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Lombardo EC, Lione R, Franchi L, Gaffuri F, Maspero C, Cozza P, Pavoni C. Dentoskeletal effects of clear aligner vs twin block-a short-term study of functional appliances. J Orofac Orthop 2024; 85:317-326. [PMID: 36651930 PMCID: PMC11358164 DOI: 10.1007/s00056-022-00443-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 11/29/2022] [Indexed: 01/19/2023]
Abstract
PURPOSE The twin block (TB) is one of the most widely used functional appliances for the correction of class II malocclusions. Align Technology (San Jose, CA, USA) developed the Invisalign® mandibular advancement (MA) that replicates the mechanism of action of a functional appliance. The aim of this study was to compare the changes produced by the TB versus those by MA. METHODS The records of 56 class II patients treated with the TB (TB group: n = 35) or the MA (MA group: n = 21) were compared to a control sample of 15 untreated class II subjects (UC2). RESULTS The TB and MA groups showed a significant reduction of the ANB angle, compared to the controls (TB group: -1.5°; MA group: -1.5°; UC2 group: +0.2°). For the Co-Gn values, the TB and MA groups showed significant differences when compared with the UC2 group with an increase of 8.4 mm in TB patients and of 8.3 mm in MA patients. The increase of the distance of Pg to the true vertical line (TVL) was the only measurement where significant differences between the three groups were found with a greater advancement of the soft tissue pogonion in the TB group compared with the MA group and the UC2 group (TB group: +3 mm; MA group: +0.9 mm; UC2 group: -1.6 mm). The angle between the palatal plane and mandibular plane revealed a more relevant reduction in the TB and MA groups. Both appliances were able to reduce overjet and vertical overbite values. CONCLUSIONS Treatment with the MA and TB appliances produced a significant elongation of the mandible with an improvement in sagittal relationship, overjet, and vertical overbite and with good control of the vertical relationship. TB subjects showed a greater advancement of the soft tissue chin.
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Affiliation(s)
| | - Roberta Lione
- Department of Dentistry, UNSBC, Tirana, Albania
- UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy
| | - Lorenzo Franchi
- Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Francesca Gaffuri
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinco, Milan, Italy
| | - Cinzia Maspero
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinco, Milan, Italy
| | - Paola Cozza
- Department of Dentistry, UNSBC, Tirana, Albania
- UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy
| | - Chiara Pavoni
- Department of Systems Medicine, University of Rome 'Tor Vergata', Viale Oxford 81, 00133, Rome, Italy.
- Department of Dentistry, UNSBC, Tirana, Albania.
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Alawdi GM, Al Fahad MF, Al Muzher SB, Alfaifi AH, Hazeem AM, Dakheel RS, Jan RH, Al-Qutub LM, Alharbi LH, Khalil A. Does Invisalign Outperform Fixed Appliance in Treating Vertical Discrepancies? Cureus 2024; 16:e65973. [PMID: 39221357 PMCID: PMC11365740 DOI: 10.7759/cureus.65973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2024] [Indexed: 09/04/2024] Open
Abstract
Aligners became popular among adult patients for their superior aesthetics and comfort in comparison to conventional fixed appliances. It has undergone numerous enhancements over time, allowing it to address more complex malocclusions. Many researchers argued that managing vertical discrepancies is more challenging than addressing anteroposterior issues. This complexity arose from the mechanical requirements for treatment and the required mechanics to prevent relapse. Studies assessing the treatment outcome of anterior open bite closure using clear aligners have yielded conflicting results regarding the mechanisms of bite closure. Proposed mechanisms included extrusion of upper or lower incisors, lingual tipping of upper or lower incisors, intrusion of upper or lower molars, counterclockwise rotation of the mandible, or various combinations of these mechanisms. The research highlighted the biomechanical challenges associated with using aligners for the treatment of deep bites as mandibular incisor intrusion and leveling the curve of Spee remain among the least predictable movements. Given the widespread use of aligners, it is imperative to rigorously assess the effectiveness of clear aligners in achieving overbite correction to ensure they deliver the desired outcome. This review aimed to assess the performance of Invisalign in the management of vertical discrepancies. It sought to identify the dentoskeletal effects of clear aligners in addressing deep bite and anterior open bite cases, understand the mechanisms behind overbite correction, and provide a comprehensive overview of the existing research on this topic.
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Fialho T, de Freitas KMS, Ohira ETB, de Souza JEP, de Oliveira RCG, de Oliveira RCG, Valarelli FP, Pinzan-Vercelino CRM, Cotrin P. Comparison of the efficiency of initial dental alignment with Invisalign® aligners changed every 7 or 14 days in mature adults: Randomized clinical trial. Orthod Craniofac Res 2024; 27:544-551. [PMID: 38321815 DOI: 10.1111/ocr.12766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 01/17/2024] [Accepted: 01/26/2024] [Indexed: 02/08/2024]
Abstract
OBJECTIVE To compare the anterior crowding correction after sequential use of the first 5 aligners between two aligner exchange protocols (7 and 14 days) in mature adult patients. MATERIALS AND METHODS Thirty-six patients over 35 years who received orthodontic treatment with Invisalign® were randomly allocated to two different aligner replacement sequence protocols: Group 1: exchange every 7 days (n = 18); and Group 2: exchange every 14 days (n = 18). All patients were scanned with iTero Element 5D® (Align Technology) in two treatment times: at pre-treatment (T1) and after using the first five aligners (T2). Little's Irregularity Index (LII) and arch widths were evaluated with OrthoCAD software. Intra and intergroup comparisons were performed with the dependent and independent t-tests. The results were considered significant for P < .05. RESULTS Thirty-five patients completed the study. Both groups' maxillary and mandibular Irregularity Indexesi were significantly lower at T2. There was no significant difference in inter-canine, inter-premolar, and intermolar distances. G2 (14 days) presented a greater decrease in mandibular irregularity than G1 (7 days). CONCLUSION Both exchange protocols (7 and 14 days) effectively correct anterior crowding in the initial phase of orthodontic treatment with aligners in mature adult patients. However, the 14-day exchange protocol provided a greater correction in mandibular anterior crowding in the evaluated period than the 7-day exchange protocol.
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Affiliation(s)
- Tiago Fialho
- Department of Orthodontics, Ingá University Center - UNINGÁ, Maringá, Paraná, Brazil
- Department of Orthodontics, Bauru Dental School, Bauru, São Paulo, Brazil
| | | | - Eduardo Terumi Blatt Ohira
- Department of Orthodontics, Ingá University Center - UNINGÁ, Maringá, Paraná, Brazil
- Department of Dentistry, UNISOCIESC, Jaraguá do Sul, Santa Catarina, Brazil
| | | | | | | | | | | | - Paula Cotrin
- Department of Orthodontics, Ingá University Center - UNINGÁ, Maringá, Paraná, Brazil
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Medeiros RB, Santos RF, Mendes-Miguel JA, Rothier EKC, Mendes FM, Dominguez GC. Accuracy of arch expansion with two thermoplastic materials in Invisalign® patients: EX30® and SmartTrack®. Dental Press J Orthod 2024; 29:e2423212. [PMID: 38865514 PMCID: PMC11163956 DOI: 10.1590/2177-6709.29.2.e2423212.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 03/25/2024] [Indexed: 06/14/2024] Open
Abstract
OBJECTIVE The purpose of this retrospective study was to compare accuracy of arch expansion using two different thermoplastic materials in Invisalign aligners: EX30® (Polyethylene Terephthalate Glycol, or PETG) and SmartTrack® (polyurethane). METHODS The study sample comprised 65 adult patients consecutively treated with Invisalign from two private practices: group 1 - treated with EX30® (358 teeth) and group 2 - treated with SmartTrack® (888 teeth). Six hundred and twenty-three measurements were assessed in three digital models throughout treatment: model 1 - initial, model 2 - predicted tooth position, and model 3 - achieved position. Sixteen reference points per arch were marked and, after best alignment, 2 points per tooth were copied from one digital model to another. Linear values of both arches were measured for canines, premolars, and first molars: on lingual gingival margins and cusp tips of every tooth. Comparisons were performed by Wilcoxon and Mann-Whitney test. RESULTS Both termoplastic materials presented significant differences between predicted and achieved values for all measurements, except for the lower molar cusp tip in the SmartTrack® group. There is no statistical difference in the accuracy of transverse expansion between these two materials. Overall accuracy for EX30® aligners in maxilla and mandible were found to be 37 and 38%, respectively; and Smarttrack® presented an overall accuracy of 56.62% in the maxilla and 68.72% in the mandible. CONCLUSIONS It is not possible to affirm one material expands better than the other. Further controlled clinical studies should be conducted comparing SmartTrack® and EX30® under similar conditions.
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Affiliation(s)
- Raquel Bueno Medeiros
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Ortodontia (São Paulo/SP, Brazil)
| | - Renata Faria Santos
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Ortodontia (São Paulo/SP, Brazil)
| | - Jose Augusto Mendes-Miguel
- Universidade Estadual do Rio de Janeiro, Faculdade de Odontologia, Departamento de Ortodontia (Rio de Janeiro/RJ, Brazil)
| | | | - Fausto Medeiros Mendes
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Odontopediatria (São Paulo/SP, Brazil)
| | - Gladys Cristina Dominguez
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Ortodontia (São Paulo/SP, Brazil)
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He X, Huang Z, Yang Y, Yuan X, Wen S, Li Y, Hu G, Lai W, Long H. A Bibliometric Analysis of Clear Aligner Treatment (CAT) From 2003 to 2023. Cureus 2024; 16:e63348. [PMID: 39077282 PMCID: PMC11283927 DOI: 10.7759/cureus.63348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2024] [Indexed: 07/31/2024] Open
Abstract
Clear aligner treatment (CAT) has been evolving over the past two decades. This study aims to conduct a comprehensive and up-to-date bibliometric analysis of publications related to CAT, presenting the research trends, landscapes, and hot spots in this field. All publications were retrieved from the Web of Science Core Collection from 2003 to 2023. In addition to a general analysis of research landscapes, the following items were analyzed, i.e., countries, institutions, authors, journals, publications, and keywords. A total of 1031 relevant publications were included in this study. From 2003 to the present, the number of publications and citations in this field showed an increasing trend. Italy led in terms of publication counts, and Sichuan University in China had the highest publication counts among institutions. In total, 33 scholars had published a minimum of 10 articles, and the collaborations among them were mostly within each country. The American Journal of Orthodontics and Dentofacial Orthopedics published the most relevant publications. "Predictability of tooth movements," "influencing factors for clinical efficacy," "biomechanics," and "patients' perception and periodontal health" stood out as the core research focus on CAT. Our study identified the most influential countries, institutions and authors, and their cooperative relationships, and detected hot research topics on CAT, calling for more high-quality international collaborative research in the future.
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Affiliation(s)
- Xian He
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, CHN
| | - Zeyu Huang
- West China School of Stomatology, Sichuan University, Chengdu, CHN
| | - Yi Yang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, CHN
| | - Xuechun Yuan
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, CHN
| | - Shangyou Wen
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, CHN
| | - Yuetian Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, CHN
| | - Guannan Hu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, CHN
| | - Wenli Lai
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, CHN
| | - Hu Long
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, CHN
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Sadek MM, Alhashmi R. Unplanned tooth movement in deepbite correction with Invisalign: A retrospective study. J World Fed Orthod 2024; 13:136-144. [PMID: 38402054 DOI: 10.1016/j.ejwf.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/24/2023] [Accepted: 12/13/2023] [Indexed: 02/26/2024]
Abstract
BACKGROUND This study aimed to investigate unplanned tooth movements in deepbite correction with Invisalign. METHODS The sample consisted of 34 adult patients with deepbite malocclusion treated with Invisalign. Pretreatment and predicted digital models were exported from ClinCheck software, while the post-treatment model was obtained from an intraoral scan taken at the end of the first set of aligners. Digital models' superimposition was done using the eModel "Compare" software. Frequency and percentage of occurrence of unplanned linear and angular movements, their magnitude, and direction were then determined. In addition, comparison of unplanned movements was performed between anterior and posterior teeth as well as between linear and angular measurements. RESULTS The percentage of unplanned movements ranged from 1.68% to 25.63% in the maxilla and 3.36% to 23.95% in the mandible, being most evident in the first and second molars. Unplanned movements were statistically significantly more frequent in posterior teeth compared with the anterior teeth (P > 0.05). In addition, the frequency of angular movements was statistically significantly higher for each tooth than linear movement (P < 0.05) with a higher mean value. Unplanned mesiodistal movements were the least frequent. CONCLUSIONS Unplanned linear as well as angular movements were evident in almost all teeth. Unplanned faciolingual inclination and mesiodistal angulation movements were the most frequently observed. Unplanned vertical movements can affect the predictability of deepbite correction and thus merit particular attention in those cases.
