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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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Park TH, Shen C, Chung CH, Li C. Vertical Control in Molar Distalization by Clear Aligners: A Systematic Review and Meta-Analysis. J Clin Med 2024; 13:2845. [PMID: 38792385 PMCID: PMC11122287 DOI: 10.3390/jcm13102845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Molar distalization is used to correct molar relationships or to create space for mild anterior crowding. However, whether clear aligners can provide proper vertical control with the sequential distalization strategy has been highly debated. Thus, the current study aimed to systematically review the amount of dentoskeletal changes in the vertical dimension that results from sequential molar distalization in clear aligner therapy without temporary anchorage devices (TADs). Methods: Registered with PROSPERO (CRD42023447211), relevant original studies were screened from seven databases and supplemented by a manual search by two investigators independently. Articles were screened against inclusion and exclusion criteria, and a risk of bias assessment was conducted for each included article. Relevant data were extracted from the included articles and meta-analysis was performed using RStudio. Results: Eleven articles (nine for maxillary distalization and two for mandibular distalization) were selected for the final review. All studies have a high or medium risk of bias. For maxillary molar distalization, the meta-analysis revealed 0.26 mm [0.23 mm, 0.29 mm] of maxillary first molar intrusion based on post-distalization dental model analysis, as well as 0.50 mm [-0.78 mm, 1.78 mm] of maxillary first molar intrusion and 0.60 mm [-0.42 mm, 1.62 mm] of maxillary second molar intrusion based on post-treatment lateral cephalometric analysis. Skeletally, there was a -0.33° [-0.67°, 0.02°] change in the SN-GoGn angle, -0.23° [-0.30°, 0.75°] change in the SN-MP angle, and 0.09° [-0.83°, 1.01°] change in the PP-GoGn angle based on post-treatment lateral cephalometric analysis. There was insufficient data for meta-analysis for mandibular molar distalization. Conclusions: No significant changes in vertical dimension were observed, both dentally and skeletally, after maxillary molar distalization with a sequential distalization strategy. However, further studies on this topic are needed due to the high risk of bias in the currently available studies.
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Affiliation(s)
- Tiffany H. Park
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Christie Shen
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (C.S.); (C.-H.C.)
| | - Chun-Hsi Chung
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (C.S.); (C.-H.C.)
| | - Chenshuang Li
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (C.S.); (C.-H.C.)
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Moradinejad M, Harrell RE, Mousavi SM, Alavi M, Basseri AD, Feiz A, Daryanavard H, Rakhshan V. Effects of clear aligners on the vertical position of the molar teeth and the vertical and sagittal relationships of the face: a preliminary retrospective before-after clinical trial. BMC Oral Health 2024; 24:234. [PMID: 38350970 PMCID: PMC10865655 DOI: 10.1186/s12903-024-03972-w] [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: 10/10/2023] [Accepted: 02/02/2024] [Indexed: 02/15/2024] Open
Abstract
INTRODUCTION Despite the popularity of clear aligners, their predictability has not been assessed adequately. Moreover, no study has investigated their effects on numerous dentomaxillary variables. Therefore, this study was conducted for the first time, assessing several new or controversial items. The aim of the study was to evaluate the effects of clear aligners on the vertical position of the molar teeth and the vertical and sagittal relationships of the face. METHODS This preliminary retrospective before-after non-randomized clinical trial was performed on 168 observations of 84 patients (33.60±9.28 years, 54 females) treated with 0.75mm Invisalign appliances. Pretreatment and posttreatment values were measured for: mandibular plane angle, occlusal plane angle, Y-Axis, ANB, facial angle, lower anterior facial height, overbite, and the distances of the molars from the palate and mandibular plane were measured. The alterations in parameters caused by treatment (delta values) were calculated for each measurement. Effects of treatment and some parameters on delta values were analyzed statistically (α=0.05). RESULTS Mean±SD of ΔMP-FH, ΔOP-FH, ΔY-Axis, ΔLAFH, ΔNPog-FH, ΔANB, ΔOverbite, ΔSNB, Δ6-PP, Δ7-PP, Δ6-MP, and Δ7-MP were respectively 0.11±1.61, 0.80±1.56, 0.15±1.18, 0.07±0.91, -0.22±1.25, 0.03±0.62, 0.04±1.15, -0.06±1.14, -0.36±0.94, -0.32±1.14, 0.19±0.96, 0.18±1.10. Only the alterations in OP-FH, 6-PP, and 7-PP were significant (P≤0.011). Age, sex, treatment duration, or pretreatment mandibular plane angle were not correlated with any delta values. However, the pretreatment occlusal plane angle was negatively correlated with ΔOP-FH and ΔY-Axis. Crowding was correlated negatively with ΔOP-FH and ΔY-Axis and positively with ΔNPog-FH. Overjet was negatively correlated with ΔANB and ΔOverbite (P≤0.035). CONCLUSIONS Invisalign intruded first/second maxillary molars and increased the occlusal plane angle. Age, sex, and treatment duration were not correlated with post-treatment anatomic alterations.
