Although molar distalization is one of the most difficult movements to achieve with conventional orthodontic treatment, it has been reported that it is one of the most predictable movement when using clear aligners. The aim of this systematic review is to assess the efficiency of molar distalization using clear aligners, and to evaluate the associated effects of this treatment. Pubmed, Scoups, science direct, Web of Science, and EBSCO databases were searched up to May 2023 for randomized controlled trials (RCTs) and non-randomized prospective and retrospective studies on maxillary and lower molar distalization using clear aligner. Ten studies were included in the systematic review, two prospective non-randomized and eight retrospective non-randomized. The predictability of molar distalization ranges from 31.1% to 87%, with good control of the vertical dimension and tipping movements. The lower molar distalization is mainly a tipping movement rather than bodily movement. Molar distalization using clear aligners appears to be effective, although variations in study protocols may contribute to differences in predictability rates. Randomized controlled trials with standardized protocols are therefore needed to provide more accurate assessments.
