[Invisible and almost invisible orthodontic appliances]

Surgical Precision Analysis of Orthognathic Surgery Combined With Invisible Orthodontic

BACKGROUND

This study aimed to explore the changes in hard tissue after applying invisible orthodontic-orthognathic treatment and the digital design, and to explore the accuracy of the treatment effect of maxillofacial tissue after invisible orthodontic treatment and orthognathic treatment.

METHODS

From September 2020 to January 2022, 25 patients with class III skeletal malocclusion and 7 patients with class II skeletal malocclusion, were treated with invisible orthodontic treatment and orthognathic combined treatment. Orthodontic treatment with preoperative invisible orthodontic treatment followed by orthodontic surgery. All patients had cephalometric lateral films after surgery to analyze orthognathic surgery's goals and surgical effects of orthognathic surgery and the digital design. Measure the angle of the sella-nasion-A point angle, angle of sella-nasion-B point, ANB angle, maxillary convex angle, mandibular plane (MP) angle, 1-SN angle, 1-MP angle, etc, and compare surgery outcome with digital design.

RESULT

All patients were satisfied with the effect and no complications occurred. Angle of sella-nasion-A point, angle of sella-nasion-B point, ANB angle, maxillary convex angle, MP angle, 1-SN angle, and 1-MP angle had no significant difference between the postoperative effect and the purpose of digital design ( P >0.05), there was no apparent deviation between the upper and lower jaw and the chin ( P >0.05).

CONCLUSION

The combined invisible orthodontic treatment and orthognathic treatment are accurate and effective, and are worthy of promotion. It supplements traditional orthognathic therapy and is suitable for corresponding patients.

Evaluation of the effectiveness of modified aligner appliance with nickel-titanium springs in treatment of mild crowding of lower incisors: A randomized controlled clinical trial

BACKGROUND

This study aimed to evaluate the effectiveness of modified aligner appliances with nickel-titanium springs (MAAs) in treating mild mandibular crowding and assess the overall alignment treatment duration, alignment improvement percentage, and mandibular incisor proclination.

METHODS

This two-armed, parallel-group randomized controlled trial included 36 patients (7 men, 29 women) with mild mandibular incisor crowding according to Little's Irregularity Index. Patients were randomly assigned to two groups: the MAA group (mean age = 22.56 ± 3.50 years) and the conventional fixed bracket group (control group; mean age = 20.89 ± 2.90 years). The duration of alignment treatment of the lower anterior teeth was calculated. The progress of alignment was evaluated every 2 weeks on the study casts, which were taken at fixed intervals: pretreatment (T0) and 2 (T1), 4 (T2), 6 (T3), and 8 (T4) weeks after beginning the treatment. Change of mandibular incisor proclination was evaluated by measuring and comparing pretreatment and postalignment lateral cephalograms.

RESULTS

No statistically significant difference was detected between the two groups in terms of alignment treatment duration (P = 0.097), whereas a significant difference was observed in the alignment improvement percentage at T1 (P = 0.000), T2 (P = 0.001), and T3 (P = 0.022). In addition, the MAA group had a lower change of mandibular incisor proclination than the control group (P = 0.000).

CONCLUSIONS

The clinical application of MAAs may be effective in lower incisor decrowding, with a reduction in lower incisor inclination compared with conventional fixed brackets. This trial was registered at ClinicalTrials.gov (identifier: NCT04988373).

Motivation, Perception, and Behavior of the Adult Orthodontic Patient: A Survey Analysis

Purpose

The article is aimed at improving the understanding of the sociocultural profile of adult orthodontic patients and their expectations. In particular, it addresses three main aspects: the motivation and needs that underpin the decision to start orthodontic treatment, how it influences the patients' daily life, and the different oral hygiene demands.

Materials and Methods

An online survey was completed by 276 patients undergoing orthodontic treatment with different techniques. The questions asked concerned gender, age, type of appliance, any previous orthodontic treatments, type of any previous retainers, reasons for therapy, satisfaction, pain, problems in eating, daily number of teeth brushings and flossings before and during the treatment, perception of cost, sensation of visibility of the appliance, and if they would recommend orthodontic treatment.

Results

A significant role within our sample is played by gender; 87.94% consisted of female patients out of which 72.57% wanted to improve their aesthetics, while only 54.84% of male patients cited the same reason. Invisible aligners were preferred by 67.70% of the patients due to them being considered the least painful, causing the fewest problems with eating, and the least visible. Metal braces were perceived as the less expensive treatment. Over a third of the patients (33.85%) had previously undergone orthodontic treatment, among them 54.05% wore a mobile retainer, 31.08% a fixed one, and 14.86% both. Daily tooth brushing and flossing increased during therapy with clear aligners by 48.94% and 126.39%, respectively.

Conclusions

The greatest demand for orthodontic treatments comes from women, as they pay more attention to aesthetics, which makes the clear aligners the most common choice. The relapse after orthodontic treatment seems to cause a higher demand for retreatment, and oral hygiene habits significantly improve during orthodontic treatment, especially with the clear aligners.