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Affiliation(s)
- Mais M Sadek
- Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt; Assistant Professor of Orthodontics, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates.
| | - Reem Alhashmi
- Orthodontic Resident, College of Dental Medicine, University of Sharjah, United Arab Emirates
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Medeiros RB, Santos RF, Mendes-Miguel JA, Rothier EKC, Mendes FM, Dominguez GC. Accuracy of Invisalign® aligners in adult patients: a retrospective study of angular tooth movements. Dental Press J Orthod 2024; 29:e2423237. [PMID: 38775600 PMCID: PMC11104947 DOI: 10.1590/2177-6709.29.2.e2423237.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/22/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE This retrospective study aimed to assess the predictability of Invisalign® aligners regarding rotational, mesio-distal and buccal-lingual tip movements. METHODS Two materials were included in the analysis - EX30, used until 2013; and SmartTrack, in current use. The study comprised 56 adult patients treated with Invisalign Comprehensive. Data sample were assessed on three sets of digital models; model 1 - initial, model 2 - predicted, and model 3 - achieved. Sixty reference points were marked in each dental arch, and two reference planes assisted the superimposition. The degree of rotation, mesio-distal and buccal-lingual tip was obtained via trigonometric calculations, through a previously published validated method. The accuracy of outcomes was compared according to the types of tooth movement and teeth groups,and the influence of predetermined variables on movement accuracy was also investigated. RESULTS Rotation and mesio-distal tip did not present any significant difference when comparing EX30 and SmartTrack groups. Only buccal-lingual tip presented a significant difference, incisor and canine groups treated with EX30 aligners presented an increase in accuracy (p= 0.007 and p = 0.007, respectively). For each additional degree planned for rotation movements, there was an increase of 0.35° in the discrepancy, and an increase of 0.40° and 0.41° for mesio-distal and buccal-lingual tip, respectively. EX30 and SmartTrack discrepancies were compared by multilevel linear regression. CONCLUSION EX30 aligners reached higher accuracy for buccal-lingual tip in anterior teeth. However, for rotation and mesio-distal tip, SmartTrack and EX30 are similarly accurate. The total amount of planned movement has a significant impact on accuracy rates, with a decrease in accuracy for every additional degree.
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Affiliation(s)
- Raquel Bueno Medeiros
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Ortodontia (São Paulo/SP, Brazil)
| | - Renata Faria Santos
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Ortodontia (São Paulo/SP, Brazil)
| | - Jose Augusto Mendes-Miguel
- Universidade Estadual do Rio de Janeiro, Faculdade de Odontologia, Departamento de Ortodontia (Rio de Janeiro/RJ Brazil)
| | | | - Fausto Medeiros Mendes
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Odontopediatria (São Paulo/SP, Brazil)
| | - Gladys Cristina Dominguez
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Ortodontia (São Paulo/SP, Brazil)
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AlMogbel A, Alshawy ES, Alhusainy A. Efficacy of clear aligner therapy over conventional fixed appliances in controlling orthodontic movement: A systematic review. J Orthod Sci 2024; 13:23. [PMID: 38784075 PMCID: PMC11114459 DOI: 10.4103/jos.jos_176_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/10/2023] [Accepted: 01/03/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE The purpose of the current systematic review was to answer the clinical research question "Is Clear Aligner Therapy (CAT) effective in controlling the orthodontic movement?" by bringing together the most up-to-date information about the available evidence for CAT. METHODOLOGY On January 1, 2023, a search was conducted in PubMed, ERIC, Embase, and CINHAL for any research papers published in the previous 10 years that provided an overview of the PICO questions. Both the titles and abstracts of the selected studies were evaluated independently by two different authors, and if there was any disagreement between the two review authors, a third reviewer was brought in to settle it. RESULTS Among included studies, three were retrospective non-randomized and two studies were prospective randomized clinical trials. Various authors reported better outcome for fixed orthodontic appliances than for clear aligner treatment (CAT) in relation to mandibular incisor proclination. The mean objective grading system score was better for braces (17) than for CAT (12) with no clinically significant difference, while staging had a significant impact on treatment efficacy. CONCLUSION The results of this study suggest that clear aligners may be an effective alternative to traditional braces, but more research is needed to confirm these findings and determine the optimal size of future prospective studies evaluating this treatment.
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Affiliation(s)
- AbdulMajeed AlMogbel
- Department of Orthodontics and Pediatric Dentistry, College of Dentistry, Qassim University, Buraydah 52571, Saudi Arabia
| | - Ebrahim S. Alshawy
- Department of Orthodontics and Pediatric Dentistry, College of Dentistry, Qassim University, Buraydah 52571, Saudi Arabia
| | - Abdulmageed Alhusainy
- Department of Conservative Dentistry, College of Dentistry, Qassim University, Buraydah 52571, Saudi Arabia
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Kravitz ND, Hansa I, Vaid NR, Moshiri M, Adel SM. Does age influence deep overbite correction with Invisalign? A prospective study evaluating mandibular incisor intrusion in adolescents vs adults. Angle Orthod 2024; 94:145-150. [PMID: 37939782 PMCID: PMC10893929 DOI: 10.2319/050223-320.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 10/01/2023] [Indexed: 11/10/2023] Open
Abstract
OBJECTIVE To compare the accuracy of mandibular incisor intrusion with Invisalign (Align Technology, Santa Clara, Calif) in adolescents to that in adults. MATERIALS AND METHODS This prospective clinical study included 58 patients treated with either Invisalign Teen or Invisalign Full. Mandibular central and lateral incisors were measured on digital models created from intraoral scans. Predicted values were determined by superimposing the initial and final ClinCheck models, and achieved values were determined by superimposing the initial ClinCheck models and the digital models from the final scans. Individual teeth were superimposed with a best-fit analysis and measured using Compare software (version 8.1; GeoDigm, Falcon Heights, Minn). RESULTS The mean accuracies of mandibular incisor intrusion were 63.5% in adolescents and 45.3% in adults, and this difference was statistically significant. The amounts of achieved intrusion were 1.7 mm in adolescents and 0.9 mm in adults, and this difference was also statistically significant. Overall, there was a weak negative correlation between age and accuracy; as age advanced, the accuracy of mandibular incisor intrusion diminished slightly. CONCLUSIONS Mandibular incisor intrusion with Invisalign is significantly more accurate in adolescents than in adults. Orthodontists could contemplate reducing the degree of overcorrection for mandibular incisor intrusion in adolescents with deep overbites undergoing Invisalign Teen but still implementing the reverse curve of Spee mechanics.
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Keilig L, Brieskorn L, Schwarze J, Schupp W, Bourauel C, Konermann A. Treatment Efficiency of Maxillary and Mandibular Orovestibular Tooth Expansion and Compression Movements with the Invisalign ® System in Adolescents and Adults. J Clin Med 2024; 13:1267. [PMID: 38592077 PMCID: PMC10932250 DOI: 10.3390/jcm13051267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 04/10/2024] Open
Abstract
OBJECTIVES Aligners are an effective and esthetic orthodontic treatment option for permanent and mixed dentition. There are only a few studies dealing with the effectiveness of orovestibular tooth movement using aligners and applying adequate examination methods. In the present retrospective study, the aligner efficiency of orovestibular movements for the entire dentition was systematically evaluated using 3D superimposition, taking into account the influence of jaw, tooth type and Invisalign® system. METHODS Group 1 (n = 18 adults, Invisalign®) and Group 2 (n = 17 adolescents, Invisalign® Teen) were treated with Invisalign® Ex30 aligner material and Invisalign® specific auxiliary means. In this non-interventional retrospective study, pre- and post-treatment maxillary and mandibular plaster cast models were scanned and superimposed with ClinChecks® via Surface-Surface Matching Algorithm on unmoved teeth providing stable references. Effectivity of planned versus clinically realized movements was evaluated for each tooth. Statistics were performed with a t-test and Bonferroni-Holm correction (α = 0.05). RESULTS Orovestibular movement efficiency was excellent without statistical significance regarding jaw, tooth type or Invisalign® system. Mandibular translational tooth movements were highly effective, and outstanding for premolars (91-98%). Maxillary translational tooth movements were successful for incisors and premolars, but less effective for canines and molars. Almost all teeth were moderately or very effectively corrected by crown tipping, performing better for mandibular (70-92%) than maxillary (22-31%) canines as much as for adolescent upper front teeth (81-85%) and lower canines (92%). CONCLUSIONS Aligners are able to effectively implement translational orovestibular movements, supported by tilting the crowns for even more efficient implementation of the movements. This phenomenon was observed in our studies for all teeth in both jaws, regardless of the Invisalign® system used. Treatment planning should nevertheless take into account the individual patient parameters with regard to the movements to be performed in order to make the aligner therapy as successful as possible in terms of realizing the desired therapeutic goal.
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Affiliation(s)
- Ludger Keilig
- Oral Technology, University Hospital Bonn, 53111 Bonn, Germany
- Department of Prosthodontics, University Hospital Bonn, 53127 Bonn, Germany
| | - Lena Brieskorn
- Oral Technology, University Hospital Bonn, 53111 Bonn, Germany
| | | | | | | | - Anna Konermann
- Department of Orthodontics, University Hospital Bonn, University of Bonn, Welschnonnenstr. 17, 53111 Bonn, Germany
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Ardila CM, Arrubla-Escobar DE, Vivares-Builes AM. Efficacy of microchips and 3D sensors for orthodontic force measurement: A systematic review of in vitro studies. Orthod Craniofac Res 2024. [PMID: 38372469 DOI: 10.1111/ocr.12768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/28/2024] [Accepted: 02/03/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVE To evaluate the efficacy of microchips and 3D microsensors in the measurement of orthodontic forces. METHODS Through September 2023, comprehensive searches were conducted on PubMed/MEDLINE, SCOPUS and SCIELO without restrictions. RESULTS After removing duplicate entries and applying the eligibility criteria, 23 studies were included for analysis. All the studies were conducted in vitro, and slightly more than half of them were centred on evaluating orthodontic forces exerted by aligners. Eight utilized microchips as measurement tools, while the remaining studies made use of 3D microsensors for their assessments. In the context of fixed appliances, key findings included a high level of agreement in 3-dimensional orthodontic force detection between simulation results and actual applied forces. Incorporating critical force-moment combinations during smart bracket calibration reduced measurement errors for most components. Translational tooth movement revealed a moment-to-force ratio, aligning with the bracket's centre of resistance. The primary findings in relation to aligners revealed several significant factors affecting the forces exerted by them. Notably, the foil thickness and staging were found to have a considerable impact on these forces, with optimal force transmission occurring at a layer height of 150 μm. Furthermore, the type of material used in 3D-printing aligners influenced the force levels, with attachments proving effective in generating extrusive forces. Deliberate adjustments in aligner thickness were observed to alter the forces and moments generated. CONCLUSIONS Microchips and 3D sensors provide precise and quantitative measurements of orthodontic forces in in vitro studies, enabling accurate monitoring and control of tooth movement.
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Affiliation(s)
- Carlos M Ardila
- School of Dentistry, University of Antioquia, Medellín, Colombia
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Gao Y, Sun X, Yan X, Tang Z, Lai W, Long H. Orthodontic Practitioners' Knowledge and Education Demand on Clear Aligner Therapy. Int Dent J 2024; 74:81-87. [PMID: 37500450 PMCID: PMC10829360 DOI: 10.1016/j.identj.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/14/2023] [Accepted: 07/03/2023] [Indexed: 07/29/2023] Open
Abstract
OBJECTIVES Clear aligner therapy (CAT) has been gaining popularity amongst the orthodontic community. No systematic course on CAT has been reported to date. The objectives of this study were to determine practitioners' knowledge and to offer insights for future tailored courses on CAT. METHODS An online questionnaire was distributed. The questionnaire comprised personal background information, predictability of tooth movement through CAT, and CAT knowledge that practitioners demanded to learn. Four senior expert orthodontists' answers to the predictability of tooth movement through CAT were averaged to be a standard reference. Descriptive statistics, 1-way analysis of variance (ANOVA), principal component analysis, Student t test, and multivariate logistics regression analysis were performed with significance set at P < .05. RESULTS In total, 190 practitioners participated in this study. As compared to the standard reference, participants overestimated the predictability of difficult-to-be-achived tooth movements (eg, molar mesialisation; P < .0001). Strategy of managing troubleshooting cases and extraction cases ranked the highest CAT knowledge that participants requested to learn. Practice type, number of completed CAT cases, number of undergoing CAT cases, years of practice, education background, and time of using CAT were the influencing factors of the questions regarding the predictability of tooth movement through CAT and CAT knowledge that were demanded to be learned. CONCLUSIONS The predictability of difficult-to-be-achieved tooth movement through CAT is often overestimated by practitioners with limited clinical experience. Tailored education on CAT, especially managing troubleshooting cases and extraction cases, should be designed for all practitioners.
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Affiliation(s)
- Yanzi Gao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xuejun Sun
- Department of Biostatistics, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, North Carolina, USA
| | - Xinyu Yan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ziwei Tang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wenli Lai
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hu Long
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Caruso S, De Felice ME, Valenti C, Pagano S, Caruso S, Gatto R, Lombardo G. An evaluation of the Invisalign® Aligner Technique and consideration of the force system: a systematic review. Syst Rev 2024; 13:43. [PMID: 38281057 PMCID: PMC10821231 DOI: 10.1186/s13643-023-02437-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 12/13/2023] [Indexed: 01/29/2024] Open
Abstract
OBJECTIVE Since its introduction 25 years ago, the Invisalign® system has undergone multiple digital and biomechanical evolutions and its effectiveness is often compared to traditional systems without considering the many differences which characterize them. The main aim of this systematic review is to look at the literature dealing with studies on teeth movements using the Invisalign® system and the management of these movements through digital planning and artificial intelligence. MATERIALS AND METHODS The following electronic databases were searched: MEDLINE, Embase, the Cochrane Oral Health Group's Trials Register, and CENTRAL. Unpublished studies were searched on ClinicalTrials.gov, the National Research Register, and Pro-Quest Dissertation Abstracts and Thesis database. RESULTS Twenty-four studies (15 retrospective, 5 prospective, 2 pilot, and 2 case-control) were included. The results of the analysis carried out on the available literature show that the Invisalign® system is recognized to be a valid alternative to conventional orthodontic treatment in no-extraction cases. The results are influenced by the methods for assessing the effectiveness of this technique and by the comparison bias of the traditional system with the innovative digital system. CONCLUSIONS Since the introduction of SmartForce and SmartTrack material, the efficacy of the treatment has improved. There is still a shortage of high-quality evidence concerning the treatment modality. In order to make the treatment with the aligners more efficient, a correct management of the ClinCheck® software and a proper use of the biomechanics are necessary. The aligned force-driven system should be taken into account when developing the digital planning.
