Quality in orthodontics: The role of customized appliances

Evidence of Effectiveness of Lingual Orthodontics as an Alternative to Conventional Labial Orthodontics. A Systematic Review

In orthodontics, both the treatment goals and the impact of orthodontic equipment on patients' aesthetic appearance have contributed to a rise in patients' aesthetic demands over the years. Patients considering orthodontic treatment are significantly concerned about the potential compromise in facial appearance that conventional orthodontic therapy might cause. Clinical practice has integrated aesthetic materials and procedures to address these restrictions. This review will examine the present data and outcomes linked to lingual orthodontics. PubMed, Scopus, Web of Science, Cochrane Library, and Embase were the electronic databases searched. Research interests mainly included biomechanics, appliance design, bonding, laboratory settings, case reports, survey research, and treatment outcomes. The goal was to locate the most recent data regarding lingual orthodontics. A consistent and predictable pattern emerges from the available evidence on lingual orthodontics. Several areas have received a lot of attention over the past decade, including the ability to forecast outcomes and patients' preparedness to embrace these changes. The current state of knowledge on the biomechanical principles of lingual orthodontics is solid, as this review shows. Lingual orthodontic appliances can efficiently handle any orthodontic scenario that a labial appliance can handle. The reason is that the completely customized lingual appliance might bring about the desired result in terms of treatment.

Digital lingual appliance combined with micro-screws for the treatment of a skeletal bimaxillary protrusion and ‘gummy’ smile

This case report describes the lingual orthodontic treatment of a 28-year-old female patient who presented with a bimaxillary protrusion malocclusion, a hyperdivergent facial pattern, mentalis strain, and a ‘gummy’ smile. To achieve favourable occlusal and facial results, the four first premolars were extracted, and micro-screws utilised to provide maximum anchorage. With the widespread application of three-dimensional technology, a digital goal-oriented treatment plan was applied for its predictability and precision. A fully customised lingual appliance system with preset torque in the anterior teeth combined with ribbon-wise arch wires was placed to prevent excessive lingual inclination of the incisors during retraction. As a result, an attractive facial profile and a well-aligned dentition with ideal intercuspation was obtained.

3D Printing: Applications in Tissue Engineering, Medical Devices, and Drug Delivery

The gemstone of 3-dimensional (3D) printing shines up from the pyramid of additive manufacturing. Three-dimensional bioprinting technology has been predicted to be a game-changing breakthrough in the pharmaceutical industry since the last decade. It is fast evolving and finds its seats in a variety of domains, including aviation, defense, automobiles, replacement components, architecture, movies, musical instruments, forensic, dentistry, audiology, prosthetics, surgery, food, and fashion industry. In recent years, this miraculous manufacturing technology has become increasingly relevant for pharmaceutical purposes. Computer-aided drug (CAD) model will be developed by computer software and fed into bioprinters. Based on material inputs, the printers will recognize and produce the model scaffold. Techniques including stereolithography, selective laser sintering, selective laser melting, material extrusion, material jetting, inkjet-based, fused deposition modelling, binder deposition, and bioprinting expedite the printing process. Distinct advantages are rapid prototyping, flexible design, print on demand, light and strong parts, fast and cost-effective, and environment friendly. The present review gives a brief description of the conceptional 3-dimensional printing, followed by various techniques involved. A short note was explained about the fabricating materials in the pharmaceutical sector. The beam of light is thrown on the various applications in the pharma and medical arena.

Three-Dimensional Modeling and 3D Printing of Biocompatible Orthodontic Power-Arm Design with Clinical Application

Three-dimensional (3D) printing with biocompatible resins offers new competition to its opposition—subtractive manufacturing, which currently dominates in dentistry. Removing dental material layer-by-layer with lathes, mills or grinders faces its limits when it comes to the fabrication of detailed complex structures. The aim of this original research was to design, materialize and clinically evaluate a functional and resilient shape of the orthodontic power-arm by means of biocompatible 3D printing. To improve power-arm resiliency, we have employed finite element modelling and analyzed stress distribution to improve the original design of the power-arm. After 3D printing, we have also evaluated both designs clinically. This multidisciplinary approach is described in this paper as a feasible workflow that might inspire application other individualized biomechanical appliances in orthodontics. The design is a biocompatible power-arm, a miniature device bonded to a tooth surface, translating significant bio-mechanical force vectors to move a tooth in the bone. Its design must be also resilient and fully individualized to patient oral anatomy. Clinical evaluation of the debonding rate in 50 randomized clinical applications for each power-arm-variant showed significantly less debonding incidents in the improved power-arm design (two failures = 4%) than in the original variant (nine failures = 18%).