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Affiliation(s)
- Mehrnaz Moradinejad
- Department of Orthodontics, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Sayed Mohammad Mousavi
- Department of Orthodontics, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Georgia School of Orthodontics, Atlanta, GA, 30350, USA
| | - Minoo Alavi
- Department of Orthodontics, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Alireza Darvish Basseri
- Department of Orthodontics, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Arman Feiz
- Oral and Maxillofacial Radiology, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hanie Daryanavard
- Department of Orthodontics, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Vahid Rakhshan
- Formerly, Department of Anatomy, Dental School, Azad University of Medical Sciences, Tehran, Iran
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Al-Moghrabi D, Alkadhimi A, Abu Arqub S, Fleming PS. Blanket or tailored prescription of retainers in orthodontics: a questionnaire-based study. Angle Orthod 2023; 94:497685. [PMID: 38319063 PMCID: PMC10893930 DOI: 10.2319/060923-400.1] [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: 06/01/2023] [Accepted: 10/01/2023] [Indexed: 02/07/2024] Open
Abstract
OBJECTIVE To explore retainer protocols and how they are influenced by orthodontic presentation and the nature of occlusal correction. MATERIALS AND METHODS A prepiloted 45-item online questionnaire targeting orthodontists was developed. The questionnaire covered clinical preferences in terms of retainer type, fabrication, and follow-up during retention; the clinical indications for adjunctive surgical procedures; and the use of active designs to mitigate relapse in specific malocclusions. RESULTS A total of 206 responses were obtained. The majority of the respondents prescribed maxillary removable and mandibular fixed retainers, with almost half (49.1%) reviewing patients for more than 1 year primarily in person (95.1%). The majority prescribed vacuum-formed (69.6%) 1-mm-thick (44.3%) retainers. Only 37.3% were aware of the type of material used, with polyethylene terephthalate glycol copolymer, followed by polypropylene, being the most common. Hawley retainers were preferred following nonsurgical maxillary expansion and with suboptimal interdigitation. A preference for clear retainers and/or fixed retainers was found in open-bite cases and deep-bite cases. Supracrestal fiberotomy was prescribed commonly (61.1%) for rotations greater than 90°. No retainer was rarely prescribed except after the correction of an anterior crossbite. CONCLUSIONS Blanket prescription of orthodontic retention is common, with limited awareness of clear plastic retainer materials. Future trials evaluating the effectiveness of approaches for retainer prescription based on the presenting malocclusion would be timely.
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Suh H, Garnett BS, Mahood K, Boyd RL, Oh H. Short-term stability of anterior open bite treatment with clear aligners in adults. Am J Orthod Dentofacial Orthop 2023; 164:774-782. [PMID: 37552148 DOI: 10.1016/j.ajodo.2023.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 08/09/2023]
Abstract
INTRODUCTION This study aimed to examine the stability of anterior open bite (AOB) treatment with clear aligners. METHODS This retrospective cohort study included 52 adult AOB patients (aged >18 years; 15 males, 37 females) who underwent nonextraction clear aligner treatment and were at least 1 year posttreatment. Eleven cephalometric measurements were evaluated at pretreatment, end of active treatment, and at least 1-year posttreatment. Overbite change, the primary outcome variable, and other cephalometric changes during treatment and retention were calculated, and repeated measures analysis of variance were performed. Stepwise multiple regression was used to make a prediction equation for open bite relapse. RESULTS The mean retention period was 2.1 ± 1.1 years. The mean change in overbite during treatment was 3.3 ± 1.5 mm; 6% of patients presented relapse at least 1 year after treatment completion. The mean change of overbite (0.2 ± 0.5 mm) during the retention period was not statistically significant (P = 0.59). None of the 11 cephalometric measurements showed significant change during the retention period. The prediction model showed that only the coefficient for a tongue posture issue at the initial examination was statistically significant. CONCLUSIONS AOB was successfully corrected in all 52 patients using only clear aligners with no additional adjunctive aids such as microimplants. When retained with maxillary and mandibular fixed retainers and maxillary and mandibular vacuum-formed retainers, there was no significant change in cephalometric measurements during the short-term retention period.
