intra-Oral Micro- and Nanoplastic Exposure: Release Mechanisms, Human Evidence, Salivary Biomonitoring and the EU Regulatory Context"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5754-0284","authenticated-orcid":false,"given":"Marcin","family":"Mikulewicz","sequence":"first","affiliation":[{"name":"Division of Facial Abnormalities, Department of Dentofacial Orthopaedics and Orthodontics, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6897-9882","authenticated-orcid":false,"given":"Katarzyna","family":"Chojnacka","sequence":"additional","affiliation":[{"name":"Department of Advanced Material Technologies, Faculty of Chemistry, Wroclaw University of Science and Technology, Wybrzeze Wyspianskiego 27, 50-370 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2873","DOI":"10.1038\/s41591-025-03902-5","article-title":"Health impacts of microplastic and nanoplastic exposure","volume":"31","author":"Lamoree","year":"2025","journal-title":"Nat. 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