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Affiliation(s)
- Silvia Caruso
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100, L'Aquila, Italy
| | - Maria Elena De Felice
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100, L'Aquila, Italy.
| | - Chiara Valenti
- CISAS "Giuseppe Colombo", University of Padua, Via Venezia, 15, 35131, Padua, Italy
- Department of Medicine and Surgery, Faculty of Dentistry, University of Perugia, S. Andrea delle Fratte, 06156, Perugia, Italy
| | - Stefano Pagano
- Department of Medicine and Surgery, Faculty of Dentistry, University of Perugia, S. Andrea delle Fratte, 06156, Perugia, Italy
| | - Sara Caruso
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100, L'Aquila, Italy
| | - Roberto Gatto
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100, L'Aquila, Italy
| | - Guido Lombardo
- Department of Medicine and Surgery, Faculty of Dentistry, University of Perugia, S. Andrea delle Fratte, 06156, Perugia, Italy
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Balboni A, Cretella Lombardo E, Balboni G, Gazzani F. Vertical effects of distalization protocol with Clear aligners in Class II patients: a prospective study. Minerva Dent Oral Sci 2023; 72:291-297. [PMID: 37162331 DOI: 10.23736/s2724-6329.23.04783-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND The aim of the present prospective study was to detect the effects on vertical dentoskeletal dimension produced by molar distalization with Clear Aligners in a group of subjects with Class II malocclusion. METHODS The Clear Aligners Group (CAG) comprised 20 patients (13 females, seven males) with a mean age of 17.2±3.2 years. The same standardized protocol of sequential distalization was applied in all subjects. For each patient lateral cephalograms have been analyzed before treatment (T1) and at the end of the therapy (T2). RESULTS At the end of treatment, clear aligners were effective in the correction of Class II dental relationship with the correction of the overjet (-1.3 mm). The treated group showed statistically significant reduction in FMA angle (-1.3°) associated with a counterclockwise rotation of the occlusal plane (POccl^PF -3.1°; SN^POccl -4.2°) and a slight intrusion of maxillary first molars to palatal plane (-0.9 mm). Finally, statistically significant differences were detected in anterior facial height (N-Me) and in the ArGo^GoMe angle (-1.2 mm and -3.4°, respectively). CONCLUSIONS Upper molar distalization with clear aligners represents a valid alternative to non-extraction treatment of Class II malocclusion, reducing the extrusion of maxillary first molars and improving the control of the occlusal plane and of the vertical dimension.
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Affiliation(s)
- Alessia Balboni
- Department of Systems Medicine, Tor Vergata University, Rome, Italy -
| | | | - Giulia Balboni
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
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15
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Fatani E, Alkhamsi HB, Arishi FO, Altaweel SM, Asiri MA, Albuni WW, Baseer MA. Impact of Invisalign G-series Updates on Improving Predicted Outcomes: A Retrospective Study. Cureus 2023; 15:e50615. [PMID: 38226098 PMCID: PMC10788698 DOI: 10.7759/cureus.50615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 11/28/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Understanding the real-world implications of periodic changes to orthodontic appliances can provide valuable insights for future treatment strategies and patient outcomes. This study aimed to investigate the impact of the latest updates added to the G7 and G8 Invisalign series on actual versus predicted outcomes and the percentage accuracy of the treatment. METHOD This retrospective study was conducted in private orthodontic practices in Riyadh, Saudi Arabia. Orthodontists carried out Invisalign® treatment using the latest updates added to the G7 and G8 Invisalign series. The study group comprised patients with different malocclusion types who received non-extraction Invisalign treatment. The Invisalign treatment plan was provided by the ClinChecks program (Invisalign, San Jose, United States) for patients treated throughout the years (2016-2022). Different dimensions were assessed to record predicted and actual treatment outcomes with the aid of iTero® (Align Technology, San Jose, United States) and ClinCheck® (Invisalign, San Jose, United States). The percentage accuracy was determined using the formula (100%-((Predicted-Actual)/Predicted) *100%). RESULTS A total of 108 patients (male = 34 (31.5%) and female = 74 (68.5%)) treated with Invisalign G7 and G8 series were considered in this study. The overall mean and standard deviation values of vertical distance (2.91±1.42), intermolar distance in the lower arch (52.68±3.15), overjet (2.71±1.06), and inter-incisal angle (138.24±12.18) were higher than the predicted model. However, the predicted model showed higher mean and standard deviation values for intercanine distances in the upper (36.94±1.57) and lower arches (28.48±1.40) and upper intermolar distances (57.21±2.91). The G7 versus G8 intercanine distance in lower (61.28±47.67 vs. 80.51±38.32), intermolar distance in upper (61.72±47.67 vs. 69.95±44.11), and intermolar distance in lower (100.68±3.80 vs. 100.89±2.52) were relatively higher in the G8 series than the G7. The accuracy percentage was higher with the G8 series than with the G7 regarding the intercanine distance in the upper arch. In contrast, the G7 series showed a higher mean percentage accuracy of vertical distance (91.11±84.83 vs. 76.76±65.45), overjet (58.44±35.17 vs. 53.71±45.87), and inter-incisal angle (34.47±44.06 vs. 27.53±37.98) than the G8 series. CONCLUSION The percentage accuracy of aligner therapy administered using the Invisalign G7 and G8 series demonstrated no significant variation.
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Affiliation(s)
- Eman Fatani
- Preventive Dentistry, College of Medicine and Dentistry, Riyadh Elm University, Riyadh, SAU
| | - Hadeel B Alkhamsi
- Dentistry, College of Medicine and Dentistry, Riyadh Elm University, Riyadh, SAU
| | - Faisal O Arishi
- Dentistry, College of Dentistry, Prince Sattam bin Abdulaziz University, Al-Kharj, SAU
| | - Shoug M Altaweel
- Dentistry, College of Dentistry, Majmaah University, Al Majma'ah, SAU
| | - Malak A Asiri
- Dentistry, College of Dentistry, King Khalid University, Abha, SAU
| | | | - Mohammad A Baseer
- Preventive Dentistry, College of Medicine and Dentistry, Riyadh Elm University, Riyadh, SAU
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Lim ZW, Meade MJ, Weir T. The predictability of maxillary curve of Spee leveling with the Invisalign appliance. Angle Orthod 2023; 93:638-643. [PMID: 37301988 PMCID: PMC10633806 DOI: 10.2319/022423-128.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/01/2023] [Indexed: 06/12/2023] Open
Abstract
OBJECTIVES To evaluate the predictability of the Invisalign appliance (Align Technology, Santa Clara, Calif) in leveling the maxillary curve of Spee (COS). MATERIALS AND METHODS A retrospective sample of adult subjects treated with the Invisalign appliance between 2013 and 2019 were selected. Patients were treated nonextraction in the maxillary arch and had either Angle Class I or II malocclusions with a minimum of 14 aligners with no bite ramps. Initial, predicted, and actual outcomes were analyzed with Geomagic Control X software (version 2017.0.3; 3D Systems, Cary, NC). RESULTS A sample of 53 cases satisfied inclusion/exclusion criteria. Paired t-tests demonstrated a significant difference between mean predicted and actual maxillary COS leveling with a shortfall of 0.11 mm (SD = 0.37; P = .033). Planned intrusion tended to be more accurate posteriorly with an overexpression of 117% for the first molars. Planned extrusion was the least accurate, with the mid-arch demonstrating expressions of -14% to -48%. These teeth intruded despite a prescribed extrusive movement. CONCLUSIONS The Invisalign appliance did not accurately predict maxillary COS leveling. Planned intrusive movements were overcorrected, and planned extrusive movements were either undercorrected or resulted in intrusion. This effect was most apparent for the upper first molar, which expressed 117% and -48% of planned intrusion and extrusion, respectively.
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Affiliation(s)
- Zi Wei Lim
- Corresponding author: Dr Zi Wei Lim, Level 10, Department of Orthodontics, Adelaide Dental School, The University of Adelaide, Corner of North Terrace and George St, Adelaide, SA 5005, Australia (e-mail: )
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Groody JT, Lindauer SJ, Kravitz ND, Carrico CK, Madurantakam P, Shroff B, Darkazanli M, Gardner WG. Effect of clear aligner attachment design on extrusion of maxillary lateral incisors: A multicenter, single-blind randomized clinical trial. Am J Orthod Dentofacial Orthop 2023; 164:618-627. [PMID: 37610383 DOI: 10.1016/j.ajodo.2023.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 07/01/2023] [Accepted: 07/01/2023] [Indexed: 08/24/2023]
Abstract
INTRODUCTION Extrusion of maxillary lateral incisors during aligner treatment is a difficult movement to achieve accurately. Despite recommendations regarding attachment design, few studies and no prospective trials compare predictability among attachments. This study aimed to compare the efficacy between optimized and horizontal attachment designs for achieving maxillary lateral incisor extrusion during clear aligner treatment. METHODS The study included maxillary lateral incisors in 3 orthodontic practices requiring at least 0.3 mm of extrusion during the first series of 20-25 aligners in patients aged ≥16 years who were scheduled to begin clear aligner treatment (Invisalign; Align Technology, San Jose, Calif). Teeth were randomly assigned to receive optimized (O), rectangular horizontal nonbeveled (H), rectangular horizontal incisally-beveled (HIB), or rectangular horizontal gingivally-beveled (HGB) attachments. After the first series, a blinded evaluator measured extrusion using superimpositions with initial and predicted models. Linear models determined the difference in the predicted extrusion percentage achieved on the basis of attachment design. Other covariates were patient age, sex, number of trays, and self-reported compliance. RESULTS Forty patients (74 teeth) were enrolled, and 38 patients (71 teeth) completed the study. Intraexaminer and interexaminer reliability for extrusion measurements was high (intraclass correlation coefficient, 0.985 and 0.991, respectively). The achieved extrusion was significantly less than predicted (mean, 73%; P <0.0001). The average achieved extrusion was 62%, 79%, 78%, and 78% for O, H, HIB, and HGB attachments, respectively, with H significantly more effective than O (P = 0.0403). Horizontal attachments (H, HIB, and HGB combined) were significantly more effective than O attachments (P = 0.0060), with an average difference in achieved extrusion of 14% of the predicted amount (95% confidence interval, 4-23; estimated 76% vs 62%). Horizontal attachments were an estimated 22% more effective than O attachments for extruding maxillary lateral incisors. CONCLUSIONS Horizontal attachments are more effective than O attachments for predicted maxillary lateral incisor extrusion between 0.3 and 2.5 mm. The 3 horizontal attachment designs evaluated performed similarly for achieving predicted extrusion. TRIAL REGISTRATION This randomized clinical trial was registered and reported at clinicaltrials.gov (NCT04968353). PROTOCOL The protocol was not published before trial commencement. FUNDING This study was funded in part by the Alexander Fellowship of the Virginia Commonwealth University School of Dentistry, the Southern Association of Orthodontists, and the Virginia Orthodontic Education and Research Foundation. No funding source influenced the study design, the collection, analysis or interpretation of data, writing of the report, or the decision to submit the article for publication.
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Affiliation(s)
- Justin T Groody
- Formerly, Department of Orthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Va; currently, Private practice, Charlotte, NC
| | - Steven J Lindauer
- Department of Orthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Va.
| | | | - Caroline K Carrico
- Department of Public Health and Policy, School of Dentistry, Virginia Commonwealth University, Richmond, Va
| | | | - Bhavna Shroff
- Department of Orthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Va
| | - Manar Darkazanli
- School of Dentistry, Virginia Commonwealth University, Richmond, Va
| | - William Graham Gardner
- Formerly, Department of Orthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Va; currently, Private practice, Charlotte, NC; Private practice, Richmond, Va
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Kawamura J, Ojima K, Nanda R. Effect of attachment type on distal bodily movement of the maxillary canine in aligner orthodontics: a finite element study. Angle Orthod 2023; 93:566-571. [PMID: 37079796 PMCID: PMC10575637 DOI: 10.2319/120121-879.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 03/01/2023] [Indexed: 04/22/2023] Open
Abstract
OBJECTIVES To clarify the effect of attachment types on bodily movement of the maxillary canine in aligner orthodontics. MATERIALS AND METHODS Using an aligner, the canine was moved bodily by 0.1 mm distally as a target position. Orthodontic tooth movement was simulated using the finite element method (FEM). The alveolar socket was displaced in the same manner as the initial movement caused by elastic deformation of the periodontal ligament. First, the initial movement was calculated, and then the alveolar socket was displaced in the same direction and with the same magnitude as the initial movement. These calculations were repeated to move the teeth after placement of the aligner. The teeth and the alveolar bone were assumed to be rigid bodies. A FEM model of the aligner was made based on the crown surfaces. The thickness of the aligner was 0.45 mm, and its Young's modulus was 2 GPa. Three types of attachments-semicircular couple, vertical rectangular, and horizontal rectangular-were placed on the canine crown. RESULTS Regardless of the type of attachment, upon placement of the aligner on the dentition the crown of the canine moved to the target position, while the apex hardly moved. That is, the canine tipped and rotated. After repeating the calculation, the canine became upright and moved bodily regardless of the attachment type. In the aligner without an attachment, the canine did not become upright. CONCLUSIONS There was almost no difference among attachment types in terms of achieving bodily movement of the canine.