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Affiliation(s)
- Heeyeon Suh
- Department of Orthodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, Calif
| | - Bella Shen Garnett
- Department of Orthodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, Calif; Private practice, San Francisco, Calif
| | - Kimberly Mahood
- Department of Orthodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, Calif
| | - Robert L Boyd
- Department of Orthodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, Calif
| | - Heesoo Oh
- Department of Orthodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, Calif.
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Llera-Romero AS, Adobes-Martín M, Iranzo-Cortés JE, Montiel-Company JM, Garcovich D. Periodontal health status, oral microbiome, white-spot lesions and oral health related to quality of life-clear aligners versus fixed appliances: A systematic review, meta-analysis and meta-regression. Korean J Orthod 2023; 53:374-392. [PMID: 37989575 PMCID: PMC10663575 DOI: 10.4041/kjod22.272] [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: 12/30/2022] [Revised: 04/25/2023] [Accepted: 08/28/2023] [Indexed: 11/23/2023] Open
Abstract
Objective : Assess and evaluate the different indicators of oral health-related quality of life (OHRQoL) among patients treated with clear aligners (CAs) versus those treated with conventional fixed orthodontics (FAs). Methods : An electronic search was performed on the database is Web of Science, Scopus, and Embase databases. Randomized and non-randomized control trials, cross-sectional, prospective cohort and retrospective trials were included. Quality was assessed with risk of bias tool and risk of bias in non-randomised studies. Meta-analyses were performed with random effects models, estimating the standardized and non-standardized mean differences, odds ratio and risk ratio as the measure of effect. The effect on time was determined using a meta-regression model. Results : Thirty one articles were included in the qualitative synthesis and 17 in the meta-analysis. CAs had a significantly lower negative impact on QoL, with an "important" effect size, while the influence of time was not significant. Periodontal indicators plaque index (PI), gingival index (GI), probing depth (PD), and bleeding on probing show significantly better values in patients treated with CAs, with moderate to large effect sizes. PI and GI have a significant tendency to improve over time. In microbiological indicators, CAs present a lower biofilm mass without differences in the percentage of patients with high counts of Streptococcus mutans and Lactobacilli bacteria. The risk of white spot lesion onset is ten times lower in carriers of CAs. Conclusions : Patients wearing CAs show better periodontal indicators, less risk of white spot development, less biofilm mass and a better QoL than patients with FAs.
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Affiliation(s)
| | | | | | | | - Daniele Garcovich
- Department of Dentistry, Universidad Europea de Valencia, Valencia, Spain
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Blundell HL, Weir T, Byrne G. Predictability of anterior open bite treatment with Invisalign. Am J Orthod Dentofacial Orthop 2023; 164:674-681. [PMID: 37330726 DOI: 10.1016/j.ajodo.2023.04.017] [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: 04/01/2023] [Accepted: 04/01/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Anterior open bite correction with Invisalign has been claimed to have relatively good predictability because of the proposed function of clear aligners to function as occlusal bite-blocks, limiting extrusion of the posterior teeth or possibly even intruding posterior teeth. This proposal, however, remains relatively unsubstantiated. The objective of this study was to investigate and determine the accuracy of Invisalign treatment in correcting anterior open bite by comparing the predicted outcome from ClinCheck to the achieved outcome for the initial aligner sequence. METHODS A retrospective study used pretreatment and posttreatment intraoral scans and predicted outcomes (ClinCheck) stereolithography files of 76 adult patients from private specialist orthodontic practices. Inclusion criteria comprised nonextraction treatment, with a minimum of 14 dual arch Invisalign aligners. Geomagic Control X software was used to measure overbite and overjet in the pretreatment, posttreatment, and predicted outcomes stereolithography files for each patient. RESULTS Approximately 66.2% of the programmed open bite closure was expressed compared with the prescribed ClinCheck outcome. The use of posterior occlusal bite-blocks and prescribed movement of teeth via anterior extrusion, posterior intrusion, or a combination of the 2 made no difference to the efficacy of open bite closure. Two-week aligner changes resulted in 0.49 mm more bite closure on average. CONCLUSIONS The prescribed bite closure in ClinCheck software overestimates the bite closure that is clinically achieved.
