1
|
Fiorillo G, Campobasso A, Croce S, Hussain U, Battista G, Lo Muzio E, Mandelli G, Ambrosi A, Gastaldi G. Accuracy of clear aligners in the orthodontic rotational movement using different attachment configurations. Orthod Craniofac Res 2024. [PMID: 39158036 DOI: 10.1111/ocr.12846] [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: 11/29/2022] [Revised: 07/02/2024] [Accepted: 08/07/2024] [Indexed: 08/20/2024]
Abstract
OBJECTIVE To evaluate the accuracy of dental rotational movements using clear aligners with different attachment configurations. MATERIALS AND METHODS This retrospective study analysed 212 teeth from 89 patients undergoing Invisalign treatment. Digital models were analysed after the virtual treatment plan (ST1) and after the first treatment phase (ET1) to evaluate the effective clinical rotational movement. The rotational movements of incisors, canines, and bicuspids were measured using data from the Clincheck Movements Table. ST1 and ET1 were compared to determine the actual rotational movement achieved (ST1-ET1). The presence or absence of attachments (rectangular or optimized) on teeth was analysed. The accuracy of rotational movements among attachment types was compared using the Kruskal-Wallis test. Multiple linear regressions were conducted with accuracy as the dependent variable and tooth type, gender, and age as predictors. RESULTS Optimized attachments had the highest median accuracy (70%), followed by rectangular (65%), and without attachment (63%), with no significant differences (p = .5). There were no significant differences across age groups, genders, or tooth types. Baseline accuracy was 68.62% (95% CI: 56.03-81.20, p < .001). Age was a significant predictor (estimate = -0.30, 95% CI: -0.58 - -0.03, p = .032), indicating decreased accuracy with increasing age. The model's R2 was 0.046, with an adjusted R2 of 0.003, indicating minimal variance explained. CONCLUSION The addition of attachment configurations to clear aligners improves rotational accuracy, but not significantly. Further advancements in these configurations are needed to enhance the performance of the aligners.
Collapse
Affiliation(s)
- Gianluigi Fiorillo
- Dental School, San Raffaele Vita-Salute University of Milan, Milan, Italy
| | - Alessandra Campobasso
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Silvia Croce
- Dental School, San Raffaele Vita-Salute University of Milan, Milan, Italy
| | - Umar Hussain
- Department of Orthodontics, Saidu College of Dentistry, Swat, Pakistan
| | - Giovanni Battista
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Eleonora Lo Muzio
- Department of Translational Medicine and for Romagna, University of Ferrara, Ferrara, Italy
| | - Gualtiero Mandelli
- Dental School, San Raffaele Vita-Salute University of Milan, Milan, Italy
| | - Alessandro Ambrosi
- Dental School, San Raffaele Vita-Salute University of Milan, Milan, Italy
| | - Giorgio Gastaldi
- Dental School, San Raffaele Vita-Salute University of Milan, Milan, Italy
| |
Collapse
|
2
|
Rajan N, Weir T, Meade MJ. Efficacy of planned moderate to severe torque changes in maxillary central incisors with the Invisalign appliance: A retrospective investigation. Am J Orthod Dentofacial Orthop 2024:S0889-5406(24)00234-8. [PMID: 39046382 DOI: 10.1016/j.ajodo.2024.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/01/2024] [Accepted: 06/01/2024] [Indexed: 07/25/2024]
Abstract
INTRODUCTION This study aimed to investigate whether there was a difference between the planned and achieved lingual root torque of the maxillary central incisors in patients treated with an initial series of Invisalign (Align Technology, Santa Clara, Calif) aligners in which >10° change in the inclination of these teeth was prescribed via the ClinCheck facility. METHODS The pretreatment, planned, and the digital models after wear of the initial series of aligners regarding adult patients who satisfied selection criteria and were treated using the Invisalign appliance were measured using the Geomagic Control X software (version 2017.0.3; 3D systems, Rock Hill, SC). RESULTS A sample of 63 patients with 126 maxillary central incisors satisfied the inclusion criteria. The mean accuracy of the planned torque change of the maxillary central incisors that was achieved was 41.9%. A clinically significant shortfall (≥5°) was detected in 78.6% of the incisors, with the majority showing an underexpression between 10°-15°. Linear regression analyses indicated that weekly or biweekly wear protocols or the presence or absence of power ridges did not influence the accuracy of planned torque expression (P >0.05). CONCLUSIONS The changes in torque expression with an initial series of Invisalign aligners were less than half of what was planned in patients in which at least a 10° change in lingual root torque of these teeth was prescribed. The presence of power ridges and the aligner change protocol did not appear to significantly affect the accuracy of maxillary central incisor torque expression.
Collapse
Affiliation(s)
- Nancy Rajan
- Orthodontic Unit, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Tony Weir
- Orthodontic Unit, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Maurice J Meade
- Orthodontic Unit, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia.
| |
Collapse
|
3
|
Mamani J, Sessirisombat C, Hotokezaka H, Yoshida N, Sirisoontorn I. Effectiveness of Clear Aligners on Sequential Maxillary Molar Distalization: Discrepancy between Treatment Goal and Outcome. J Clin Med 2024; 13:4216. [PMID: 39064256 PMCID: PMC11278389 DOI: 10.3390/jcm13144216] [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: 05/24/2024] [Revised: 07/11/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024] Open
Abstract
Objectives: The purpose of this preliminary study was to determine the differences between planned and actual maxillary molar movements after the completion of treatment with an initial set of clear aligners including sequential maxillary molar distalization. Methods: The data records of 14 non-growing patients who completed orthodontic treatment with sequential maxillary molar distalization using clear aligners were retrospectively evaluated (n= 14, 4 males and 10 females, 33.61 ± 8.57 years). Data on planned tooth movements were obtained from ClinCheck software (ClinCheck Pro version 5.3). The amounts of actual tooth movements were obtained by performing superimposition of lateral cephalograms taken before and after treatment. The amounts of distal translation and tipping between planned and actual maxillary molar movements were compared with the paired Student's t-test. Results: The statistically significant differences between planned and actual translation movements of maxillary first and second molars were shown after completing treatment with the first series of aligners (p < 0.05). The average actual amount of molar distalization on maxillary first molars was less than the planned amount by 1.32 ± 0.42 mm. Similarly, the average actual amount of molar distalization on maxillary second molars was less than the planned amount by 1.57 ± 0.45 mm. The accuracy for molar distalization, namely, the percentage of actual distal translation to planned movement, was 40.11% for maxillary first molars and 35.39% for maxillary second molars. However, the difference between the planned and actual angulation movements was not significant (p > 0.05). Conslusions: In conclusion, the amounts of actual distal translation of maxillary molars through the utilization of clear aligners were significantly lower than planned. However, there were no statistically significant differences between the degrees of actual and planned molar angulation movement.
