# Predictability of ClinCheck in Overbite Correction with Aligners: A Systematic Review
## 3 Results
### Quantitative Assessment of Overbite Correction  
For each study, the mean overbite was analyzed at three timepoints: T1, T2(CC) and T3(R) [10; 20; 46; 48; 49]. The weighted mean overbite measurements were as follows:  
- T1: 4.39 mm (SD: 0.37; 95%; CI: 4.34-4.44 mm);  
- T2(CC): 1.62 mm (SD: 0.25; 95%, CI: 1.59-1.65 mm);  
- T3(R): 3.24 mm (SD: 0.18; 95%, CI: 3.21-3.26 mm). Figure 6: Forest plot showing the differences between T2(CC)-T3(R) for each study (open bite and deep bite). The black dot represents the mean difference expressed in mm between T2(CC) and T3(R); the horizontal bars indicate 95% confidence intervals [10; 20; 45; 46; 47; 48; 49]. The actual correction obtained T1-T3(R) was 1.15 mm, while the planned correction (T1-T2(CC) was 2.77 mm, resulting in an effective correction rate of the overbite of 41.5% [45; 47]. The weighted mean overbite for open bite studies was as follows:  
- T1: \(-\)1.28 mm (SD: 0.19; 95%,CI: \(-\)1.31, \(-\)1.25 mm)  
- T2(CC): 1.58 mm (SD: 0.08; 95%, CI: 1.56 \(-\)1.59 mm)  
- T3 (R): 0.49 mm (SD: 0.10; 95%, CI: 0.48 \(-\)0.51 mm). The actual correction obtained was 1.77 mm compared to a planned correction of 1.86 mm, yielding a correction rate of 62.1% [45; 47]. Figures 7 and 8 show the mean overbite data at T1, T2(CC) and T3(R), both in open bite and deep bite groups. orthodontists have increasingly used aligners in clinical practice. As aligners grow in popularity, it is prudent to understand how ClinCheck can predict and provide reliable data. This systematic review aims to assess the reliability of virtual planning in managing vertical discrepancies with clear aligners, with particular emphasis on the divergence between the overbite correction predicted by ClinCheck at T2(CC) and the clinical outcomes observed at T3(R). Five out of seven studies analyzed and measured overbite values using the Geomagic 3D System software, while two studies utilized ClinCheck software. Both ClinCheck and Geomagic 3D System software are representations of the force system used by the Invisualign appliance. [PERSON] et al. found that the discrepancy values for overbite and overjet measured at baseline and those predicted by ClinCheck showed high agreement with the measurement obtained using the Geomagic 3D software system [42]. This supports the utility of Invisalign predictability data in guiding clinicians to recognize potential limitations of the system and apply overcorrections when necessary to achieve the desired treatment outcomes [52]. All studies included in this systematic review focused on overbite correction in adult patients, eliminating the potential confounding factors related to craniofacial growth. Furthermore, all studies involved experienced orthodontists, ruling out clinician experience as a source of variability. Two studies did not specify the gender distribution on their sample, whereas four studies showed a predominance of female participants, in line with the demographic profile commonly observed among patients undergoing aligner therapy [53]. A concordance between T2(CC) and T3(R) was observed for open bite correction. The Invasalign system was found to be both effective and predictable for open bite and one study reported that anterior extrusion is the main mechanism of correction [47]. The findings reported by [PERSON] et al. contrast with those of other authors, who have indicated that anterior extrusion is the primary mechanism responsible for open bite closure [18; 39; 54]. Conversely, other studies have observed greater posterior intrusion, documenting approximately 0.4 mm of upper molar intrusion and 0.6 mm of lower molar intrusion [34]. Intrusion of the molars may contribute to bite closure by promoting mandibular automation. When this biomechanical effect is paired with the extrusion of anterior teeth, it frequently facilitates effective resolution of bite discrepancies in numerous clinical cases.