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Song JH, Lee JH, Joo BH, Choi YJ, Chung CJ, Kim KH. Treatment outcome comparison of Invisalign vs fixed appliance treatment in first premolar extraction patients. Am J Orthod Dentofacial Orthop 2024; 165:399-413. [PMID: 38142394 DOI: 10.1016/j.ajodo.2023.10.014] [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: 10/01/2023] [Accepted: 10/01/2023] [Indexed: 12/25/2023]
Abstract
INTRODUCTION In this study, we compared the dentitional changes after Invisalign and conventional orthodontic treatment with 4 first premolar extractions. METHODS This retrospective study included 57 patients whose orthodontic treatment involved the extraction of 4 first premolars because of bialveolar protrusion. A total of 27 patients were treated with Invisalign (mean age, 25.5 ± 5.2 years) and 30 patients with the fixed appliance (mean age, 24.4 ± 5.8 years). The angular and linear changes of the maxillary and mandibular central incisors, second premolars, first molars, and second molars were measured from the recordings on the basis of the lateral cephalograms taken before and after treatment. The angular changes of the canines and second premolars were measured using panoramic radiographs. RESULTS The overbite and interincisal angle increased significantly in the Invisalign group compared with in the conventional fixed appliance group (P <0.05). The maxillary central incisors showed increased lingual tipping in the Invisalign group (P <0.05), whereas there was no statistically significant difference in the angular change of the mandibular incisors between groups (P >0.05). The maxillary first and second molars showed mesial tipping in the Invisalign group (P <0.05). The maxillary second premolars, first and second molars, and the mandibular second molars showed mesial movement in the Invisalign group (P <0.05). CONCLUSIONS The Invisalign group showed more statistically significant lingual tipping of the maxillary central incisors, distal tipping of the maxillary canines, and mesial tipping of the maxillary first and second molars after maximum retraction of the anterior teeth compared with the fixed appliance group.
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Affiliation(s)
- Ji-Hye Song
- Department of Orthodontics, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, South Korea
| | - Ji-Hyun Lee
- Department of Orthodontics, Gangnam Severance Dental Hospital, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, South Korea
| | - Bo-Hoon Joo
- The Institute of Clear Aligner Center of The STAR 28 Dental Group, Seoul, South Korea
| | - Yoon Jeong Choi
- Department of Orthodontics, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, South Korea
| | - Chooryung J Chung
- Department of Orthodontics, Gangnam Severance Dental Hospital, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, South Korea
| | - Kyung-Ho Kim
- Department of Orthodontics, Gangnam Severance Dental Hospital, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, South Korea.
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Kang J, Jeon HH, Shahabuddin N. Does aligner refinement have the same efficiency in deep bite correction?: A retrospective study. BMC Oral Health 2024; 24:338. [PMID: 38491450 PMCID: PMC10943900 DOI: 10.1186/s12903-024-04099-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/04/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Refinements are very common in clear aligner treatments. The aim of this study is to assess whether the predictability of deep overbite correction is similar over several refinements using clear aligners (Invisalign, Align Technology, San Jose, Calif) and examine the accuracy of vertical movement and inclination change of individual teeth. METHODS This retrospective study included 20 deep bite patients (7M and 13F; 32.63 ± 11.88 years old; an initial overbite of 5.09 ± 0.98 mm), consecutively treated from September 2016 and March 2023, who completed at least two sets of aligners, including refinements. The initial, predicted, and achieved models were exported from ClinCheck or OrthoCAD (Cadent Inc, Carlstadt, NJ) and superimposed via best-fit surface-based registration using SlicerCMF (version 4.9.0; cmf.slicer.org). We also examined 15 out of 20 patients who completed treatments. The overbite correction and changes in vertical movement and inclination for individual teeth were measured. Descriptive statistics and a paired t-test or Wilcoxon signed-rank test were performed. P < 0.05 was considered statistically significant. RESULTS The mean accuracy of overbite correction was 37.63% after 1st set, followed by 11.19%, 6.32%, and 13.80% (2nd-4th sets), respectively. There were statistically significant differences between the predicted and achieved vertical movements and inclination changes for all teeth for the 1st and 2nd sets. For the completed cases, the mean overbite correction was 38.54% compared to the initially planned overbite correction, which is similar to one of the 1st set. Still, the vertical movements and inclination changes of all teeth present statistically significant differences between the initially planned and finally achieved movements except for maxillary lateral incisor torque. CONCLUSIONS The most overbite correction occurs during the 1st set of aligners, and refinement treatment does not significantly improve the deep bite correction.