Collapse
Affiliation(s)
- Jatuphol Mamani
- Department of Clinical Dentistry, Walailak University International College of Dentistry (WUICD), 87 Ra-nong 2 Road, Dusit, Bangkok 10300, Thailand
| | - Chidchanok Sessirisombat
- Department of Clinical Dentistry, Walailak University International College of Dentistry (WUICD), 87 Ra-nong 2 Road, Dusit, Bangkok 10300, Thailand
| | - Hitoshi Hotokezaka
- Department of Orthodontics and Dentofacial Orthopedics, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan
| | - Noriaki Yoshida
- Department of Orthodontics and Dentofacial Orthopedics, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan
| | - Irin Sirisoontorn
- Department of Clinical Dentistry, Walailak University International College of Dentistry (WUICD), 87 Ra-nong 2 Road, Dusit, Bangkok 10300, Thailand
| |
Collapse
|
4
|
Li P, Zhang Z, Liu J, Xue H. LIPUS can promote osteogenesis of hPDLCs and inhibit the periodontal inflammatory response via TLR5. Oral Dis 2024; 30:3386-3399. [PMID: 37983889 DOI: 10.1111/odi.14807] [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: 05/22/2023] [Revised: 09/26/2023] [Accepted: 11/02/2023] [Indexed: 11/22/2023]
Abstract
In this study, we isolated human periodontal ligament cells (hPDLCs) to find the optimal time of LIPUS stimulation and to explore how LIPUS affects inflammatory and osteogenic responses in hPDLCs in an inflammatory environment. The target molecules of LIPUS were identified by high-throughput sequencing. RT-qPCR and WB were used to detect how LIPUS affected the expression of related genes in TNFα-induced inflammation. The expression of ROS and inflammatory factors was detected by flow cytometry. Immunohistochemistry was used to further verify gene expression in rats. hPDLCs were isolated successfully. The optimal LIPUS stimulation condition was 45 mW/cm2 for 30 min and continued for 3 days, and this intensity significantly promoted the osteogenesis and mineralization of hPDLCs. LIPUS significantly inhibited the upregulation of IL-6 and ROS, increased the percentage of cells in the G2 phase, inhibited cell apoptosis, and inhibited the upregulation of TLR5 expression in an inflammatory environment. LIPUS can effectively restrain the inflammation and oxidative stress response of hPDLCs and promote osteogenesis in an inflammatory environment. LIPUS inhibited the periodontal inflammatory response through TLR5 in hPDLCs and dental pulp.
Collapse
Affiliation(s)
- Ping Li
- Departments of Stomatology and Central Lab, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
| | - Zhipeng Zhang
- Departments of Stomatology and Central Lab, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
| | - Jingjing Liu
- Department of Stomatology, The Dushu Lake Hospital Affiliated to Soochow University, Suzhou, Jiangsu, China
| | - Hui Xue
- Departments of Stomatology and Central Lab, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
| |
Collapse
|
5
|
Correa L, Albaladejo A, Curto A. A longitudinal pilot study examining the influence of the orthodontic system chosen in adult patients (brackets versus aligners) on oral health-related quality of life and anxiety. BMC Oral Health 2024; 24:745. [PMID: 38937720 PMCID: PMC11212429 DOI: 10.1186/s12903-024-04464-7] [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: 02/22/2024] [Accepted: 06/07/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND In recent years, the demand for orthodontic treatment with aligners has increased, led by patient need, as aligners typically provide them with improved aesthetics and less physical discomfort. In deciding with the patient on an appropriate orthodontic system, it is important to take into account the potential discomfort and the perceptions that patients have in relation to their treatment. The objective of this study was to analyze the influence of brackets or aligners on oral health-related quality of life (OHRQoL) and anxiety levels in a sample of adult patients during the first month of treatment. METHODS The pilot study was carried out at the Dental Clinic of the University of Salamanca between November 2023 and February 2024. Eighty adult patients who initiated orthodontic treatment were selected and divided into two groups: the brackets group (Victory®; 3 M Unitek, California, USA) (n = 40) and the aligners group (Invisalign®; Align Technology, California, USA) (n = 40). OHRQoL was analyzed using the Oral Health Impact Profile-14 (OHIP-14) questionnaire, and anxiety was analyzed using the State-Trait Anxiety Inventory (STAI). The follow-up time was one month, with scores recorded at the beginning (T0) and one month after starting treatment (T1). RESULTS The mean patient age was 33.70 (± 5.45) years old. The total sample (n = 80) consisted of 66.2% men and 33.8% women. In the brackets group, one month after starting treatment, the dimension with the highest impact was that of physical pain (5.62 ± 1.51). In the aligners group, where the dimension of psychological disability had the highest score (4.22 ± 1.02). In the brackets group the total OHIP score was higher at one month (T1) (33.98 ± 6.81) than at the start of treatment (T0) (21.80 ± 3.34); this greater impact on OHRQoL one month after starting treatment was not observed in the aligners group (T1 = 27.33 ± 6.83; T0 = 27.33 ± 6.22). The orthodontic system used did not influence participants' anxiety (p > 0.05). Age and sex were not influential factors in either OHRQoL or anxiety. CONCLUSIONS The bracket system significantly influenced patients' OHRQoL. In the sample studied, no influence of the orthodontic system (brackets versus aligners) on anxiety was observed.
Collapse
Affiliation(s)
- Laura Correa
- Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | | | - Adrián Curto
- Faculty of Medicine, University of Salamanca, Salamanca, Spain.
| |
Collapse
|
6
|
Castilhos JS, Gasparello GG, Mota-Júnior SL, Hartmann GC, Miyagusuku LFI, Pithon MM, Tanaka OM. Accessories in clear aligner therapy: Laypeople's expectations for comfort and satisfaction. J Dent Res Dent Clin Dent Prospects 2024; 18:102-109. [PMID: 39071215 PMCID: PMC11282201 DOI: 10.34172/joddd.40793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/20/2024] [Indexed: 07/30/2024] Open
Abstract
Background This study explored the layperson's perception of comfort, satisfaction, and willingness to use various accessories in clear aligner therapy. Methods A total of 267 people analyzed standardized intraoral photographs of a female model in orthodontic treatment using: 1) only clear aligner (CA), the control group; 2) clear aligner+attachments (AT); 3) clear aligners+Cl II elastics (EL); 4) clear aligner+hybrid treatment with esthetic braces (HEB); 5) Clear aligner+hybrid treatment with metallic braces (HMB); 6) clear aligner+mini-implants (MI); 7) clear aligner+mini-implants and elastics for intrusion (MIE). In addition, a social media questionnaire was distributed to assess the willingness to undergo orthodontic treatment with various accessories. Results There was a significant difference between CA and all the other groups (P<0.001), with CA being considered more comfortable and providing greater satisfaction compared to other accessories. Moreover, AT showed a significant difference in reducing treatment time compared to other groups. Conclusion The CA was the most comfortable, exhibiting a higher satisfaction rate and a greater willingness to use it. The AT therapy was perceived as more comfortable and was associated with higher satisfaction and a greater likelihood of use, especially if it resulted in reduced treatment time. On the other hand, the participants reported that the HMB, MI, and MIE accessories were less comfortable.