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Affiliation(s)
- Haylea L Blundell
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia.
| | - Tony Weir
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Graeme Byrne
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
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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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Withayanukonkij W, Chanmanee P, Promsawat M, Viteporn S, Leethanakul C. Root resorption during maxillary molar intrusion with clear aligners: a randomized controlled trial. Angle Orthod 2023; 93:629-637. [PMID: 37922387 PMCID: PMC10633803 DOI: 10.2319/010723-14.1] [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: 01/01/2023] [Accepted: 04/01/2023] [Indexed: 11/05/2023] Open
Abstract
OBJECTIVES To compare changes in maxillary molar root resorption, intrusion amount, dentoskeletal measures, and maximum bite force (MBF) between clear aligners (CA) and fixed appliances with miniscrew (FM) during molar intrusion. MATERIALS AND METHODS Forty adults with anterior open bite were randomized into either CA or FM groups. Lateral cephalograms, cone-beam computed tomography (CBCT), and MBF were collected at pretreatment (T0) and 6 months of treatment (T1). Maxillary molar intrusion in FM were intruded by nickel-titanium (NiTi) closed-coil spring delivered force (150 grams/side) while clear aligners combined with squeezing exercise were performed in CA. Parametric tests were used for statistical analysis. RESULTS After 6 months of treatment, significant root resorption of 0.21-0.24 mm in CA and 0.38-0.47 mm in FM were found while maxillary molars were intruded 0.68 and 1.49 mm in CA and FM, respectively. CA showed significant less root resorption and intrusion than FM. Overbite, bite closing, and MBF increased significantly. CA showed significantly less overbite and SN-MP changes but more MBF increase than FM. MBF in CA was correlated with the amount of maxillary molar intrusion (r = 0.736, P < .05). CONCLUSIONS Maxillary molar intrusion and root resorption in CA were half the amount in FM in 6 months. The amount of maxillary molar root resorption was one-third of the intrusion distance. CA displayed less overbite increase and bite closing but more MBF increase than FM. MBF in CA was positively correlated with the molar intrusion amount.
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Affiliation(s)
| | | | | | | | - Chidchanok Leethanakul
- Corresponding author: Dr Chidchanok Leethanakul, Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla 90112, Thailand (e-mail: )
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Kau CH, Soh J, Christou T, Mangal A. Orthodontic Aligners: Current Perspectives for the Modern Orthodontic Office. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1773. [PMID: 37893491 PMCID: PMC10608554 DOI: 10.3390/medicina59101773] [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: 09/06/2023] [Revised: 09/23/2023] [Accepted: 09/29/2023] [Indexed: 10/29/2023]
Abstract
Orthodontic aligners are changing the practice of orthodontics. This system of orthodontic appliances is becoming the mainstay appliance of choice for orthodontic offices in many countries. Patient preferences and lifestyle needs have made this appliance the primary choice when seeking care. In the early days, appliances lacked the efficiency and effectiveness of traditional bracket-wire systems, but modern systems are now able to handle a more comprehensive orthodontic caseload. Current systems provide newer biomechanical strategies and artificial intelligence-driven tooth movements for better outcomes. These improvements now mean that an orthodontist can be better prepared to manage a larger number of orthodontic malocclusions. This paper aims to discuss some of the evolution of orthodontic aligners and to describe to orthodontists the fundamentals of aligner therapy. In addition, it will provide an evidence-based outcome to the existing treatment outcomes in the current literature.
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Affiliation(s)
- Chung How Kau
- Department of Orthodontics, University of Alabama at Birmingham, Birmingham, AL 35233, USA;
- Department of Surgery, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - Jen Soh
- Private Orthodontic Practice, Braces & Aesthetics Dental Clinic Pte Ltd., Singapore 307506, Singapore;
| | - Teti Christou
- Department of Orthodontics, University of Alabama at Birmingham, Birmingham, AL 35233, USA;
| | - Akanksha Mangal
- Orthodontic Clinical Fellowship, School of Orthodontics, Jacksonville University, Jacksonville, FL 32211, USA;
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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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Wu Y, Yu Q, Xia Y, Wang B, Chen S, Gu K, Zhang B, Zhu M. Does mandibular advancement with clear aligners have the same skeletal and dentoalveolar effects as traditional functional appliances? BMC Oral Health 2023; 23:65. [PMID: 36732724 PMCID: PMC9896678 DOI: 10.1186/s12903-023-02709-5] [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: 11/16/2022] [Accepted: 01/03/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The study aimed to compare the dentoskeletal effects of Vanbeek Activator, Herbst, Twin-Block and Mandibular Advancement with clear aligners in children with skeletal Class II malocclusions. METHODS A sample with sixty-three patients (37 males, 26 females) was included and divided into untreated control group (C, n = 12), Vanbeek Activator group (V, n = 14), Herbst