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Affiliation(s)
- Jessica Kang
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, 240 South 40th Street, Philadelphia, PA, 19104-6030, USA
| | - Hyeran Helen Jeon
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, 240 South 40th Street, Philadelphia, PA, 19104-6030, USA.
| | - Nishat Shahabuddin
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, 240 South 40th Street, Philadelphia, PA, 19104-6030, USA
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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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Zhu L, Liu L, Wang W, Deng WW. Effects of different patterns of movement for correcting a deep curve of Spee with clear aligners on the anterior teeth: a finite element analysis. BMC Oral Health 2024; 24:217. [PMID: 38341537 PMCID: PMC10859030 DOI: 10.1186/s12903-024-03906-6] [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: 08/08/2023] [Accepted: 01/16/2024] [Indexed: 02/12/2024] Open
Abstract
OBJECTIVE To analyse the anterior teeth effects of clear aligners on five different patterns of mandibular molar movement and to define the most effective configuration to be implemented with clear aligners through finite element analysis. METHODS A three-dimensional mandibular model with a deep overbite in the mandible was constructed using cone beam computerized tomography (CBCT) data. The model included the mandibular dentition, mandibular periodontal ligaments, attachments, and aligners. Five models were created: (1) configuration A: second molar distalization (0.25 mm); (2) configuration B: second molar distalization (0.25 mm), first molar extrusion (0.15 mm); (3) configuration C: second molar distalization (0.25 mmm), first and second premolar extrusion(0.15 mm); (4) configuration D: second molar distalization (0.25 mm), first molar and first/second premolar extrusion(0.15 mm); and (5) configuration E: second molar distalization (0.25 mm), first molar and first/second premolar extrusion (0.15 mm), first molar and first/second premolar expansion (0.15 mm). RESULTS In all configurations, the anterior teeth exhibited labial tipping and the mandibular central incisor of configuration E showed the highest labial tipping. Configuration E demonstrated a relatively minor impact on mandibular molars distalization compared with configuration A. Configuration A showed the highest distal displacement value, and configuration E produced the lowest displacement value. Configuration E caused the highest periodontal ligament (PDL) pressure of the central and lateral incisors. The differences in the canines between configurations C and D,were not significant, and the stress distribution differed among the five groups. CONCLUSIONS All patterns utilizing clear aligners facilitated mandibular molar distalization. Extruding the premolars and second molar distalization at the same time had little impact on second molar distalization; When expansion and extrusion were simultaneously performed during the distalization of mandibular molars, our prime consideration was the alveolar bone on the labial side of the anterior teeth to prevent the occurrence of gingival recession, dehiscence, and fenestration. Due to the lack of consideration for periodontal tissues in this study, clinical protocols should be designed based on the periodontal status of the mandibular anterior teeth.