Collapse
Affiliation(s)
- Jussimar Scheffer Castilhos
- Department of Orthodontics, Medicine and Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Gil Guilherme Gasparello
- Department of Orthodontics, Medicine and Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Sergio Luiz Mota-Júnior
- Orthodontist, Private Practice, Juiz de Fora Federal University, Juiz de Fora, Minas Gerais, Brazil
| | - Giovani Ceron Hartmann
- Department of Orthodontics, Medicine and Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Luiz Fernando Iyda Miyagusuku
- Undergraduate Student in Dentistry, Medicine and Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Matheus Melo Pithon
- Department of Orthodontics, Southwest Bahia State University – UESB, Jequié, Bahia, Brazil
| | - Orlando Motohiro Tanaka
- Department of Orthodontics, Medicine and Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| |
Collapse
|
7
|
Roulias P, Vasoglou G, Angelopoulos G, Pandis N, Sifakakis I. Effect of aligners on patients' oral health-related quality of life and anxiety: a prospective pilot study. BMC Psychol 2024; 12:346. [PMID: 38867321 PMCID: PMC11170843 DOI: 10.1186/s40359-024-01834-2] [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: 11/30/2023] [Accepted: 05/30/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND This prospective study explored the impact of aligners on the oral health-related quality of life and anxiety of patients during the first month of orthodontic treatment and the first month of the retention phase. METHODS A total of 23 male and female patients (median age 25 y) treated with clear aligners were included. The OHRQoL questionnaire was used at certain time points during treatment (T1: placement of the first aligner; T2: after one day of use; T3: after seven days; T4: after one month; and T5: after one month in the retention phase). The State-Trait Anxiety Inventory (STAI) was also self-administered to assess state and trait anxiety (Y1 and Y2 subscales, respectively) at the T1, T4 and T5 time points. A population average generalized estimating equations logistic regression model was fit to assess the effect of time on the responses, and the Wald test was used to examine the overall effect of time. RESULTS Overall time was a significant predictor for most of the questions. However, time was marginally significant for the OHRQoL questions evaluating oral symptoms such as bad taste/smell, sores, and food accumulation. Tooth discolouration did not differ between time points. The general activity disturbance was significantly lower in the retention phase. Higher depression and anxiety scores were reported at the initial appointment and decreased thereafter. CONCLUSIONS CAT has a negative impact on quality of life and psychological status during the initial days of treatment. These impairments ameliorate at later treatment stages.
Collapse
Affiliation(s)
- Panagiotis Roulias
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Vasoglou
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Gerassimos Angelopoulos
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, Dental School/Medical Faculty, University of Bern, Bern, Switzerland
| | - Iosif Sifakakis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
| |
Collapse
|
8
|
Wei R, Deng J, Guo X, Yang Y, Miao J, Liu A, Chai H, Huang X, Zhao Z, Cen X, Wang R. Construction of Zwitterionic Coatings with Lubricating and Antiadhesive Properties for Invisible Aligner Applications. Macromol Rapid Commun 2024:e2400234. [PMID: 38824415 DOI: 10.1002/marc.202400234] [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: 05/23/2024] [Indexed: 06/03/2024]
Abstract
Invisible aligners have been widely used in orthodontic treatment but still present issues with plaque formation and oral mucosa abrasion, which can lead to complicated oral diseases. To address these issues, hydrophilic poly(sulfobetaine methacrylate) (polySBMA) coatings with lubricating, antifouling, and antiadhesive properties have been developed on the aligner materials (i.e., polyethylene terephthalate glycol, PETG) via a simple and feasible glycidyl methacrylate (GMA)-assisted coating strategy. Poly(GMA-co-SBMA) is grafted onto the aminated PETG surface via the ring-opening reaction of GMA (i.e., "grafting to" approach to obtain G-co-S coating), or a polySBMA layer is formed on the GMA-grafted PETG surface via free radical polymerization (i.e., "grafting from" approach to obtain G-g-S coating). The G-co-S and G-g-S coatings significantly reduce the friction coefficient of PETG surface. Protein adsorption, bacterial adhesion, and biofilm formation on the G-co-S- and G-g-S-coated surfaces are significantly inhibited. The performance of the coatings remains stable after storage in air or artificial saliva for 2 weeks. Both coatings demonstrate good biocompatibility in vitro and is not caused irritation to the oral mucosa of rats in vivo over 2 weeks. This study proposes a promising strategy for the development of invisible aligners with improved performance, which is beneficial for oral health treatment.
