Introduction

The field of orthodontics has changed markedly in recent years. The most recent Economics of Orthodontics Survey by the American Association of Orthodontists (AAO) in 2014 reported that 28% of all orthodontic patients are adults.1 This number has gradually been increasing, 14% higher than in 2012, and is markedly higher than 1970 when only 6.9% of patients were over the age of 21.2 Adults in the 2014 survey attributed seeking orthodontic treatment for improvements in relationships and careers, and 92% of the respondents reported that they would recommend other adults seek orthodontic treatment.1 This rise in adult orthodontic treatment is likely also related to an increased emphasis on esthetics in dentistry.

An increase in available clear brackets and clear aligner systems, such as Invisalign® and ClearCorrect®, have contributed to adult electivity, as many patients in this population may oppose the idea of metal braces and wires. Clear aligner therapy also improves the ability to maintain good oral hygiene and healthy gingival tissues. The growth of this patient population has also led to the emphasis on accelerating tooth movement to shorten the overall treatment time. Proposed methods to accelerate orthodontic tooth movement have ranged from pharmacological methods to vibration and will be discussed here. Further evolutions in orthodontics include the use of skeletal anchorage to improve control of tooth movement, as well as a surge of technology including digital scanners and cone beam computed tomography.