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Affiliation(s)
- Lin Zhu
- Graduate School of Dalian Medical University, Dalian, China
| | - Lin Liu
- Department of Orthodontics, DaLian Stomatological Hospital, DaLian, China.
| | - Wei Wang
- Urumql DW Innovation InfoTech Co., Ltd., Urumqi, Xinjiang, China
| | - Wen Wen Deng
- Department of Orthodontics, DaLian Stomatological Hospital, DaLian, China
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Meade MJ, Weir T. Predicted and achieved overjet and overbite measurements with the Invisalign appliance: a retrospective study. Angle Orthod 2024; 94:3-9. [PMID: 37839803 DOI: 10.2319/030923-161.1] [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: 03/01/2023] [Accepted: 07/01/2023] [Indexed: 10/17/2023] Open
Abstract
OBJECTIVES To determine whether achieved outcome regarding overjet and overbite matched the predicted outcome following treatment with Invisalign (Align Technology, San Jose, Calif) aligner appliances. MATERIALS AND METHODS Data including pretreatment, predicted and achieved overjet, and overbite measurements provided by Align's digital treatment facility, ClinCheck Pro, were evaluated. Descriptive statistics, Mann-Whitney U-test, and Wilcoxon rank-sum intraclass correlation (ICC) test results were calculated. RESULTS From an initial sample of 600, 355 adult patients satisfied the inclusion and exclusion criteria. ICC scores for data input were excellent. Median (interquartile range [IQR]) age was 30.14 (23.33, 39.92) years and most (n = 259; 72.95%) were women. Almost one-third (n = 101; 28.45%) had undergone extraction as part of their treatment. More aligners were prescribed in the initial digital treatment plan for patients (median, 44; IQR: 35, 51.5; minimum, 17; maximum, 92) undergoing extractions as part of their orthodontic treatment than those who were not (median, 24; IQR: 18.25, 32; minimum, 13; maximum, 85) (P < .0001). Planned changes in overjet differed significantly from achieved outcomes (P < .001). Planned increases in overbite resulted in up to more than twice (222.72%) as much increase than predicted. Planned reduction of overbite achieved 8.69% of its predicted reduction in extraction cases. CONCLUSIONS Achieved overjet and overbite measurements differed significantly from the predicted outcomes at the end of an initial sequence of aligners. Planned increases in overbite resulted in greater overbite correction than predicted, particularly in extraction cases. Planned overbite reduction was challenging, especially in patients with extractions.
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Muro MP, Caracciolo ACA, Patel MP, Feres MFN, Roscoe MG. Effectiveness and predictability of treatment with clear orthodontic aligners: A scoping review. Int Orthod 2023; 21:100755. [PMID: 37086643 DOI: 10.1016/j.ortho.2023.100755] [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: 11/24/2022] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 04/24/2023]
Abstract
INTRODUCTION In an ideal clinical setting, orthodontic therapy with clear aligners (CA) should improve the patients' initial malocclusion and must guarantee equivalence between the results predicted and those obtained clinically to be considered an effective treatment. Therefore, this scoping review aimed to identify the orthodontic literature concerning the effectiveness and predictability of CA treatments. METHODS A systematic computerized search was performed in 3 databases: PubMed, Scopus, and Embase. Inclusion criteria selected observational and clinical studies performed in at least 10 adult orthodontic patients, whose results of CA treatment's effectiveness and/or predictability were assessed. RESULTS The 3 database computerized searches resulted in 1,553 articles, and 169 full texts were considered potentially relevant. After applying the eligibility criteria, 33 studies were included. Most studies (76%) were designed as cohort studies and have been published in the last 5 years (79%). The majority included only non-extraction treatments (73%), and 79% reported results achieved with the Invisalign® system. The most predictable movement was the buccolingual tipping, while the least predictable movements were rotation, intrusion, and extrusion. Aligner treatment was effective for mild to moderate crowding resolution, and the success of overbite correction still seems to be limited. CONCLUSIONS The studies have demonstrated improvement of initial malocclusion through CA treatments. Still, predictability degree is overestimated and does not accurately reflect the occlusion immediately at the end of treatment. In future studies, there should be an effort to broaden the utilization of alternative aligner systems beyond Invisalign® and broadly disseminate their outcomes to strengthen clear aligners evidence base.
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Affiliation(s)
| | | | - Mayara Paim Patel
- Dental Research Division, School of Dentistry, Guarulhos University, Guarulhos, São Paulo, Brazil
| | | | - Marina Guimarães Roscoe
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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