Collapse
Affiliation(s)
- Rufang Wei
- Laboratory of Advanced Theranostic Materials and Technology, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315201, P. R. China
- Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Ningbo Cixi Institute of Biomedical Engineering, Ningbo, 315300, P. R. China
- Cixi Biomedical Research Institute, Wenzhou Medical University, Zhejiang, 325035, P. R. China
| | - Junjie Deng
- Laboratory of Advanced Theranostic Materials and Technology, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315201, P. R. China
- Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Ningbo Cixi Institute of Biomedical Engineering, Ningbo, 315300, P. R. China
- Cixi Biomedical Research Institute, Wenzhou Medical University, Zhejiang, 325035, P. R. China
| | - Xiangshu Guo
- Laboratory of Advanced Theranostic Materials and Technology, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315201, P. R. China
- Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Ningbo Cixi Institute of Biomedical Engineering, Ningbo, 315300, P. R. China
- Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, P. R. China
| | - Yanyu Yang
- Laboratory of Advanced Theranostic Materials and Technology, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315201, P. R. China
- Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Ningbo Cixi Institute of Biomedical Engineering, Ningbo, 315300, P. R. China
- Cixi Biomedical Research Institute, Wenzhou Medical University, Zhejiang, 325035, P. R. China
| | - Jiru Miao
- Laboratory of Advanced Theranostic Materials and Technology, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315201, P. R. China
- Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Ningbo Cixi Institute of Biomedical Engineering, Ningbo, 315300, P. R. China
| | - Ashuang Liu
- Laboratory of Advanced Theranostic Materials and Technology, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315201, P. R. China
- Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Ningbo Cixi Institute of Biomedical Engineering, Ningbo, 315300, P. R. China
- Cixi Biomedical Research Institute, Wenzhou Medical University, Zhejiang, 325035, P. R. China
| | - Haiyang Chai
- Laboratory of Advanced Theranostic Materials and Technology, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315201, P. R. China
- Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Ningbo Cixi Institute of Biomedical Engineering, Ningbo, 315300, P. R. China
- Cixi Biomedical Research Institute, Wenzhou Medical University, Zhejiang, 325035, P. R. China
| | - Xinqi Huang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P. R. China
| | - Zhihe Zhao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P. R. China
| | - Xiao Cen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P. R. China
| | - Rong Wang
- Laboratory of Advanced Theranostic Materials and Technology, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315201, P. R. China
- Zhejiang International Scientific and Technological Cooperative Base of Biomedical Materials and Technology, Ningbo Cixi Institute of Biomedical Engineering, Ningbo, 315300, P. R. China
- Cixi Biomedical Research Institute, Wenzhou Medical University, Zhejiang, 325035, P. R. China
| |
Collapse
|
9
|
Ghislanzoni LH, Kalemaj Z, Manuelli M, Magni C, Polimeni A, Lucchese A. How well does Invisalign ClinCheck predict actual results: A prospective study. Orthod Craniofac Res 2024; 27:465-473. [PMID: 38205876 DOI: 10.1111/ocr.12752] [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] [Accepted: 12/21/2023] [Indexed: 01/12/2024]
Abstract
INTRODUCTION This study aimed to compare achieved movements with predicted movements after 28-week use of Invisalign Lite aligners. SETTINGS AND SAMPLE POPULATION The digital impressions of 21 subjects treated with Invisalign Lite at a private practice and in the dental clinic (Milan, Italy) were taken and analysed. Subjects were Caucasian with a mean age of 20.1 years. METHODS Patients were analysed at two time points: at T0, before starting therapy, and at T1, after 28 weeks of treatment with Invisalign clear aligners, with a 2-week change interval. The changes that occurred between T0 and T1 were compared to the predicted changes between T0 and Ts (setup/ClinCheck). Tooth movement performance was estimated through variables calculated as the difference between obtained and planned movements. RESULTS In both maxillary and mandibular arches, the teeth that exhibited the least accurate expression of torque were the central incisors. Tip was not accurate on maxillary central incisors and canines, mandibular central incisors, lateral incisors, first premolars, second premolars and first molars. Rotations were under-expressed on maxillary lateral incisors, canines and second premolars and on mandibular central incisors, canines, first premolars, second premolars and first molars. The overall angular changes showed a tendency to underperformance. Transverse linear changes were accurate with a significant overperformance on maxillary and mandibular first molars. CONCLUSIONS Torque correction of maxillary central incisors, as well as rotational correction of most of the teeth, showed significant differences between what was planned and what was obtained.
Collapse
Affiliation(s)
- Luis Huanca Ghislanzoni
- Department of Orthodontics, University of Geneva, Geneva, Switzerland
- Private Practice, Lausanne, Switzerland
| | | | - Maurizio Manuelli
- Unit of Orthodontics, Division of Dentistry, IRCCS Ospedale San Raffaele Scientific Institute, Milan, Italy
- Department of Orthodontics, School of Dentistry, Vita-Salute San Raffaele University, Milan, Italy
- Unit of Dentistry, Division of Orthodontics, Research Center for Oral Pathology and Implantology, IRCCS Ospedale San Raffaele Scientific Institute, Milan, Italy
- Private Practice Milano, Pavia, Bologna, Italy
| | | | - Antonella Polimeni
- Department of Oral and Maxillo-Facial Science, 'Sapienza' University of Rome, Rome, Italy
| | - Alessandra Lucchese
- Unit of Orthodontics, Division of Dentistry, IRCCS Ospedale San Raffaele Scientific Institute, Milan, Italy
- Department of Orthodontics, School of Dentistry, Vita-Salute San Raffaele University, Milan, Italy
- Unit of Dentistry, Division of Orthodontics, Research Center for Oral Pathology and Implantology, IRCCS Ospedale San Raffaele Scientific Institute, Milan, Italy
| |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
O’Connor J, Weir T, Freer E, Kerr B. Clinical expression of programmed maxillary buccal expansion and buccolingual crown inclination with Invisalign EX30 and SmartTrack aligners and the effect of 1-week vs. 2-week aligner change regimes: A retrospective cohort study. Korean J Orthod 2024; 54:142-152. [PMID: 38618737 PMCID: PMC11129936 DOI: 10.4041/kjod23.022] [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: 02/14/2023] [Revised: 09/04/2023] [Accepted: 11/14/2023] [Indexed: 04/16/2024] Open
Abstract
Objective : This retrospective cohort study aimed to assess and compare the accuracy of 3 different Invisalign® treatment regimens in terms of variations of aligner change frequency and type of aligner material in achieving maxillary dental buccal expansion. Methods : Altogether, 120 adult patients whose treatment involved maxillary dental expansion with Invisalign® were included. The patients were divided into 3 groups, with each group comprising 40 patients as follows: SmartTrack® 1-week changes (ST1), SmartTrack® 2-week changes (ST2), and EX30® 2-week changes (EX2). The groups were assessed by comparing actual changes achieved with those prescribed by ClinCheck®. The rates of clinically significant inaccuracies (CSI) observed for buccal expansion (≥ 0.5 mm) and buccolingual inclination (≥ 2°) during expansion were then determined. Results : In terms of expansion, the ST1 group demonstrated the highest CSI rate at all tooth levels, whereas the ST2 group had the lowest rate of CSI and the lowest mean inaccuracy for each tooth level. In terms of buccolingual inclination, the ST1 group had the highest CSI rate across all tooth levels, whereas the EX2 group had the lowest CSI rate at all tooth levels except for the canine level where the ST2 group had the lowest CSI rate. A tendency toward overexpression of buccal crown inclination, and underexpression of buccal expansion was observed at all tooth levels. Conclusions : Two-week aligner change regimens offer improved accuracy compared with 1-week aligner changes. SmartTrack® 2-week changes were the most accurate for buccal expansion, whereas EX30® 2-week changes were the most accurate for buccolingual inclination.
