Evaluation of bonding of clear aligner attachments on aesthetic crown materials: a systematic review of in vitro studies.

OBJECTIVES: This study aims to assess the impact of various surface roughening treatments and bonding agents on aesthetic crown materials for the bonding of clear aligner attachments in orthodontic treatment. The primary objective is to assess their impact on shear bond strength, and the secondary objective is to assess their effect on surface roughness. METHODS: This systematic review of literature (2015-2025) followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Data were collected from scientific articles investigating the impact of various surface roughening procedures on the bond strength and surface roughness for clear aligner attachments bonded to aesthetic crown materials. The articles were retrieved from three databases: Scopus, PubMed, and Web of Science. Risk of bias was assessed using the QUIN bias assessment tool for dental in vitro studies. RESULTS: The results of the included articles were organised into tables in Word under the headings of author, country, material used, intervention(s), and results. The findings showed a positive increase in bond strength and surface roughness following surface treatments. CONCLUSION: This systematic review concludes that etching with hydrofluoric acid for 1 min and bonding with Filtek Z350 composite resin result in relatively higher bond strength and surface roughness. These findings may assist orthodontists in enhancing the bond strength of clear aligner attachments to aesthetic crown materials, hence improving orthodontic tooth movement. No external or internal funding was received for this review. It is registered with PROSPERO under the registration ID CRD420251174624. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251174624, identifier CRD420251174624.