Staging of Orthodontic Tooth Movement in Clear Aligner Therapy: A Scoping Review

Background Staging, defined as the planned sequencing of orthodontic tooth movement across successive aligners, is considered fundamental to treatment predictability in clear aligner therapy (CAT). Despite its clinical importance, evidence on staging remains scattered across biomechanical, computational, digital treatment-planning, and clinical studies. Our literature search did not identify any comprehensive synthesis specifically dedicated to staging. Objective To systematically map the current evidence on staging in clear aligner therapy, focusing on conceptual principles, biomechanics, digital treatment planning, clinical applications, and emerging technologies. Methods A scoping review was conducted according to the Joanna Briggs Institute methodology and reported following PRISMA-ScR guidelines. PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar were searched from inception to 31 May 2026. Studies addressing staging or movement sequencing in clear aligner therapy were included. Data were extracted using a standardised form and synthesised narratively. Results Of 348 records identified, 12 studies met the inclusion criteria. Five themes emerged: (1) concept and definition of staging, (2) biomechanical principles, (3) clinical staging strategies, (4) digital treatment planning, and (5) automated staging and future directions. The evidence suggests that staging has evolved from sequential tooth movement into a comprehensive biomechanical and digital treatment-planning strategy incorporating movement sequencing, anchorage management, attachment design, force optimisation, computational modelling, and artificial intelligence. However, prospective clinical evidence remains limited. Conclusions Staging is an important component of contemporary clear aligner therapy, integrating biomechanics with digital treatment planning, which may contribute to improved treatment predictability. Future research should emphasise standardised terminology, prospective clinical validation of staging protocols, and transparent integration of artificial intelligence into clinical decision support.