Collapse
Affiliation(s)
| | - Tony Weir
- Department of Orthodontics, The University of Queensland, Brisbane, Australia
| | - Elissa Freer
- Department of Orthodontics, The University of Queensland, Brisbane, Australia
| | - Brett Kerr
- Department of Orthodontics, The University of Queensland, Brisbane, Australia
| |
Collapse
|
12
|
Migliorati M, Drago S, Castroflorio T, Pesce P, Battista G, Campobasso A, Gastaldi G, Valvecchi FF, Mari AD. Accuracy of orthodontic movements with 3D printed aligners: A prospective observational pilot study. Korean J Orthod 2024; 54:160-170. [PMID: 38800861 PMCID: PMC11129935 DOI: 10.4041/kjod23.268] [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: 12/15/2023] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 05/29/2024] Open
Abstract
Objective Owing to the availability of 3D software, scanners, and printers, clinicians are encouraged to produce in-office aligners. Recently, a new directprinting resin (Tera Harz TC-85DAC) has been introduced. Studies on its mechanical characteristics and biological effects have been published; however, evidence on its efficacy in orthodontic treatment remains scarce. This pilot study aimed to investigate the accuracy of teeth movement achieved with directprinted aligners. Methods Seventeen patients (eight males and nine females) with a mean age of 27.67 ± 8.95 years, presenting with dental rotations < 30° and spaces/crowding < 5 mm, were recruited for this study. The teeth movement was planned starting from a T0 digital dental cast. The 3D direct-printed aligners were produced using Tera Harz TC-85DAC resin. Once the orthodontic treatment was completed, a final digital cast was obtained (T1). The planned teeth positions were then superimposed onto the T0 and T1 digital models. The differences between the programmed movements and the achieved overall torque, tip, rotation, and transverse dimensions were assessed using the paired t test or Wilcoxon's signed rank test. Results The overall accuracies for torque, tip, and rotation were 67.6%, 64.2%, and 72.0%, respectively. The accuracy of the change in transverse diameter was 99.6%. Conclusions Within the limits of the present pilot study (difficulties with abnormally shaped teeth and use of attachments), it can be concluded that 3D printed aligners can be successfully printed in-house and utilized for mildly crowded cases, with a comparable accuracy of tooth movement to that of other aligners.
Collapse
Affiliation(s)
- Marco Migliorati
- Department of Digital Orthodontics, University of Genova, Genova, Italy
| | - Sara Drago
- Department of Digital Orthodontics, University of Genova, Genova, Italy
| | | | - Paolo Pesce
- Department of Digital Orthodontics, University of Genova, Genova, Italy
| | | | | | - Giorgio Gastaldi
- Department of Orthodontic, Università Vita Salute San Raffaele, Milano, Italy
| | | | - Anna De Mari
- Department of Orthodontic, Università Vita Salute San Raffaele, Milano, Italy
| |
Collapse
|
13
|
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.
Collapse
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)
| |
Collapse
|
14
|
D'Antò V, Rongo R, Casaburo SD, Martina S, Petrucci P, Keraj K, Valletta R. Predictability of tooth rotations in patients treated with clear aligners. Sci Rep 2024; 14:11348. [PMID: 38762583 PMCID: PMC11102536 DOI: 10.1038/s41598-024-61594-2] [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: 12/30/2023] [Accepted: 05/07/2024] [Indexed: 05/20/2024] Open
Abstract
Clear aligners are employed daily for the treatment of several malocclusions. Previous clinical studies indicated low accuracy for the correction of tooth rotations. The aim of this study was to evaluate the predictability of tooth rotations with clear aligners. The sample comprised 390 teeth (190 mandibular; 200 maxillary), measured from the virtual models of 45 participants (21 men, 24 women; mean age: 29.2 ± 6.6 years old). For each patient, pre-treatment (T0) digital dental models (STL files), virtual plan (T1) and post-treatment digital dental models (T2) of both the mandibular and maxillary arches were imported onto Geomagic Control X, a 3D metrology software which allows angular measurements. Rotations were calculated by defining reproducible vectors for all teeth in each STL file and superimposing both T0 with T1 to determine the prescribed rotation, and T0 with T2 to determine the achieved rotation. Prescribed and achieved rotations were compared to assess movement's accuracy. The Wilcoxon signed-rank test and paired t-test were used to assess differences between the prescribed and achieved movements (P < 0.05). The overall predictability of rotational movement was 78.6% for the mandibular arch and 75.0% for the maxillary arch. Second molar accuracy was the lowest in both arches. Clear aligners were not able to achieve 100% of the planned movements.
Collapse
Affiliation(s)
- Vincenzo D'Antò
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, School of Orthodontics, University of Naples Federico II, Via Pansini, 5, 80131, Naples, Italy.
| | - Roberto Rongo
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, School of Orthodontics, University of Naples Federico II, Via Pansini, 5, 80131, Naples, Italy
| | - Sossio Dario Casaburo
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, School of Orthodontics, University of Naples Federico II, Via Pansini, 5, 80131, Naples, Italy
| | - Stefano Martina
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via Al-Lende, 84081, Baronissi, Italy
| | - Paolo Petrucci
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, School of Orthodontics, University of Naples Federico II, Via Pansini, 5, 80131, Naples, Italy
| | - Kreshnik Keraj
- Department of Prosthodontic, Faculty of Dental Medicine, University of Medicine, Rruga e "Dibrës", AL1005, Tirana, Albania
| | - Rosa Valletta
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, School of Orthodontics, University of Naples Federico II, Via Pansini, 5, 80131, Naples, Italy
| |
Collapse
|
15
|
Tunca Y, Kaya Y, Tunca M, Keskin S. Comparison of anxiety, pain, and quality of life in individuals with mild or moderate malocclusion between conventional fixed orthodontic treatment versus Invisalign: a randomised clinical trial. BMC Oral Health 2024; 24:576. [PMID: 38760747 PMCID: PMC11102135 DOI: 10.1186/s12903-024-04335-1] [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: 02/25/2024] [Accepted: 05/06/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND We evaluated anxiety, pain, and oral-health-related quality of life in individuals treated with conventional fixed appliances (Group A) and clear aligners (Group B) for moderate malocclusion during the initial phase of orthodontic treatment. METHODS Sixty individuals, separated into Group A (n = 30) and Group B (n = 30), were included in the study. They completed the Anxiety Levels, Oral Health Impact Profile-14, and Oral Health Related Quality of Life - United Kingdom/Surveys after the application of attachments on days 0 (T1), 10 (T10), and 20 (T20). Their pain levels were evaluated with the Visual Analogue Scale on days 0, 2, and 6 in the 2nd and 6th hours and on the 1st, 3rd, 7th, 14th, and 21st days. RESULTS Per the VAS questionnaire, pain levels in the 2nd hour, 6th hour, 1st day, and 3rd day were significantly lower in Group B than in Group A. In the OHIP-14 survey results, the comparison between Group A and Group B showed a significant difference only on the 1st day. The STAI and OHRQoL-UK survey results did not differ significantly between the groups. CONCLUSIONS We found no significant difference between the two groups in terms of anxiety levels, and pain among individuals in Group A was higher than in Group B only at the beginning of the treatment. No significant differences were observed in terms of individuals' quality of life. TRIAL REGISTRATION NCT06133296 (retrospectively registered)- Registration Date:15/11/2023.