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Affiliation(s)
- Jun Kawamura
- Corresponding author: Jun Kawamura, DDS, PhD, Kawamura Dental Office, 4-21 Sodensakae-machi Gifu City, Gifu, 502-0847, Japan (e-mail: )
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Marcelino V, Baptista S, Marcelino S, Paço M, Rocha D, Gonçalves MDP, Azevedo R, Guimarães AS, Fernandes GVO, Pinho T. Occlusal Changes with Clear Aligners and the Case Complexity Influence: A Longitudinal Cohort Clinical Study. J Clin Med 2023; 12:jcm12103435. [PMID: 37240538 DOI: 10.3390/jcm12103435] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/28/2023] [Accepted: 05/07/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Clear aligners (CA) are used 22 h daily, creating a bite-block effect. This work aims to (i) analyze occlusal changes before the beginning of treatment, after the first set of CA and after the use of additional aligners; (ii) compare planned occlusal contacts with the ones obtained after the first set of CA; (iii) analyze the occlusal changes occurred after reaching the orthodontic goals after 3 months of using CA only at night; (iv) evaluate and characterize which tooth movements did not allow the treatment to be completed at the end of the first set of aligners, and finally (v) verify the possible relation between the changes in occlusal contact and areas and parameters such as case complexity and facial biotype. MATERIALS AND METHODS A quantitative, comparative, and observational longitudinal cohort study design was implemented to evaluate the clinical data and the complexity levels of cases receiving CA. A non-probabilistic and convenience sample of 82 individuals was recruited. The orthodontic malocclusion traits were classified as simple, moderate, or complex corrections based on the basis of the Align® recommendations with the Invisalign® evaluation tool. According to the Invisalign® criteria, patients need only one complex problem for their case to be classified as complex. Meshlab® v. 2022.02, ClinCheck® version Pro 6.0, My-Itero® version 2.7.9.601 5d plus, and IBM® SPSS Statistics software (Statistical Program for Social Sciences), version 27.0 for Windows were the software® used. RESULTS A statistically significant decrease in area and occlusal contacts number were observed from before the start of orthodontic treatment (T0) to the end of treatment (T1). The changes in the occlusal area (from T0 to T1) were statistically different between hyperdivergent (28.24 [15.51-40.91]) and hypodivergent (16.23 [8.11-24.97]) biotypes (p = 0.031). A significant difference between the hyperdivergent (4.0 [2.0-5.0]) and normodivergent (5.5 [4.0-8.0]) group was found in T1 for the anterior contacts (p = 0.044). Anterior contacts obtained were significantly higher than the planned (p = 0.037) Between T1 and T2 statistically significant increases of occlusal areas, posterior and total contacts were observed. CONCLUSIONS Occlusal contact and area were decreased, either at the end of the first set or after the use of additional aligners. Anterior occlusal contacts obtained were higher than planned as opposed to posterior occlusal contacts obtained. The hardest tooth movements to achieve to complete the treatment were distalization, rotation, and posterior extrusion. After completing orthodontic treatment (T1) to 3 months after (T2) using additional aligners only at night, posterior occlusal contacts were significantly increased, which could be due to the natural settling of the teeth in this period.
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Affiliation(s)
- Vanessa Marcelino
- UNIPRO-Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), 4585-116 Gandra, Portugal
| | - Sofia Baptista
- UNIPRO-Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), 4585-116 Gandra, Portugal
| | - Sandra Marcelino
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
| | - Maria Paço
- UNIPRO-Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), 4585-116 Gandra, Portugal
| | - Duarte Rocha
- UNIPRO-Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), 4585-116 Gandra, Portugal
| | - Maria Dos Prazeres Gonçalves
- TOXRUN-Toxicology Research Unit, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), 4585-116 Gandra, Portugal
| | - Rui Azevedo
- TOXRUN-Toxicology Research Unit, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), 4585-116 Gandra, Portugal
| | - António Sérgio Guimarães
- Laboratory of Neuroimmune Interface of Pain Research, Faculdade São Leopoldo Mandic, Campinas 13045-755, Brazil
| | | | - Teresa Pinho
- UNIPRO-Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), 4585-116 Gandra, Portugal
- Institute for Molecular and Cell Biology, i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal
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Inchingolo AM, Ceci S, Coloccia G, Azzollini D, Malcangi G, Mancini A, Inchingolo F, Trerotoli P, Dipalma G, Patano A. Predictability and Effectiveness of Nuvola ® Aligners in Dentoalveolar Transverse Changes: A Retrospective Study. Biomedicines 2023; 11:biomedicines11051366. [PMID: 37239039 DOI: 10.3390/biomedicines11051366] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/28/2023] [Accepted: 05/03/2023] [Indexed: 05/28/2023] Open
Abstract
Nowadays, many people use clear aligners to address their dental issues. The efficacy of transparent dental aligners must be investigated even though they are more aesthetically pleasing, easy to use, and tidy than permanent tools. Thirty-five patients in this study's sample group who used Nuvola® clear aligners for their orthodontic therapy were prospectively observed. Initial, simulated, and final digital scans were analysed with a digital calliper. The actual results were compared with the prescribed ending position to evaluate the efficacy of transversal dentoalveolar expansion. Aligner treatments in Groups A (12) and B (24), particularly in the dental tip measures, demonstrated high adherence to the prescription. On the other hand, the gingival measures exhibited a greater level of bias, and the differences were statistically significant. However, there was no difference in the outcomes between the two groups (12 vs. 24). Within specific parameters, the evaluated aligners were shown to be helpful in predicting movements in the transverse plane, particularly when considering movements linked to the vestibular-palatal inclination of the dental elements. This article compares the expansion effectiveness of Nuvola® aligners compared with other work in the literature using competitor companies.
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Affiliation(s)
| | - Sabino Ceci
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Giovanni Coloccia
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Daniela Azzollini
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Paolo Trerotoli
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
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Yan X, Zhang X, Ren L, Yang Y, Wang Q, Gao Y, Jiang Q, Jian F, Long H, Lai W. Effectiveness of clear aligners in achieving proclination and intrusion of incisors among Class II division 2 patients: a multivariate analysis. Prog Orthod 2023; 24:12. [PMID: 37009943 PMCID: PMC10068686 DOI: 10.1186/s40510-023-00463-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 03/14/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND The predictability of incisor movement achieved by clear aligners among Class II division 2 patients is poorly understood. The aim of this retrospective study was to determine the effectiveness of clear aligners in proclining and intruding upper incisors and its influencing factors. METHODS Eligible patients with Class II division 2 malocclusion were included. For clear aligner therapy, three types of incisor movements were designed: proclination, intrusion and labial movement. Pre-treatment and post-treatment dental models were superimposed. The differences between predicted and actual (DPA) tooth movement of incisors were analyzed. Univariate and multivariate linear regression were used to analyze the potential influencing factors. RESULTS A total of 51 patients and their 173 upper incisors were included. Actual incisor proclination and intrusion were less than predicted ones (both P < 0.001), while actual labial movement was greater than predicted one (P < 0.001). Predictability of incisor proclination and intrusion was 69.8% and 53.3%, respectively. Multivariate linear regression revealed that DPA of proclination was significantly positively associated with predicted proclination (B = 0.174, P < 0.001), ipsilateral premolar extraction (B = 2.773, P < 0.001) and ipsilateral canine proclination (B = 1.811, P < 0.05), while negatively associated with molar distalization (B = - 2.085, P < 0.05). The DPA of intrusion was significantly positively correlated with predicted intrusion (B = 0.556, P < 0.001) while negatively associated with labial mini-implants (B = - 1.466, P < 0.001). The DPA of labial movement was significantly positively associated with predicted labial movement (B = 0.481, P < 0.001), while negatively correlated with molar distalization (B = - 1.004, P < 0.001), labial mini-implants (B = - 0.738, P < 0.001) and age (B = - 0.486, P < 0.05). CONCLUSIONS For Class II division 2 patients, predicted incisor proclination (69.8%) and intrusion (53.3%) are partially achieved with clear aligner therapy. Excessive labial movement (0.7 mm) of incisors may be achieved. Incisor movement is influenced by predicted movement amount, premolar extraction, canine proclination, molar distalization, mini-implants and age.
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Affiliation(s)
- Xinyu Yan
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Center for Oral Research, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Ren Min Nan Road, Chengdu, 610041, China
| | - Xiaoqi Zhang
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Center for Oral Research, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Ren Min Nan Road, Chengdu, 610041, China
| | - Linghuan Ren
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Center for Oral Research, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Ren Min Nan Road, Chengdu, 610041, China
| | - Yi Yang
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Center for Oral Research, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Ren Min Nan Road, Chengdu, 610041, China
| | - Qingxuan Wang
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Center for Oral Research, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Ren Min Nan Road, Chengdu, 610041, China
| | - Yanzi Gao
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Center for Oral Research, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Ren Min Nan Road, Chengdu, 610041, China
| | - Qingsong Jiang
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Center for Oral Research, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Ren Min Nan Road, Chengdu, 610041, China
| | - Fan Jian
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Center for Oral Research, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Ren Min Nan Road, Chengdu, 610041, China
| | - Hu Long
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Center for Oral Research, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Ren Min Nan Road, Chengdu, 610041, China.
| | - Wenli Lai
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Center for Oral Research, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, Ren Min Nan Road, Chengdu, 610041, China.
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Wang Y, Chen J, Qin S, Han X, Liao L, Sima X, Guo W. An in vivo evaluation of clear aligners for optimal orthodontic force and movement to determine high-efficacy and periodontal-friendly aligner staging. Heliyon 2023; 9:e15317. [PMID: 37113787 PMCID: PMC10126945 DOI: 10.1016/j.heliyon.2023.e15317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 03/15/2023] [Accepted: 04/03/2023] [Indexed: 04/29/2023] Open
Abstract
Objectives To investigate the effect of aligner displacement on tooth movement and periodontal health to improve the efficiency of aligner treatment and explore the mechanism in vivo. Methods A two-tooth site was established by a finite element (FE) model to virtually evaluate aligner staging. A randomized controlled experiment was conducted when the tooth sites in beagles were treated with fixed or aligner appliances with different movement and force, and tooth movement and internal structure were recorded during the alignment. After sacrificing five dogs, bone-periodontal ligament (PDL)-tooth specimens were removed and processed to conduct uniaxial compression and tensile tests as well as micro-CT imaging and histological analysis. Results Three displacements of 0.25, 0.35 and 0.45 mm were obtained from FE analysis and applied in beagles. In general, aligners had poorer performance on movement compared to fixed systems in vivo, but the aligner with a staging of 0.35 mm had the highest accuracy (67.46%) (P < 0.01). Loaded with severe force, fixed sites exhibited tissue damage due to excess force and rapid movement, while aligners showed better safety. The PDL under a 0.35-mm aligner treatment had the highest elastic modulus in the biomechanical test (551.4275 and 1298.305 kPa) (P < 0.05). Conclusions Compared to fixed appliances, aligners achieve slightly slower movement but better periodontal condition. Aligners with an interval of 0.35 mm have the highest accuracy and best PDL biomechanical and biological capacities, achieving the most effective and safest movement. Even with complexity of oral cavity and lack of evaluation of other factors, these results provide insight into faster displacement as a method to improve the efficacy of aligners.
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Affiliation(s)
- Yuru Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China School/Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jie Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China School/Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Siwen Qin
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China School/Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xue Han
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China School/Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lijun Liao
- Sichuan Hospital of Stomatology, Chengdu, China
| | - Xiutian Sima
- Department of Neurosurgery, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
- Corresponding author. Department of Neurosurgery, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chengdu 610041, China.
| | - Weihua Guo
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China School/Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Corresponding author. Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Sec., Ren Min Nan Road, Chengdu 610041, China.
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Jedliński M, Mazur M, Greco M, Belfus J, Grocholewicz K, Janiszewska-Olszowska J. Attachments for the Orthodontic Aligner Treatment-State of the Art-A Comprehensive Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4481. [PMID: 36901488 PMCID: PMC10001497 DOI: 10.3390/ijerph20054481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/25/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND In recent years the burden of aligner treatment has been growing. However, the sole use of aligners is characterized by limitations; thus attachments are bonded to the teeth to improve aligner retention and tooth movement. Nevertheless, it is often still a challenge to clinically achieve the planned movement. Thus, the aim of this study is to discuss the evidence of the shape, placement and bonding of composite attachments. METHODS A query was carried out in six databases on 10 December 2022 using the search string ("orthodontics" OR "malocclusion" OR "Tooth movement techniques AND ("aligner*" OR "thermoformed splints" OR "invisible splint*" AND ("attachment*" OR "accessor*" OR "auxill*" AND "position*"). RESULTS There were 209 potential articles identified. Finally, twenty-six articles were included. Four referred to attachment bonding, and twenty-two comprised the influence of composite attachment on movement efficacy. Quality assessment tools were used according to the study type. CONCLUSIONS The use of attachments significantly improves the expression of orthodontic movement and aligner retention. It is possible to indicate sites on the teeth where attachments have a better effect on tooth movement and to assess which attachments facilitate movement. The research received no external funding. The PROSPERO database number is CRD42022383276.