group (H, n = 11), Twin-Block group (TB, n = 12) and MA group (MA, n = 14). Cephalometric analysis and Johnston Pitchfork analysis were performed to quantify the skeletal and dentoalveolar components in molar relationship and overjet correction. Compare the differences of cephalometric data and Johnston-analysis data. RESULTS The treatment changes showed significant differences in SNB, FH-NP, NA-PA, Co-Go, Co-Pog, ANB, lower facial height ratio, U1-PP, U6-PP, L1-MP and U1-L1. All the appliances improved overjet relationships significantly (Vanbeek, Herbst, Twin-Block and MA were 2.77 mm, 5.53 mm, 4.73 mm and 3.66 mm respectively) with significant retraction of maxillary incisors. The lower incisor displacement of group V and MA was negative, while that of group H and TB was positive and there were significant differences. Molar relationships were also improved by 3.45 mm, 6.85 mm, 3.48 mm and 0.92 mm for Vanbeek, Herbst, Twin-Block and MA. Mandible displacement showed a trend of group H > TB > V > MA. The displacement of maxillary molars in group H was greater than that in group C, TB and MA, and that of mandibular ones was greater than that in group C, V and MA, significantly. Herbst, Twin-Block and MA have more significant dentoalveolar effect than Vanbeek, while Vanbeek has more skeletal effect than the others especially in restraining maxillary growth. CONCLUSIONS Four appliances are all effective in mandibular advancement, modification of class II molar relationship and deep overjet, with unavoidable increase in lower facial ratio. Vanbeek Activator has the most skeletal effects. Vanbeek and MA have a good control of mandibular incisors while more compensatory lower incisors proclination in Herbst and Twin-Block. Herbst has greater maxillary molar distalization. MA allows aligning and leveling meanwhile leading the mandible forward.
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Affiliation(s)
- Yanqi Wu
- grid.16821.3c0000 0004 0368 8293Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200011 China ,grid.412523.30000 0004 0386 9086National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200011 China
| | - Qian Yu
- Department of Pediatric Dentistry, Shanghai Xuhui District Dental Center, Shanghai, 200032 China
| | - Yunhui Xia
- grid.16821.3c0000 0004 0368 8293Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200011 China ,grid.412523.30000 0004 0386 9086National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200011 China
| | - Bo Wang
- grid.16821.3c0000 0004 0368 8293Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200011 China ,grid.412523.30000 0004 0386 9086National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200011 China
| | - Siyue Chen
- grid.16821.3c0000 0004 0368 8293Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200011 China ,grid.412523.30000 0004 0386 9086National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200011 China
| | - Kaijun Gu
- grid.16821.3c0000 0004 0368 8293Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200011 China ,grid.412523.30000 0004 0386 9086National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200011 China
| | - Bojun Zhang
- grid.16821.3c0000 0004 0368 8293Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200011 China ,grid.412523.30000 0004 0386 9086National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200011 China
| | - Min Zhu
- Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China. .,College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200011, China. .,National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, 200011, China. .,Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200011, China.
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Sabouni W, Venugopal A, Adel SM, Vaid N. Correction of anterior open bite of varying severity using clear aligner therapy—A case series. Clin Case Rep 2022; 10:e6277. [PMID: 36052021 PMCID: PMC9422631 DOI: 10.1002/ccr3.6277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 08/08/2022] [Accepted: 08/12/2022] [Indexed: 11/30/2022] Open
Abstract
In open bite cases, a comprehensive diagnostic differentiation is crucial in determining the best corrective therapy. In non‐surgical open bite treatment, fixed appliances, either labial or lingual, are usually employed. With the addition of extra‐radicular screws, more sophisticated orthodontic movements may now be performed without the necessity for orthognathic surgery. Clear aligner therapy, on the contrary, has grown in popularity as a treatment option for more complex cases, such as open bite malocclusions. This article discusses three cases with an anterior open bite that were treated using various mechanics as dictated by the malocclusion. Case 1 was addressed wholly using clear aligner therapy, with careful consideration of attachment geometry and mechanics. Case 2 with clear aligner therapy, attachment geometry selection, and vertical elastics; and Case 3 with clear aligner therapy, attachments, and temporary anchorage devices.
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Affiliation(s)
- Waddah Sabouni
- Private Practice Invislign Centre Dubai United Arab Emirates
| | - Adith Venugopal
- Department of Orthodontics Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University Chennai India
- Department of Orthodontics University of Puthisastra Phnom Penh Cambodia
| | - Samar M. Adel
- Faculty of Dentistry Alexandria University Alexandria Egypt
| | - Nikhilesh Vaid
- Department of Orthodontics Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University Chennai India
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