Collapse
Affiliation(s)
- Yasemin Tunca
- Faculty of Dentistry, Department of Orthodontics, Van Yuzuncu Yil University, Van, 65080, Turkey
| | - Yesim Kaya
- Faculty of Dentistry, Department of Orthodontics, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Murat Tunca
- Faculty of Dentistry, Department of Orthodontics, Van Yuzuncu Yil University, Van, 65080, Turkey.
| | - Sıddık Keskin
- Faculty of Medicine, Department of Biostatistics, Van Yuzuncu Yil University, Van, 65080, Turkey
| |
Collapse
|
16
|
Kiong M, Ashari A, Zamani NSM, How RAWM, Wahab RMA, Mohamed AMFS, Lee HJ, Mokhtar MHH. Effect of attachment flash on clear aligner force delivery: an in vitro study. BMC Oral Health 2024; 24:538. [PMID: 38715004 PMCID: PMC11075209 DOI: 10.1186/s12903-024-04284-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 04/22/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND The introduction of auxiliaries such as composite attachment has improved the force delivery of clear aligner (CA) therapy. However, the placement of the attachment may give rise to a flash, defined as excess resin around the attachment which may affect CA force delivery. This in vitro study aims to determine the differences in the force generated by the attachment in the presence or absence of flash in CA. MATERIALS AND METHODS Tristar Trubalance aligner sheets were used to fabricate the CAs. Thirty-four resin models were 3D printed and 17 each, were bonded with ellipsoidal or rectangular attachments on maxillary right central incisors. Fuji Prescale pressure film was used to measure the force generated by the attachment of CA. The images of colour density produced on the films were processed using a calibrated pressure mapping system utilising image processing techniques and topographical force mapping to quantify the force. The force measurement process was repeated after the flash was removed from the attachment using tungsten-carbide bur on a slow-speed handpiece. RESULTS The intraclass correlation coefficient showed excellent reliability (ICC = 0.96, 95% CI = 0.92-0.98). The average mean force exerted by ellipsoidal attachments with flash was 8.05 ± 0.16 N, while 8.11 ± 0.18 N was without flash. As for rectangular attachments, the average mean force with flash was 8.48 ± 0.27 N, while 8.53 ± 0.13 N was without flash. Paired t-test revealed no statistically significant difference in the mean force exerted by CA in the presence or absence of flash for both ellipsoidal (p = 0.07) and rectangular attachments (p = 0.41). Rectangular attachments generated statistically significantly (p < 0.001) higher mean force than ellipsoidal attachments for flash and without flash. CONCLUSION Although rectangular attachment generated a significantly higher force than ellipsoidal attachment, the force generated by both attachments in the presence or absence of flash is similar (p > 0.05).
Collapse
Affiliation(s)
- Marisa Kiong
- Department of Family Oral Health, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Asma Ashari
- Department of Family Oral Health, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia.
| | - Nurul Syahira Mohamad Zamani
- Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, 43600, Bangi, Selangor, Malaysia
| | - Reuben Axel Wee Ming How
- Tristar Aligner Materials, 7-32 Berjaya Times Square, 1 Jalan Imbi, 55100, Kuala Lumpur, Malaysia
| | - Rohaya Megat Abdul Wahab
- Department of Family Oral Health, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Alizae Marny Fadzlin Syed Mohamed
- Department of Family Oral Health, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - HeeJeong Jasmine Lee
- College of Information and Communication Engineering, Sungkyunkwan University, Suwon, 16419, South Korea
| | - Mohd Hadri Hafiz Mokhtar
- Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, 43600, Bangi, Selangor, Malaysia.
| |
Collapse
|
17
|
Alhamwi AM, Burhan AS, Idris MI, Nawaya FR. Duration of orthodontic treatment with clear aligners versus fixed appliances in crowding cases: a systematic review. Clin Oral Investig 2024; 28:249. [PMID: 38607436 DOI: 10.1007/s00784-024-05629-y] [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: 10/28/2023] [Accepted: 03/20/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVE To critically appraise and assess the currently observed evidence about the difference in orthodontic treatment duration between clear aligners and fixed appliances in crowding cases. MATERIALS AND METHODS An electronic search without limitations was conducted from inception to June 2023 covering nine databases: The Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Scopus, Web of Science, Google Scholar, Trip, CINAHL via EBSCO, EMBASE via OVID and ProQuest. Randomized controlled trials (RCTs) and matched non-randomized studies were included in this systematic review. Risk of Bias was assessed via Cochrane's tool (RoB 2) for RCTs and ROBINS-I tool for non-randomized studies. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework was employed to evaluate the overall quality of evidence. RESULTS Out of the 3537 articles initially identified, ten eligible studies were included in this systematic review; six were RCTs. Only one study offered extraction-based treatment, while the other nine adopted non-extraction treatments. According to the GRADE, there is low evidence that treatment duration in mild to moderate crowding cases with clear aligners is similar to that in fixed orthodontic appliances. Meta-analysis was not administered due to high inconsistency. CONCLUSIONS Based on currently available information, there was no significant difference in the treatment duration between the CA and FA groups in mild to moderate crowding cases. Further well-performed RCTs, especially in severe cases, are required. CLINICAL RELEVANCE Time efficiency is an essential outcome measure for clinical orthodontic practice. While the type of appliance used is a critical determinant of treatment duration, orthodontists should be aware of other factors that can significantly impact treatment time, such as patient and treatment-related factors.