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Affiliation(s)
- Maciej Jedliński
- Department of Interdisciplinary Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
- Department of Dental and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Marta Mazur
- Department of Interdisciplinary Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
- Department of Dental and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Mario Greco
- Department of Paediatric Dentistry, University of L’Aquila, 67100 L’Aquila, Italy
| | - Joyce Belfus
- Faculty of Dentistry, Universidad de los Andes, Santiago 7620001, Chile
| | - Katarzyna Grocholewicz
- Department of Interdisciplinary Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
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Santucci V, Rossouw PE, Michelogiannakis D, El-Baily T, Feng C. Assessment of Posterior Dentoalveolar Expansion with Invisalign in Adult Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4318. [PMID: 36901328 PMCID: PMC10001966 DOI: 10.3390/ijerph20054318] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
PURPOSE The primary aim was to evaluate dentoalveolar expansion with Invisalign clear aligners comparing linear measurements in ClinCheck vs. cone beam computed tomography (CBCT). This would enable an assessment of to what extent expansion gained from Invisalign clear aligners was due to buccal tipping and/or bodily translation of the posterior teeth. The study also evaluated the predictive value of Invisalign ClinCheck® (Align Technology, San Jose, CA, USA) to final outcomes. METHODS The orthodontic records of thirty-two (32) subjects comprised the sample to conduct this study. Linear values of the upper arch width were measured for premolars and molars at two different points (occlusal and gingival) utilized for ClinCheck® measurements and three different points for CBCT measurements before (T0 and after treatment (T1). Paired T-tests at a significance level of 0.05 were used for analyses. RESULTS Expansion was found to be possible with Invisalign clear aligners. However, more expansion was measured at the cusp tips compared to gingival margins (p < 0.0001), indicating more tipping was occurring than bodily translation. ClinCheck® also showed a significant overestimation of the amount of expansion capable, with nearly 70% expression in the first premolar area, and the expression decreased as one moved posteriorly with only 35% expressed at the first molar area (p < 0.0001). CONCLUSIONS Dentoalveolar expansion with Invisalign is achieved through buccal tipping of posterior teeth and bodily translation; and there is a significant overestimation of the amount of expansion achieved between ClinCheck® and clinical results.
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Affiliation(s)
- Vincent Santucci
- Private Practice, 1700 Waterfront Building 700, Wichita, KS 67206, USA
| | - Paul Emile Rossouw
- Division of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Ave., Rochester, NY 14620, USA
| | - Dimitrios Michelogiannakis
- Division of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Ave., Rochester, NY 14620, USA
| | - Tarek El-Baily
- 7-020D Katz Group Centre for Pharmacy and Health Research, Department of Dentistry and Dental Hygiene, University of Alberta, Edmonton, AB T6G 2R7, Canada
| | - Changyong Feng
- Medical Center, Department of Biostatistics and Computational Biology, School of Medicine and Dentistry, University of Rochester, Rochester, NY 14642, USA
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25
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Bates MT, Shroff B, Carrico CK, Kheirandish N, Lindauer SJ. Perceived efficacy of extrusion of maxillary lateral incisors with aligners. Am J Orthod Dentofacial Orthop 2023; 163:252-259. [PMID: 36376173 DOI: 10.1016/j.ajodo.2021.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 11/01/2021] [Accepted: 11/01/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION This study aimed to assess the perceived efficacy of aligners (Invisalign; Align Technology, Santa Clara, Calif) at performing extrusive movements of maxillary lateral incisors and to evaluate and compare differences in treatment planning protocols and other interventions used when required between orthodontists and general dentists with various degrees of experience. METHODS An original 18-question survey was sent by mail to a randomized and geographically proportionate selection of orthodontic specialists (N = 400) and general dentists (N = 400) listed as providers on the Invisalign Web site. The data were analyzed using analysis of variance and chi-square tests. RESULTS One hundred twenty-six providers responded to the survey (15.8% response rate), including 36 general dentists and 90 orthodontists. Overall, the average perceived efficacy was 4.71 out of 10 (95% confidence interval, 4.28-5.14). The threshold for identification of tracking issues was significantly associated with provider type (P = 0.0305). General dentists were significantly more likely to prefer an optimized attachment (P = 0.0001), whereas orthodontists were significantly more likely to prefer a gingivally-beveled horizontal rectangular attachment (P <0.0001). A refinement scan was the most common intervention method, followed by the bootstrap technique. CONCLUSIONS The average perceived efficacy for extruding maxillary lateral incisors with aligners was 4.71 out of 10. Orthodontists had a lower tolerance than general dentists for tracking issues. A refinement scan was the most common method of intervention. General dentists and orthodontists differed in their treatment planning preferences and timing of intervention.
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Affiliation(s)
- Mason T Bates
- Department of Orthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Va
| | - Bhavna Shroff
- Department of Orthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Va.
| | - Caroline K Carrico
- Department of Dental Public Health and Policy, School of Dentistry, Virginia Commonwealth University, Richmond, Va
| | | | - Steven J Lindauer
- Department of Orthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Va
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Coachman C, Valavanis K, Silveira FC, Kahn S, Tavares AD, Mahn E, Parize H, Saliba FMP. The crown lengthening double guide and the digital Perio analysis. J ESTHET RESTOR DENT 2023; 35:215-221. [PMID: 35506552 DOI: 10.1111/jerd.12920] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 04/21/2022] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This article describes a surgical crown lengthening double guide, which was digitally obtained to improve diagnosis, treatment outcome, and follow-up. CLINICAL CONSIDERATIONS The rehabilitation of anterior dental esthetics should involve interdisciplinary and facially driven planning for achieving pleasant long-term outcomes. Surgical crown lengthening is one of the most common periodontal surgery, which can be assisted by digital tools to improve surgical planning and follow-up. CONCLUSION The double guide for surgical crown lengthening allows the proper management of hard and soft tissues for achieving a predefined goal based on biological requirements and facially driven planning. In addition, the digital quality control allows the follow-up compared with the pre-operative condition and planned treatment plan. CLINICAL SIGNIFICANCE The use of digital tools allow the clinician to develop a facially driven planning with proper communication with the team and patient, leading to a shorter, more predictable, and less invasive surgical technique, reducing postoperative inflammation and increasing patient comfort.
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Affiliation(s)
| | | | | | - Sergio Kahn
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | | - Hian Parize
- Department of Prosthodontics, University of Sao Paulo, Sao Paulo, Brazil
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Tien R, Patel V, Chen T, Lavrin I, Naoum S, Lee RJH, Goonewardene MS. The predictability of expansion with Invisalign: A retrospective cohort study. Am J Orthod Dentofacial Orthop 2023; 163:47-53. [PMID: 36195544 DOI: 10.1016/j.ajodo.2021.07.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 07/01/2021] [Accepted: 07/01/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Few studies have evaluated the predictability of expansion with Invisalign for the current SmartTrack material. METHODS Pretreatment, predicted, and posttreatment digital models from Invisalign's ClinCheck software were obtained for 57 adult patients with a planned arch expansion of at least 3 mm. Arch width measurements were collected using a software measuring tool (MeshLab), Invisalign's arch width table, and the centroid of the clinical crown. Data for 30 patients were remeasured for each method to assess intrarater reliability. Predictability of expansion was calculated by comparing the amount of achieved expansion to predicted expansion. RESULTS The predictability of expansion across centroids for the maxillary teeth was: 72.2% canines, 78.9% first premolars, 81.1% second premolars, 63.5% first molars, and 41.5% second molars. The predictability of expansion across centroids for the mandibular teeth was: 82.3% canines, 93.0% first premolars, 87.7% second premolars, 79.8% first molars, and 42.9% second molars. The average expansion was significantly different from that predicted for each type of tooth in both the maxilla and mandible. Both underexpansion and overexpansion were observed. Arch width measurement reliability for each employed method was as follows: MeshLab (average error 0.197 mm); calculated centroids (0.002 mm); ClinCheck arch width table (0.000 mm). CONCLUSIONS On average, the amount of predicted expansion is not achieved with the Invisalign system and varies according to tooth type and arch. Discretion is required when overcorrecting to compensate for expansion inaccuracy. Both underexpansion and overexpansion were observed; further investigation into factors influencing underexpansion and overexpansion is required.
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Affiliation(s)
- Richard Tien
- University of Western Australia Dental School, the University of Western Australia, Nedlands, Western Australia, Australia
| | - Vraj Patel
- University of Western Australia Dental School, the University of Western Australia, Nedlands, Western Australia, Australia
| | - Tulrica Chen
- University of Western Australia Dental School, the University of Western Australia, Nedlands, Western Australia, Australia
| | - Igor Lavrin
- University of Western Australia Dental School, the University of Western Australia, Nedlands, Western Australia, Australia; Private practice, Melbourne, Victoria, Australia
| | - Steven Naoum
- University of Western Australia Dental School, the University of Western Australia, Nedlands, Western Australia, Australia
| | - Richard J H Lee
- University of Western Australia Dental School, the University of Western Australia, Nedlands, Western Australia, Australia
| | - Mithran S Goonewardene
- University of Western Australia Dental School, the University of Western Australia, Nedlands, Western Australia, Australia.
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da Silva VM, Ayub PV, Massaro C, Janson G, Garib D. Comparison between clear aligners and 2 × 4 mechanics in the mixed dentition: a randomized clinical trial. Angle Orthod 2023; 93:3-10. [PMID: 36066265 PMCID: PMC9797137 DOI: 10.2319/032322-237.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/01/2022] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES To compare the efficacy and efficiency between clear aligners and 2 × 4 fixed appliances for correcting maxillary incisor position irregularities in the mixed dentition. MATERIALS AND METHODS The sample comprised 32 patients from 7 to 11 years of age randomly allocated into two parallel treatment groups: the clear aligners group, 14 patients (6 girls, 8 boys) with a mean initial age of 9.33 years (standard deviation [SD] = 1.01) treated with clear aligners; and the fixed appliances group, 13 patients (9 girls, 4 boys) with a mean initial age of 9.65 years (SD = 0.80) treated with partial (2 × 4) fixed appliances. Digital models were acquired before treatment and after appliance removal. Primary outcomes were incisor irregularity index and treatment time. Secondary outcomes were arch width, perimeter, length, size and shape, incisor leveling, incisor mesiodistal angulation, plaque index, and white spot lesion formation (International Caries Detection and Assessment System index). Intergroup comparisons were evaluated using t-tests or Mann-Whitney U-tests with Holm-Bonferroni correction (P < .05). RESULTS Treatment time was approximately 8 months in both groups. No intergroup differences were observed for changes in any of the variables. Similar posttreatment arch shapes were observed in both groups. CONCLUSIONS Clear aligners and 2 × 4 mechanics displayed similar efficacy and efficiency for maxillary incisor position corrections in the mixed dentition. The choice of appliance should be guided by clinician and family preference.
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Fiori A, Minervini G, Nucci L, d'Apuzzo F, Perillo L, Grassia V. Predictability of crowding resolution in clear aligner treatment. Prog Orthod 2022; 23:43. [PMID: 36437397 PMCID: PMC9702322 DOI: 10.1186/s40510-022-00438-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/02/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND To assess the predictability of crowding resolution and the efficacy of different strategies to gain space during clear aligners treatment. METHODS A total of 10 clinicians were randomly recruited using the Doctor Locator by Align Technology (California). For each clinician, four consecutive patients treated with aligners and manual stripping were selected for a total of 40 subjects. Thus, 80 arches were collected and uploaded on the Orthoanalyzer software for arch measurements. The data were gained on the starting arch form (T0), on the virtual arch developed with digital planning (vT1), and on the arch form achieved at the end of the aligner sequences (T1). The following parameters were scored: Little's Irregularity Index, transversal arch diameters, (intercuspid, interpremolar, and intermolar width), incisor position/arch length, and enamel interproximal reduction (IPR). RESULTS For all the measurements, statistically significant differences were found at different stages. The predictability of crowding resolution was very high, ranging from 87% in the upper arch and 81% in the lower one. Among the different strategies to gain space, variations in sagittal incisor position were predictable, with a value of 70% both in the upper and lower arch. Conversely, changes in arch diameters were less reliable varying between 49 and 67% in the lower arch and 59-83% in the upper one. Moreover, IPR was the least accurate procedure, wavering at 49% in the upper arch and 42% in the lower arch. CONCLUSIONS The predictability of crowding resolution during treatment with aligners was high. However, the virtual arch forms obtained at the end of digital planning (vT1) did not correspond with the arch forms at the end of the aligner sequences (T1). The IPR was the least predictable strategy to gain space, being, perhaps, an operator-dependent procedure.
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Affiliation(s)
- Adriana Fiori
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi De Crecchio 6, 80138, Naples, Italy
| | - Giuseppe Minervini
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi De Crecchio 6, 80138, Naples, Italy
| | - Ludovica Nucci
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi De Crecchio 6, 80138, Naples, Italy.
| | - Fabrizia d'Apuzzo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi De Crecchio 6, 80138, Naples, Italy
| | - Letizia Perillo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi De Crecchio 6, 80138, Naples, Italy
| | - Vincenzo Grassia
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi De Crecchio 6, 80138, Naples, Italy
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Oliveira P, Bugaighis I, Nunes Costa H, Mariano Pereira P. Perception of Need for Further Refinement in a Clear Aligner Treatment among Orthodontists, Dentists and Laypeople: A Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15498. [PMID: 36497574 PMCID: PMC9741232 DOI: 10.3390/ijerph192315498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/16/2022] [Accepted: 11/16/2022] [Indexed: 06/17/2023]
Abstract
Clear aligner treatment often requires further refinement to improve the orthodontic treatment outcome. However, the perceptions of treatment outcomes evaluated by orthodontists and dentists are sparse, and laypeople's perceptions have yet to be explored. Here, we explore the perceptions of orthodontists, dentists, and laypeople concerning the treatment outcomes achieved after completing the first sequence of aligners. This cross-sectional study involved 37 orthodontists, 67 dentists, and 93 laypeople. We administered an online questionnaire containing intra-oral photographs of nine completed cases with pre- and post-first sequences of aligners. As a control, we used a digital prediction system for the treatment outcome. Self-perception was reported using a visual analog scale. Both orthodontists and dentists had similar perceptions about treatment outcomes (p = 0.363) but significantly differed from laypeople (p ≤ 0.0001). Both orthodontists and dentists recommended further treatment; orthodontists were more critical than dentists (p ≤ 0.001). Orthodontists were more critical than dentists in their evaluations of the need for further treatments; however, their perceptions of treatment outcomes were similar. Laypeople were more satisfied with the treatment outcomes, were less concerned with occlusion, and were more focused on the aesthetic results of the treatment.
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Affiliation(s)
- Patrícia Oliveira
- Department of Orthodontics, Egas Moniz—Cooperativa de Ensino Superior CRL, Monte da Caparica, 2829-511 Almada, Portugal
| | - Iman Bugaighis
- Department of Orthodontics, Egas Moniz—Cooperativa de Ensino Superior CRL, Monte da Caparica, 2829-511 Almada, Portugal
- The Libyan Authority for Scientific Research, Tripoli P.O. Box 80045, Libya
| | - Hélder Nunes Costa
- Department of Orthodontics, Egas Moniz—Cooperativa de Ensino Superior CRL, Monte da Caparica, 2829-511 Almada, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz—Cooperativa de Ensino Superior CRL, Monte da Caparica, 2829-511 Almada, Portugal
| | - Pedro Mariano Pereira
- Department of Orthodontics, Egas Moniz—Cooperativa de Ensino Superior CRL, Monte da Caparica, 2829-511 Almada, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz—Cooperativa de Ensino Superior CRL, Monte da Caparica, 2829-511 Almada, Portugal
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Batra P, Gribel BF, Abhinav BA, Raghavan S, Arora A. A comparative evaluation of presurgical infant orthopedics of modified Grayson's technique with clear aligners incorporating a nasal elevator in patients with unilateral cleft lip and palate. Am J Orthod Dentofacial Orthop 2022; 162:714-727. [PMID: 35981905 DOI: 10.1016/j.ajodo.2021.06.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 06/01/2021] [Accepted: 06/01/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess the differences between 2 methods of presurgical infant orthopedics: the modified Grayson's technique and a new technique using clear aligners in patients with complete unilateral cleft lip and palate. METHODS For this prospective comparative cohort study, 30 patients were divided into 2 groups: group A (modified Grayson technique) and group B (clear aligner trays), with 15 patients each. Scanned cast measurements were taken before and after treatment and evaluated using an appropriate 3-dimensional software assessing treatment changes in the alveolus (eg, reduction of width between major and minor segment, angulation change of each respective segment [intragroup and intergroup, respectively]). This was supplemented with standardized anterioposterior, Worms-eye view, and profile photographs assessing changes in columellar angle, nostril width, height, nasolabial angle, and soft-tissue cleft gap. Furthermore, the number of visits for each patient group was also tabulated and assessed. The differences were compared using the independent t test and Mann-Whitney U test for the respective parameters. RESULTS Groups A and B showed similar posttreatment changes, with no overt significant differences. However, there was a statistically significant difference in the number of visits (P <0.05), with group B having much lower visits to the center than group A. The posttreatment values matched previously established growth reference values. The analysis of photographic measurements showed improved nasal asymmetry in both groups without any significant difference. CONCLUSIONS Because there was no difference in the treatment results between the 2 methods and a reduction in the number of required patient visits, presurgical infant orthopedics via clear aligners could pave the way for a more patient-efficient approach.
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Affiliation(s)
- Puneet Batra
- Manav Rachna Dental College, Faridabad, Haryana, India
| | | | - B A Abhinav
- Manav Rachna Dental College, Faridabad, Haryana, India
| | | | - Anika Arora
- Manav Rachna Dental College, Faridabad, Haryana, India
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Lione R, Balboni A, Di Fazio V, Pavoni C, Cozza P. Effects of pendulum appliance versus clear aligners in the vertical dimension during Class II malocclusion treatment: a randomized prospective clinical trial. BMC Oral Health 2022; 22:441. [PMID: 36217134 PMCID: PMC9552402 DOI: 10.1186/s12903-022-02483-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/28/2022] [Indexed: 11/11/2022] Open
Abstract
Background The aim of the present study was to compare the effects on vertical dentoskeletal dimension produced by Pendulum appliance and Clear Aligners in patients with Class II malocclusion.
Trial design This is a prospective two-arm parallel group randomized clinical trial with 1:1 allocation ratio. Methods The Pendulum Group (PG) consisted of 20 patients (15F, 5 M) with a mean age of 17.2 ± 4.3 years. The Clear Aligners Group (CAG) comprised 20 patients (13F, 7 M) with a mean age of 17.2 ± 3.2 years. Distalization’s protocol in PG involved the activation of TMA wires till the achievement of Class I molar relationship. A protocol of sequential distalization was applied in the CAG. For each subject lateral cephalograms have been analyzed before treatment (T1) and at the end of the therapy (T2). Descriptive statistics and statistical between-group comparisons (PG vs CAG) were calculated for the craniofacial starting forms at T1 and for the T2–T1 changes. Statistical between-group comparisons for the T2–T1 changes were performed with independent samples t-tests (P < 0.05).
Results The PG showed significantly greater increases in SN^GoGn° when compared with CAG (+ 2.1 and − 0.3 degrees, respectively). Clockwise rotation of the occlusal plane with significantly greater increase of SN^POccl angle was observed in PG (+ 2.8 degrees) when compared with CAG (− 4.2 degrees). The PG revealed a significant increase in the N-Me variable with a mean change of + 4.4 mm compared to the CAG with mean values of − 1.2 mm. The PG showed an increase in the ArGo^GoMe angle (+ 0.7° degrees) compared to the CAG (− 3.4° degrees). The PG showed significantly greater increases in both maxillary and mandibular first molar to palatal plane (+ 1.3 and + 2.1 mm, respectively) when compared with CAG (− 0.9 and − 0.2 mm, respectively).
Conclusions Upper molar distalization with clear aligners represents a valid alternative to non-extraction treatment of Class II malocclusion, reducing the extrusion of maxillary first molars and improving the management of the occlusal plane and vertical dimension. Trial registration: ClinicalTrials.gov, NCT05298280. Registered 28 March 2022—Retrospectively registered, https://clinicaltrials.gov.
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Affiliation(s)
- Roberta Lione
- Department of Systems Medicine, University of Rome 'Tor Vergata', Viale Oxford, 81, 00133, Rome, Italy. .,Department of Dentistry, UNSBC, Tirana, Albania. .,Department of Faculty of Medicine and Surgery, UniCamillus International Medical University, Rome, Italy.
| | - Alessia Balboni
- Department of Systems Medicine, University of Rome 'Tor Vergata', Viale Oxford, 81, 00133, Rome, Italy
| | - Valentina Di Fazio
- Department of Systems Medicine, University of Rome 'Tor Vergata', Viale Oxford, 81, 00133, Rome, Italy
| | - Chiara Pavoni
- Department of Systems Medicine, University of Rome 'Tor Vergata', Viale Oxford, 81, 00133, Rome, Italy.,Department of Dentistry, UNSBC, Tirana, Albania
| | - Paola Cozza
- Department of Dentistry, UNSBC, Tirana, Albania.,Department of Faculty of Medicine and Surgery, UniCamillus International Medical University, Rome, Italy
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Ertugrul BY, Veli İ. Evaluating the effects of orthodontic treatment with clear aligners and conventional brackets on mandibular condyle bone quality using fractal dimension analysis of panoramic radiographs. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:538-545. [PMID: 35688416 DOI: 10.1016/j.jormas.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/24/2022] [Accepted: 06/04/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Orthodontic treatment carried out with clear aligners has become a method that is preferred by patients. In this study, the effect following orthodontic treatment with clear aligners and with conventional brackets, on the mandibular condyle trabecular bone formation is aimed to be examined. MATERIALS AND METHODS Thirty two individuals (16 females and 16 males) with a mean age of 16.80 ± 3,10 years who received orthodontic treatment with clear aligners and conventional brackets were included in the study. Individuals included in the study from the archive data were divided into two groups according to treatment types. The mandibular condyle bone quality in the panoramic images taken from the patients before orthodontic treatment (T0) and after orthodontic treatment (T1) has been compared retrospectively. This examination is carried out via the fractal analysis method. RESULT The mandibular condyle bone density in individuals that have undergone orthodontic treatment with clear aligners, has been reduced following orthodontic treatment. In individuals that have undergone orthodontic treatment with conventional brackets however the mandibular condyle bone density has increased following treatment (T0) in comparison to before being treated (T1). The mandibular condyle bone density change according to different treatment groups has been found to be statistically different. CONCLUSION Orthodontic treatment with clear aligners provides several advantages to patients. However, besides determining the effectiveness of the treatment, complications must also be examined. Application of clear aligners in orthodontic treatment may cause a decrease in bone density in the mandibular condyle. When evaluating orthodontic treatments carried out with clear aligners, the change of the mandibular condyle head bone should be taken into consideration.
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Affiliation(s)
| | - İlknur Veli
- Izmir Katip Celebi University Faculty of Dentistry, Department of Orthodontics, Izmir, Turkey
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Grünheid T, Tasca AW, Kanyusik JS, Walters SA, Larson BE. Assessment of orthodontic treatment efficacy of Clarity Aligners using the Peer Assessment Rating index and the American Board of Orthodontics Cast-Radiograph Evaluation. Am J Orthod Dentofacial Orthop 2022; 162:861-869. [PMID: 36100480 DOI: 10.1016/j.ajodo.2021.07.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 07/01/2021] [Accepted: 07/01/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION 3M Oral Care Solutions (St Paul, Minn) has recently introduced Clarity Aligners into the market. This cohort study evaluated the orthodontic treatment efficacy of this clear aligner system using the Peer Assessment Rating (PAR) index and the American Board of Orthodontics Cast-Radiograph Evaluation (CR-Eval). METHODS Pretreatment and posttreatment dental models of 87 subjects who had undergone orthodontic treatment using Clarity Aligners in both arches to align their teeth to a target setup were independently evaluated by 4 examiners using the PAR index and the American Board of Orthodontics CR-Eval. Changes in CR-Eval and PAR scores from pretreatment to posttreatment were calculated, with PAR score reductions also expressed as percentages. RESULTS Treatment with Clarity Aligners reduced the CR-Eval scores from 39.05 ± 14.98 to 30.34 ± 8.76, resulting in a statistically significant difference of 8.76 ± 11.45 between pretreatment and posttreatment scores. Similarly, aligner treatment reduced the weighted PAR scores from 13.40 ± 9.26 to 5.80 ± 4.84, resulting in a statistically significant difference of 7.50 ± 7.56 between pretreatment and posttreatment scores. The overall median PAR reduction was 53%, with 94% of the subjects having reduced PAR scores after treatment. Seventy-eight percent of subjects had >30% PAR reduction, 57% had >50% PAR reduction, and 33% had >70% PAR reduction. CONCLUSIONS The results suggest that Clarity Aligners may be an effective treatment modality in mild to moderate malocclusions.
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Affiliation(s)
- Thorsten Grünheid
- Division of Orthodontics, School of Dentistry, University of Minnesota, Minneapolis, Minn.
| | - Amy W Tasca
- Division of Orthodontics, School of Dentistry, University of Minnesota, Minneapolis, Minn
| | - John S Kanyusik
- Division of Orthodontics, School of Dentistry, University of Minnesota, Minneapolis, Minn
| | | | - Brent E Larson
- Division of Orthodontics, School of Dentistry, University of Minnesota, Minneapolis, Minn
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Roberts WE, Chang CH, Chen J, Brezniak N, Yadav S. Integrating skeletal anchorage into fixed and aligner biomechanics. J World Fed Orthod 2022; 11:95-106. [DOI: 10.1016/j.ejwf.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 04/08/2022] [Indexed: 11/30/2022]
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Deep Bite Treatment with Aligners: A New Protocol. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12136709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Deep bites can be treated by the intrusion of anterior teeth and the extrusion of the posterior teeth, or both, according to the exposure of the incisors in the smile. The aim of this paper is to propose a protocol to improve the effectiveness of deep bite treatments. Orthodontic movements are programmed following the “frog staging” protocol for the anterior teeth, the application of retention attachments and the overengineered final setup. Two case reports described the clinical and radiographic changes with orthodontic treatment using Invisalign clear aligners by applying this protocol.
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Blundell HL, Weir T, Byrne G. Predictability of overbite control with the Invisalign appliance comparing SmartTrack with precision bite ramps to EX30. Am J Orthod Dentofacial Orthop 2022; 162:e71-e81. [PMID: 35750579 DOI: 10.1016/j.ajodo.2022.05.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 05/05/2022] [Accepted: 05/05/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Although the Invisalign appliance has reported difficulty in achieving the overbite outcomes predicted by ClinCheck software (Align Technology, Santa Clara, Calif), the effect of modifications to the material and components of the appliance are largely unquantified. This study aimed to investigate and determine the accuracy of Invisalign in correcting a deep overbite by comparing the predicted outcome from ClinCheck to the achieved posttreatment outcome for treatment groups that use different components of the appliance system. METHODS A retrospective study was conducted using pretreatment and posttreatment intraoral scans and predicted outcomes (ClinCheck) stereolithography files of 2 groups of consecutively treated adult patients from private specialist orthodontic practices, 1 group treated with EX30 material with no bite ramps (n = 29) and 1 treated with the newer SmartTrack material and precision bite ramps (n = 39). Inclusion criteria comprised nonextraction treatment, with a minimum of 14 dual arch Invisalign aligners using a 2-weekly aligner change protocol. Geomagic Control X software (3D Systems, Rock Hill, SC) was used to measure overbite in the pretreatment, posttreatment, and predicted outcome stereolithography files for each patient. Results were compared with a previously published treatment group that used SmartTrack material and no precision bite ramps. RESULTS The regression coefficient analysis indicated that for both groups, the deeper the pretreatment overbite and the greater overbite reduction projected according to ClinCheck, there is a linear increase in the discrepancy of overbite expression posttreatment. ClinCheck overpredicted overbite reduction in 96.6% of patients with precision bite ramp in which, on average, 43.4% of the prescribed overbite reduction was expressed. For EX30 patients, ClinCheck overpredicted overbite reduction in 87.2% of patients in which, on average, 55.1% of the prescribed overbite reduction was expressed. CONCLUSIONS The use of precision bite ramps does not appear to significantly improve the ability of SmartTrack material to predictably open the bite. SmartTrack material with or without bite ramps does not appear to produce better bite opening predictability than that seen with EX30 material.