Collapse
Affiliation(s)
- Ahmad Marwan Alhamwi
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Al Mazzeh Street, Damascus, Syria.
| | - Ahmad Sharafeddin Burhan
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Al Mazzeh Street, Damascus, Syria
| | - Mohammad Ibrahim Idris
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Al Mazzeh Street, Damascus, Syria
| | - Fehmieh Rafik Nawaya
- Department of Pediatric Dentistry, Faculty of Dentistry, Syrian Private University, Damascus, Syria
| |
Collapse
|
18
|
Kusaibati AM, Sultan K, Hajeer MY, Gkantidis N. Digital setup accuracy for moderate crowding correction with fixed orthodontic appliances: a prospective study. Prog Orthod 2024; 25:13. [PMID: 38584176 PMCID: PMC10999400 DOI: 10.1186/s40510-024-00513-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/08/2024] [Indexed: 04/09/2024] Open
Abstract
OBJECTIVES To evaluate the accuracy of a semi-automatic 3D digital setup process in predicting the orthodontic treatment outcome achieved by labial fixed appliances. SUBJECTS AND METHODS Twenty-five adult patients (18 to 24 years old) with class I malocclusion and moderate crowding were prospectively enrolled and received treatment on both jaws through the straight-wire technique. Prior to treatment commencement, a semi-automatic digital setup simulating the predicted treatment outcome was performed for each patient through Orthoanalyzer software (3Shape®, Copenhagen, Denmark) to obtain the prediction model. This was compared to the final outcome model through 3D superimposition methods. Metric variables and inspection of color-coded distance maps were used to detect how accurately the digital setup predicts the actual treatment outcome. RESULTS The mean absolute distances (MAD) between the superimposed dental arches of the predicted and the final models were: 0.77 ± 0.13 mm following superimposition on the palate, 0.52 ± 0.06 mm following superimposition on the maxillary dental arch, and 0.55 ± 0.15 mm following superimposition on the mandibular dental arch. The MAD at the palatal reference area was 0.09 ± 0.04 mm. Visualization of color-coded distance maps indicated that the digital setup accurately predicted the final teeth position in a few cases. Almost half of the cases had posteriorly wider upper and lower dental arches and palatally/lingually positioned or inclined anterior teeth, whereas the rest still showed errors within 2-3 mm, distributed over the entire dental arches with no distinct pattern. CONCLUSIONS The accuracy of semi-automatic prediction of the labial fixed appliance treatment outcome in Class I cases with moderate crowding is not yet sufficient. While average measures showed deviations less than 1 mm, examination of individual color-coded distance maps revealed significant disparities between the simulated and the actual results.
Collapse
Affiliation(s)
| | - Kinda Sultan
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, Syria
| | - Mohammad Younis Hajeer
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, Syria
| | - Nikolaos Gkantidis
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland.
| |
Collapse
|
19
|
Abdelemam AA, Abdelrahman HH, Hassan MG. #clearaligners and social media: An in-depth analysis of clear aligners' content on Instagram. Orthod Craniofac Res 2024; 27:259-266. [PMID: 37854022 DOI: 10.1111/ocr.12722] [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: 09/04/2023] [Revised: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND AND OBJECTIVES Clear aligners-related posts are popularized on social media platforms to educate patients and peers and to market aligners in dental practices. This study aimed to characterize the account credentials and content of the top-performing posts to understand the spread of clear aligners-related information on Instagram. MATERIALS AND METHODS This cross-sectional web-based study analysed 13 Instagram clear aligners-related hashtags. Content analysis was performed for the "Top 10 posts" listed under the "Top" section for each hashtag within Instagram, as sorted by Instagram's algorithm. Data were analysed for the poster's background, credentials, role, post format, content, and engagement level ratio. Duplicate posts and those not relevant to clear aligners were excluded. Quantitative and qualitative analyses of the collected data were conducted. RESULTS A total of 29 192 596 posts mentioned the selected hashtags, of which 130 posts were screened in this study. Most posts were authored by dentists (n = 84), 79.8% of them were orthodontic specialists. Self-promotional posts comprised 90.2%, while educational posts accounted for only 8.9%. Interestingly, the number of likes and comments received on posts by patients (n = 19, median = 112, IQR = 340) was significantly higher than those posted by dentists (n = 84, median = 93, IQR = 81.75) (P = .004). CONCLUSION More than 29 million posts about clear aligners were identified on Instagram. Orthodontists are the leading authors of aligners hashtags. However, the majority of the posts are self-promotional and have nonfactual information. Social media awareness among orthodontic specialists may help provide more evidence-based content about clear aligners and can act as an interactive networking and health communication platform.
Collapse
Affiliation(s)
- Ahmed A Abdelemam
- Department of Orthodontics, Faculty of Dentistry, Assiut University, Assiut, Egypt
| | - Hams H Abdelrahman
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Mohamed G Hassan
- Department of Orthodontics, Faculty of Dentistry, Assiut University, Assiut, Egypt
- Division of Bone and Mineral Diseases, Department of Medicine, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
| |
Collapse
|
20
|
Cárdenas Machuca HY, Granda Reyes HJ, Marchena Gómez XN, Sierra Carbajal LA, Soldevilla Galarza LC, Mattos-Vela MA. [Fixed orthodontic appliances and clear aligner system: a comparative review]. REVISTA CIENTÍFICA ODONTOLÓGICA 2024; 12:e198. [PMID: 39119126 PMCID: PMC11304852 DOI: 10.21142/2523-2754-1202-2024-198] [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: 03/24/2024] [Accepted: 05/08/2024] [Indexed: 08/10/2024] Open
Abstract
One of the biggest controversies in current orthodontics is determining the appliance to use, since today patients seek better results in shorter times, in addition to putting aesthetics first. OBJECTIVE compare the benefits and disadvantages that arise when using fixed orthodontic appliances and transparent aligners. MATERIALS AND METHODS An investigation and compilation of specialized bibliographic information on the topic was carried out in scientific search engines such as PubMed, SciElo and Web of Science between the years 1991 to 2023, focused on research work related to the effects of the use of orthodontic appliances. fixed compared to clear aligners. RESULTS The review was carried out based on 53 articles found that met the selection criteria. CONCLUSION Fixed orthodontic appliances are better in complex cases, they are more precise and less likely to relapse; Transparent aligners are more aesthetic, hygiene is more affective and the bone density of the mandibular condyle decreases.