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Affiliation(s)
| | - Tony Weir
- Department of Orthodontics, The University of Queensland, Brisbane, Queensland, Australia
| | - Graeme Byrne
- School of Engineering and Mathematical Sciences, La Trobe University, Bendigo, Victoria, Australia
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Initial Displacement and Stress Distribution of Upper Central Incisor Extrusion with Clear Aligners and Various Shapes of Composite Attachments Using the Finite Element Method. Dent J (Basel) 2022; 10:dj10060114. [PMID: 35735656 PMCID: PMC9222152 DOI: 10.3390/dj10060114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 12/04/2022] Open
Abstract
A clear aligner is an esthetic and more comfortable option for patients who need orthodontic treatment. However, some types of tooth movement, such as extrusion, are difficult with this tool. Therefore, composite attachments have been suggested to improve tooth movement. This study aims to evaluate the initial displacement and stress distribution during upper central incisor extrusion using the conventional composite attachments. Maxillary models with the upper teeth, clear aligners, and composite attachments placed on the labial surface of the upper right central incisor were constructed. Four models were created to simulate upper central incisor extrusion: (1) without any composite attachment; (2) rectangular beveled attachment; (3) ellipsoid attachment; and (4) horizontal rectangular attachment. Clear aligners were designed to perform upper central incisor extrusion. The constructed models were analyzed using the finite element method. Initial displacement and stress distribution were analyzed. Output analysis found that the upper right central incisor in the model with a horizontal rectangular attachment had the greatest extrusive movement, followed by the model with ellipsoid attachment and the model with beveled attachment. Maximum compressive stress was seen at the cervical region of the composite attachment. Composite attachments including horizontal rectangular attachment, ellipsoid attachment, and rectangular beveled attachment can be used to perform upper central incisor extrusion.
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Perrotti G, Carrafiello A, Rossi O, Karanxha L, Baccaglione G, Del Fabbro M. Clinical Use of Aligners Associated with Nuvola ® OP System for Transverse Maxillary Deficiency: A Retrospective Study on 100 Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095751. [PMID: 35565146 PMCID: PMC9103427 DOI: 10.3390/ijerph19095751] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/05/2022] [Accepted: 05/07/2022] [Indexed: 01/26/2023]
Abstract
Introduction: Aligners represent a common treatment for orthodontic patients thanks to their countless advantages including aesthetics, comfort, and oral hygiene maintenance; at the same time, they are associated with a reduced number of visits and a low incidence of complications. Although aligners have undergone considerable improvements over time, to date they have limitations in resolving the most serious malocclusions related to transverse maxillary deficiency. The aim of the present study was to retrospectively evaluate an orthodontic protocol (the Nuvola® OP System) which associates a morpho-functional corrector (to be used for 30 min/day) with the aligner, allowing for the treatment of cases that would be difficult or unpredictable with aligners alone. Methods: Linear measurements were taken on STL files of 100 patients. In 77 patients between 18 and 55 years (mean 28.6 ± 16.2 (standard deviation) years), 3D superimpositions of the maxilla obtained from intraoral scans before and after treatment were performed in order to evaluate the degree of maxillary expansion. The normality of the data distribution was tested. The pre- and post-treatment data were compared using a paired t-test with a 5% significance level. After treatment, a questionnaire was proposed to assess patients’ degree of satisfaction and compliance. Results: A statistically significant difference (p < 0.05) for each distance evaluated was found. The maximum expansion was obtained at the first molar level (2.35 ± 1.64 mm). Of the subjects who completed the questionnaire, 96% were satisfied and 90% were able to perform the protocol without difficulty for the required duration. Conclusions: A significant expansion of the maxillary arch as well as a high degree of patient satisfaction and compliance were observed with the Nuvola® OP System. Further studies are needed in order to clinically evaluate the relative contribution of the aligners and morpho-functional device to the obtained expansion.
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Affiliation(s)
| | | | - Ornella Rossi
- Lake Como Institute, 22100 Como, Italy; (G.P.); (O.R.)
| | - Lorena Karanxha
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milano, Italy;
| | | | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20122 Milano, Italy;
- IRCCS Orthopedic Institute Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy
- Correspondence: ; Tel.: +39-02-50319950; Fax: +39-02-50319960
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Fujiyama K, Kera Y, Yujin S, Tanikawa C, Yamashiro T, Guo X, Ni A, Deguchi T. Comparison of clinical outcomes between Invisalign and conventional fixed appliance therapies in adult patients with severe deep overbite treated with nonextraction. Am J Orthod Dentofacial Orthop 2022; 161:542-547. [PMID: 34629236 DOI: 10.1016/j.ajodo.2020.08.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 08/01/2020] [Accepted: 08/01/2020] [Indexed: 12/30/2022]
Abstract
INTRODUCTION The use of aligner therapy for orthodontic treatment has increased substantially in the past decade. However, no study has compared treatment outcomes between the conventional fixed appliance and Invisalign therapies in patients with a severe deep overbite. METHODS This study included 50 consecutive adult patients who underwent treatment with either Invisalign (n = 25; mean age, 23.3 ± 8.5 years) or a conventional fixed appliance (n = 25; mean age, 23.1 ± 6.5 years) to correct overbite >5 mm and >60% deep overbite. Cephalometric analysis and peer assessment rating was used to compare the clinical outcome between groups. RESULTS Cephalometric analysis showed significant differences in N-Me (P = 0.0005) and Mp-L6 (P = 0.0001) between Invisalign and fixed appliance treatment groups. No significant differences were observed in the peer assessment rating analysis or total treatment duration between the 2 groups. CONCLUSIONS Both Invisalign and conventional fixed appliances were effective in treating patients with a severe deep overbite. Invisalign therapy may be preferable over conventional fixed appliance therapy in patients with high angle and deep overbite. However, because this study had a retrospective design, the results should be viewed with caution.
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Affiliation(s)
| | | | - Shimizu Yujin
- Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Chihiro Tanikawa
- Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Takashi Yamashiro
- Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Xiaohan Guo
- Division of Biostatistics, College of Dentistry, Ohio State University, Columbus, Ohio
| | - Andy Ni
- Division of Biostatistics, College of Dentistry, Ohio State University, Columbus, Ohio
| | - Toru Deguchi
- Division of Orthodontics, College of Dentistry, Ohio State University, Columbus, Ohio.
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Hariharan A, Arqub SA, Gandhi V, Da Cunha Godoy L, Kuo CL, Uribe F. Evaluation of interproximal reduction in individual teeth, and full arch assessment in clear aligner therapy: digital planning versus 3D model analysis after reduction. Prog Orthod 2022; 23:9. [PMID: 35254555 PMCID: PMC8901911 DOI: 10.1186/s40510-022-00403-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 02/23/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Aim
To evaluate the correspondence between the interproximal reduction (IPR) performed clinically and that programmed in ClinCheck® and further assess which teeth showed an amount of implemented IPR (I-IPR) that corresponds with that programmed in ClinCheck®.
Materials and methods
Pre- (T0) and post-treatment (T1) ClinCheck® digital models for 75 subjects (30 males and 45 females), mean age (38 ± 15) years, were included. To calculate the amount of I-IPR, Ortho Analyzer software (3Shape, Copenhagen, Denmark) was used to measure the mesiodistal widths for the maxillary and mandibular teeth from second premolar to the contralateral second premolar on the initial (T0) and final (T1) STL models. I- IPR performed by tooth was obtained by comparing the mesiodistal width of each tooth at T0 and T1. The amount of programmed IPR (P-IPR) in ClinCheck® was compared to that implemented clinically using the following formula: IPR difference = (P-IPR) − (I-IPR).
Results
Statistically significant differences were observed between the average value of digitally programmed and implemented IPR per tooth for both the maxillary (p < .0001) and mandibular (p < .0001) teeth. The mean P-IPR for the maxillary teeth was 0.28 ± 0.16 mm versus the mean I-IPR of 0.15 ± 0.15 mm. In the mandibular arch, the mean P-IPR was 0.31 ± 0.17 mm, while the I-IPR was 0.17 ± 0.16 mm. The mean I-IPR was consistently lower than the mean P-IPR regardless of teeth and sites (p < 0.0001). The difference between the P-IPR compared to the I-IPR was larger for mandibular anterior teeth than for maxillary anterior teeth (p = 0.0302) and larger for maxillary posterior teeth than mandibular posterior teeth (p = 0.0059).
Conclusion
The amount of implemented-IPR in clear aligner therapy is less than that digitally programmed for most teeth. Regardless of the regions, I-IPR was consistently lower than that programmed. Mandibular anterior teeth and maxillary posterior teeth showed greater discrepancy between P-IPR and I-IPR than the maxillary anterior and mandibular posteriors. Further prospective studies are needed to determine the factors affecting the precision of IPR and the clinical implications of a significantly reduced I-IPR on treatment outcomes.
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Mapelli A, Serafin M, Dolci C, Gibelli D, Caprioglio A, Sforza C, Tartaglia GM. Consistency and Reliability Analyses of a Comprehensive Index for the Evaluation of Teeth Alignment Performance. J Clin Med 2022; 11:jcm11041016. [PMID: 35207290 PMCID: PMC8875412 DOI: 10.3390/jcm11041016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/12/2022] [Accepted: 02/14/2022] [Indexed: 02/06/2023] Open
Abstract
(1) Introduction: The purpose of this work was to describe a method and propose a novel accuracy index to assess orthodontic alignment performance. (2) Methods: Fifteen patients who underwent orthodontic treatment using directly printed clear aligners were recruited. The study sample included 12 maxillary and 10 mandibular arches, whose pre-treatment, predicted and post-treatment digital models were superimposed on the untreated posterior teeth by means of a best-fit surface-based registration, which was also used to transfer three anatomical landmarks, digitally labeled on the crown of each anterior moving tooth, from the pre-treatment to the predicted and post-treatment models. The Teeth Alignment Performance (TAP) index, quantifying how close the final landmarks were to their expected final position, was proposed as an accuracy index of both individual tooth and group of teeth movement, and its inter-examiner repeatability was tested. (3) Results: No systematic inter-rater discrepancy associated with TAP was observed (p > 0.05), not even when a slight systematic inter-rater difference in landmark labelling was detected (for the upper central incisors, p < 0.001). In addition, all Intra-class Correlation Coefficient (ICC) values showed excellent inter-rater agreement (>0.95), and the small Random Error of Measurement (REM), ranging from 1% for the arch TAP to 3% for the lower canine TAP, indicated that this accuracy index is highly repeatable. (4) Conclusions: The TAP index was proven to be comprehensive, consistent and reliable in assessing the performance of teeth alignment according to a digital plan. The proposed method is also suitable to be implemented in the clinical digital workflow.
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Affiliation(s)
- Andrea Mapelli
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (A.M.); (C.D.); (A.C.); (G.M.T.)
| | - Marco Serafin
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy; (D.G.); (C.S.)
- Correspondence:
| | - Carolina Dolci
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (A.M.); (C.D.); (A.C.); (G.M.T.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Daniele Gibelli
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy; (D.G.); (C.S.)
| | - Alberto Caprioglio
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (A.M.); (C.D.); (A.C.); (G.M.T.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Chiarella Sforza
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy; (D.G.); (C.S.)
| | - Gianluca Martino Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (A.M.); (C.D.); (A.C.); (G.M.T.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
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Performance of Rigid and Soft Transfer Templates Using Viscous and Fluid Resin-Based Composites in the Attachment Bonding Process of Clear Aligners. Int J Dent 2022; 2022:1637594. [PMID: 35190741 PMCID: PMC8858075 DOI: 10.1155/2022/1637594] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 01/09/2022] [Accepted: 01/17/2022] [Indexed: 12/17/2022] Open
Abstract
Objectives The study aims at assessing the accuracy of the process of attachment bonding in aligner treatments. The analysis leads to the error estimation in the faithful reproduction of master model attachments using two types of transfer templates and two light-curing resin-based composites usually used in orthodontics. Methods The authors have used two transfer templates made of two different materials. The first, named Leone-biocompatible thermoforming material hard/soft, has a lower Young's modulus and is labelled as soft, while the other, named Leone-biocompatible thermoforming material, is marked as rigid. The resin-based composites possess different mechanical and rheological properties. Specifically, Transbond™ XT Light Cure Paste Adhesive, 3M has a higher viscosity than the TetricEvoflow, Ivoclar Vivadent, a flowable nanohybrid composite. The authors attempt to estimate the performance ranking between the four possible couples obtained by combining the two light-curing resin-based composites and transfer templates. Each combination was repeated in six models and compared with twelve master models, resulting in 36 total samples. A 3-D laser scanner is used to generate a digital model of each model. The comparison between digital models is the base for a comparative assessment in terms of relative and absolute error. The relative error is estimated using scalar performance indicators ranging from 0 to 1, where 1 indicates the optimum matching. The absolute error estimated from the mean square error between the coordinates of each digital model yields the reproduction accuracy in micrometer. Furthermore, the authors attempted to assess the error distribution by evaluating the point-by-point difference between the digital models. Results This analysis aims at localizing the sources of error in the considered models. The use of Transbond™ XT Light Cure Paste Adhesive, 3M with a rigid transfer template is always associated with significant accuracy and minor dispersion. However, in a few instances, using the soft template or the flowable resin-based composite can lead to bad performances. Significance. The data processing bestowed the following performance ranking from the first with lower reproduction error to the last characterized by the worst performance: (1) attachments bonding with rigid template and Transbond™ XT Light Cure Paste Adhesive, 3M, (2) attachments bonding with soft template and Transbond™ XT Light Cure Paste Adhesive, 3M, (3) attachments bonding with rigid template and TetricEvoflow, Ivoclar Vivadent, and (4) attachments bonding with soft template and TetricEvoflow, Ivoclar Vivadent.
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Clinical effectiveness of clear aligner treatment compared to fixed appliance treatment: an overview of systematic reviews. Clin Oral Investig 2022; 26:2353-2370. [PMID: 34993617 DOI: 10.1007/s00784-021-04361-1] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 12/29/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To evaluate the available evidence regarding clinical effectiveness of clear aligner treatment (CAT). MATERIALS AND METHODS A comprehensive literature search was conducted for systematic reviews investigating effectiveness of CAT published up to July 15, 2021. This was accomplished using different electronic databases. No language restriction was applied. Screening, quality assessment, and data extraction were performed by two authors independently. Information was categorized and narratively synthesized for the key findings from moderate and high-quality reviews. RESULTS A total of 361 potentially eligible reviews were identified. After excluding the non-relevant/low-quality reviews, 18 systematic reviews were included. CAT was found to be effective for mild to moderate malocclusions, and was associated with inferior outcomes when treating severe cases or with achieving specific tooth movements. There were conflicting results regarding treatment duration; however, CAT may be associated with shorter treatment in mild to moderate cases. Relapse was greater with CAT, while periodontal health was better. The risk of root resorption tended to be lower with CAT. Regarding pain, the results were unclear, although CAT was found to be more comfortable and associated with a reduced impact on eating and chewing. CONCLUSIONS The level of evidence regarding CAT is moderate; hence, further high-quality randomized clinical trials are required. Evidence supports use of aligners as an alternate to fixed appliances in patients with mild-to-moderate malocclusion but not in severe cases. Advancement in technology could enhance the accuracy of CAT in delivering planned outcomes. CLINICAL RELEVANCE CAT can be used effectively for selected cases with mild to moderate malocclusion. REGISTRATION PROSPERO registration number: CRD42021246855.
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A comparison of SureSmile TM, Insignia TM, and Invisalign TM, in treating non-extraction cases of mild to moderate crowding: a prospective clinical trial. AUSTRALASIAN ORTHODONTIC JOURNAL 2022. [DOI: 10.2478/aoj-2022-0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Objectives: To compare the ability of SureSmileTM, InsigniaTM and InvisalignTM to achieve predicted intra-arch tooth positions and further compare their objective grading scores for alignment/rotations, marginal ridge relationships and buccolingual inclination.
Materials and methods: The study was a prospective clinical trial of 145 arches from 44 females and 29 males (54 SureSmileTM arches, 35 InsigniaTM arches, and 56 InvisalignTM arches). All arches were treated by a non-extraction approach and had ≤7 mm of crowding and 45° of tooth rotation. The manufacturer’s recommendations were followed for each group and the final scans were acquired before refinements, rebonding, or wire bending. The virtual set-ups were superimposed on the final scans and the coordinates of 34 landmarks per arch were compared. One hundred and twenty-six end-of-participation arches were suitable for 3D printing and were compared using the American Board of Orthodontics Objective Grading Scores (OGS) for alignment/ rotations, marginal ridge relationships, and buccolingual inclination.
Results: No statistically significant differences were identified in the mean deviation between the target and achieved the position of the anterior landmarks within the treatment groups. The exception was the Suresmile group which had greater vertical discrepancies in the position of the labial CEJ. Although the mean differences between the target and achieved anterior landmark positions for all groups were under 0.5 mm, the range of maximum discrepancy was between 0.7 mm and 4.1 mm. The InsigniaTM system showed significantly greater deviation in upper posterior landmark positions in the transverse and sagittal dimensions, and lower posterior landmarks in the transverse dimension. However, this was due to the InsigniaTM initial set-ups being wider. There was no statistically significant difference between the three systems in combined intra-arch OGS. However, the InvisalignTM system had a significantly poorer alignment/rotation score than the SureSmileTM group. The InsigniaTM system performed better in achieving buccolingual tooth inclination compared to SuresmileTM, and the InvisalignTM system performed better than the SuresmileTM system in the marginal ridge score.
Conclusions: The three systems were comparable in achieving the predicted tooth positions of the anterior teeth in non-extraction, mild-to-moderate, crowded cases. Large discrepancies requiring operator intervention were common within the three systems. Although the three systems had no statistically significant difference in overall intra-arch OGS scores, there were significant differences in the score components.
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Sachdev S, Tantidhnazet S, Saengfai NN. Accuracy of Tooth Movement with In-House Clear Aligners. J World Fed Orthod 2021; 10:177-182. [PMID: 34625386 DOI: 10.1016/j.ejwf.2021.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/06/2021] [Accepted: 08/18/2021] [Indexed: 10/20/2022]
Abstract
AIM To evaluate accuracy of tooth movements with in-house clear aligners. METHODS This prospective clinical study included 30 participants for anterior clear aligners with crowding not exceeding 4 mm. per arch, non-extraction cases with no changes in posterior relationship. Aligners were created with OrthoAnalyzerTM software, attachments were placed as needed and IPR was performed in required areas. The final stage of tooth movement was compared with predicted tooth movement by superimposition of the two STL models. Maxillary arch was superimposed on stable posterior teeth and best fit on palatal rugae while mandibular arch was superimposed on unmoved posterior teeth. The amount of differences in predicted and achieved tooth movements were compared. Six types of tooth movement were included in the comparison which were labial, lingual, mesiodistal, intrusion, extrusion and rotation. RESULTS Total sample consisted of 259 anterior teeth (126 maxillary, 133 mandibular). The achieved tooth movements were significantly lesser than the predicted tooth movements in all the six types of tooth movement. Overall accuracy of tooth movement with clear aligner was 56.18%. The most accurate tooth movement was mesiodistal (72.33%). The least accurate movement was intrusion (43.28%). While mesiodistal, labial, rotation and lingual tooth movements were more predictable than intrusion and extrusion. CONCLUSION Understanding the accuracy of different tooth movements might help in case selection, treatment plan and development or increase accuracy and predictability of in-house clear aligners.
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Affiliation(s)
- Sivaporn Sachdev
- Resident, Department of Orthodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Syrina Tantidhnazet
- Resident, Department of Orthodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Koletsi D, Iliadi A, Eliades T. Predictability of rotational tooth movement with orthodontic aligners comparing software-based and achieved data: A systematic review and meta-analysis of observational studies. J Orthod 2021; 48:277-287. [PMID: 34176358 PMCID: PMC8385585 DOI: 10.1177/14653125211027266] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To evaluate all available evidence on the prediction of rotational tooth movements with aligners. DATA SOURCES Seven databases of published and unpublished literature were searched up to 4 August 2020 for eligible studies. DATA SELECTION Studies were deemed eligible if they included evaluation of rotational tooth movement with any type of aligner, through the comparison of software-based and actually achieved data after patient treatment. DATA EXTRACTION AND DATA SYNTHESIS Data extraction was done independently and in duplicate and risk of bias assessment was performed with the use of the QUADAS-2 tool. Random effects meta-analyses with effect sizes and their 95% confidence intervals (CIs) were performed and the quality of the evidence was assessed through GRADE. RESULTS Seven articles were included in the qualitative synthesis, of which three contributed to meta-analyses. Overall results revealed a non-accurate prediction of the outcome for the software-based data, irrespective of the use of attachments or interproximal enamel reduction (IPR). Maxillary canines demonstrated the lowest percentage accuracy for rotational tooth movement (three studies: effect size = 47.9%; 95% CI = 27.2-69.5; P < 0.001), although high levels of heterogeneity were identified (I2: 86.9%; P < 0.001). Contrary, mandibular incisors presented the highest percentage accuracy for predicted rotational movement (two studies: effect size = 70.7%; 95% CI = 58.9-82.5; P < 0.001; I2: 0.0%; P = 0.48). Risk of bias was unclear to low overall, while quality of the evidence ranged from low to moderate. CONCLUSION Allowing for all identified caveats, prediction of rotational tooth movements with aligner treatment does not appear accurate, especially for canines. Careful selection of patients and malocclusions for aligner treatment decisions remain challenging.
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Affiliation(s)
- Despina Koletsi
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Anna Iliadi
- Department of Dental Biomaterials, School of Dentistry, National and Kapodistrian University of Athens, Attica, Greece
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Mampieri G, Castroflorio T, Conigliaro A, Giancotti A. Treatment of impacted canines with aligners: An alternative and viable option. Clin Case Rep 2021; 9:e04856. [PMID: 34584717 PMCID: PMC8457405 DOI: 10.1002/ccr3.4856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/23/2021] [Accepted: 09/06/2021] [Indexed: 11/17/2022] Open
Abstract
To recover impacted canines without esthetic issues, the aligners can be a resolutive tool allowing by pontics the camouflage of absent canines during orthodontic treatment. Knowledge of biomechanics, correct staging of dental movements, and surgery planification are strategic to achieve a good result.
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Affiliation(s)
- Gianluca Mampieri
- Department of Clinical Sciences and Translational Medicine University of Rome Tor VergataRomeItaly
| | | | | | - Aldo Giancotti
- Department of Clinical Sciences and Translational Medicine University of Rome Tor VergataRomeItaly
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Efficient Design of a Clear Aligner Attachment to Induce Bodily Tooth Movement in Orthodontic Treatment Using Finite Element Analysis. MATERIALS 2021; 14:ma14174926. [PMID: 34501017 PMCID: PMC8433704 DOI: 10.3390/ma14174926] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 08/27/2021] [Accepted: 08/27/2021] [Indexed: 01/31/2023]
Abstract
Clear aligner technology has become the preferred choice of orthodontic treatment for malocclusions for most adult patients due to their esthetic appeal and comfortability. However, limitations exist for aligner technology, such as corrections involving complex force systems. Composite attachments on the tooth surface are intended to enable active control of tooth movements. However, unintended tooth movements still occur. In this study, we present an effective attachment design of an attachment that can efficiently induce tooth movement by comparing and analyzing the movement and rotation of teeth between a general attachment and an overhanging attachment. The 3D finite element modes were constructed from CBCT data and used to analyze the distal displacement of the central incisor using 0.5- and 0.75-mm-thick aligners without an attachment, and with general and overhanging attachments. The results show that the aligner with the overhanging attachment can effectively reduce crown tipping and prevent axial rotation for an intended distal displacement of the central incisor. In all models, an aligner with or without attachments was not capable of preventing the lingual inclination of the tooth.
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Blundell HL, Weir T, Kerr B, Freer E. Predictability of overbite control with the Invisalign appliance. Am J Orthod Dentofacial Orthop 2021; 160:725-731. [PMID: 34373153 DOI: 10.1016/j.ajodo.2020.06.042] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 04/01/2020] [Accepted: 06/01/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Control of overbite is considered essential in achieving ideal orthodontic outcomes. Questions have been raised regarding the accuracy of ClinCheck software (Align Technology, Santa Clara, Calif) in predicting posttreatment outcomes with Invisalign, with the paucity of well-researched literature available on this topic. This research aimed to investigate and determine the accuracy of Invisalign (Align Technology) in correcting a deep overbite by comparing the outcomes predicted by ClinCheck with achieved posttreatment outcomes. METHODS A retrospective study was conducted using pretreatment and posttreatment intraoral scans and predicted outcome (ClinCheck) stereolithography files of 42 adult patients consecutively treated with Invisalign from January 2014 and completed before July 2018, selected from the files of 1 experienced orthodontist. Patients included in the study were treated without extractions and with a minimum of 14 dual arch Invisalign aligners using a 2-weekly aligner change protocol. The pretreatment, posttreatment, and predicted outcome stereolithography files for each patient were imported into Geomagic Control X (3D Systems, Rock Hill, SC) software to measure overbite. RESULTS The deeper the patient's initial overbite and the greater the amount of programmed reduction in overbite according to ClinCheck, the greater the discrepancy in overbite expression posttreatment. ClinCheck over-predicted overbite reduction in 95.3% of patients in which, on average, only 39.2% of the prescribed overbite reduction was expressed. CONCLUSIONS Overbite reduction may result in suboptimal outcomes when using the Invisalign appliance unless remedial measures are employed. The deeper the initial overbite, the more challenging it is to achieve the prescribed posttreatment overbite.
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Affiliation(s)
- Haylea L Blundell
- Postgraduate Student, Department of Orthodontics, The University of Queensland, Brisbane, Australia.
| | - Tony Weir
- Honorary Senior Lecturer, Department of Orthodontics, The University of Queensland, Brisbane, Australia
| | - Brett Kerr
- Lecturer, Department of Orthodontics, The University of Queensland, Brisbane, Australia
| | - Elissa Freer
- Discipline lead in Orthodontics, The University of Queensland, Brisbane, Australia
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