Collapse
Affiliation(s)
- Harvy Yassbeck Cárdenas Machuca
- Universidad Nacional Mayor de San Marcos, Facultad de Odontología. Lima, Perú. , , , , , Universidad Nacional Mayor de San Marcos Universidad Nacional Mayor de San Marcos Facultad de Odontología Lima Peru
| | - Henry Josue Granda Reyes
- Universidad Nacional Mayor de San Marcos, Facultad de Odontología. Lima, Perú. , , , , , Universidad Nacional Mayor de San Marcos Universidad Nacional Mayor de San Marcos Facultad de Odontología Lima Peru
| | - Xiomara Nicole Marchena Gómez
- Universidad Nacional Mayor de San Marcos, Facultad de Odontología. Lima, Perú. , , , , , Universidad Nacional Mayor de San Marcos Universidad Nacional Mayor de San Marcos Facultad de Odontología Lima Peru
| | - Luisa Andrea Sierra Carbajal
- Universidad Nacional Mayor de San Marcos, Facultad de Odontología. Lima, Perú. , , , , , Universidad Nacional Mayor de San Marcos Universidad Nacional Mayor de San Marcos Facultad de Odontología Lima Peru
| | - Luciano Carlos Soldevilla Galarza
- Universidad Nacional Mayor de San Marcos, Facultad de Odontología. Lima, Perú. , , , , , Universidad Nacional Mayor de San Marcos Universidad Nacional Mayor de San Marcos Facultad de Odontología Lima Peru
| | - Manuel Antonio Mattos-Vela
- Universidad Nacional Mayor de San Marcos, Facultad de Odontología. Lima, Perú. , , , , , Universidad Nacional Mayor de San Marcos Universidad Nacional Mayor de San Marcos Facultad de Odontología Lima Peru
| |
Collapse
|
21
|
Li Q, Yang K. Surface wear of attachments in patients during clear aligner therapy: a prospective clinical study. Prog Orthod 2024; 25:7. [PMID: 38369617 PMCID: PMC10874919 DOI: 10.1186/s40510-023-00506-y] [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: 08/23/2023] [Accepted: 11/29/2023] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND This prospective clinical study aimed to quantitatively evaluate the surface wear of attachments and investigate the associated risk factors. Additionally, the wear values and regions of three types of commonly used attachments were explored. METHODS Participants were recruited from the population of patients who received clear aligner therapy from October to December 2022. Intraoral scanning was performed on eligible participants before treatment (T0), immediately after initial bonding of attachments (T1), and at 2 months (T2), 4 months (T3), 6 months (T4), and 8 months (T5) after starting treatment. The attachment volume, average depth and regions of attachment wear were measured using superimposed digitized models. The Kruskal-Wallis test was performed to compare data between multiple groups. Multiple linear regression analyses were performed to evaluate risk factors for the volume of attachment wear. RESULTS A total of 47 patients with 617 attachments were included. As treatment time increased, the attachment volume decreased significantly (P = 0.003). The initial attachment volume was positively related to the volume of attachment wear (β = 0.527, P < 0.001). The volume of attachment wear was significantly greater in females than in males (β = 0.147, P = 0.020) and in optimized attachments than in conventional attachments (β = 0.308, P < 0.001). The wear of 3-mm rectangular attachments progressed from edges to buccal surfaces, with the deepest wear at corners of gingival edges; the wear of the optimized attachments was primarily located on surface ridges. The wear volume ratio of the optimized root control attachments was significantly greater than that of the 3-mm rectangular attachments at T3 (P = 0.011), T4 (P < 0.001), and T5 (P < 0.001). CONCLUSIONS The volume of attachment wear increased gradually with treatment time. Sex, attachment type, and initial attachment volume were risk factors for the volume of attachment wear. The deepest wear regions of 3-mm rectangular attachments were at the corners of gingival edges, while the deepest wear regions of optimized attachments were at surface ridges. Four months after treatment, optimized root control attachments showed more relative wear than 3-mm rectangular attachments.
Collapse
Affiliation(s)
- Qiuying Li
- Department of Orthodontics, School of Stomatology, Capital Medical University, No.4, Tiantanxili, Beijing, China
| | - Kai Yang
- Department of Orthodontics, School of Stomatology, Capital Medical University, No.4, Tiantanxili, Beijing, China.
| |
Collapse
|
22
|
Martina H, Stefano Adriana AD, Ernesto B, Alessandra I, Roberto AV, Gabriella G. Lower molar distalization using clear aligners: Is it effective? A systematic review. J Orthod Sci 2024; 13:11. [PMID: 38516119 PMCID: PMC10953721 DOI: 10.4103/jos.jos_174_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: 09/28/2023] [Revised: 01/09/2024] [Accepted: 01/24/2024] [Indexed: 03/23/2024] Open
Abstract
Distalization is one of the most useful movements in orthodontic treatments. The aim of this systematic review is to analyze the effectiveness of lower molar distalization using clear aligner therapy (CAT). An electronic search was made from January 2012 to October 2022 using PubMed, Scopus, and LILACS databases without language limitations. This systematic review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses checklist. The search strategy resulted in 151 studies. A screening was performed to remove duplicates, and all the studies that did not respond to our questions for the title or abstract. Three studies underwent full text analysis. From the evaluation of the studies included in this review, it is possible to state that lower molar distalization is a clinical solution, but it is not a full bodily movement. CAT can provide more specifically a distal tipping movement. This is confirmed analyzing the discrepancy between expected movement and obtained movement. CAT can be considered a valid therapeutic option in patients with dental class III malocclusion, but it is obtained as a tipping movement instead of a body movement. Over-correction should be considered during the planning of the therapy.
Collapse
Affiliation(s)
- Horodynski Martina
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Roma RM, Italy
| | - A. De Stefano Adriana
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Roma RM, Italy
| | - Bottone Ernesto
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Roma RM, Italy
| | | | - A. Vernucci Roberto
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Roma RM, Italy
| | - Galluccio Gabriella
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Roma RM, Italy
| |
Collapse
|
23
|
Paim J, Souza LFDD, Fialho T, Borba DBDM, Freitas KMSD, Cotrin P, Neis VB, Ohira E. Assessment of patients' knowledge and preferences for the use of orthodontic aligners. J Orthod 2024:14653125241229456. [PMID: 38323415 DOI: 10.1177/14653125241229456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
OBJECTIVE To evaluate the knowledge and preference of patients treated at a Dental School in Jaraguá do Sul, Brazil, about using aligners and the reasons for choosing this device as a treatment option. DESIGN A cross-sectional study. PARTICIPANTS A total of 82 participants aged 18-45 years recruited at a screening clinic. METHODS A questionnaire was completed in person using a tablet with digital forms. RESULTS Almost half of the participants (49%) knew about aligners; 40% were aged 18-24 years, and 77% were female. When observing the images of the types of orthodontic appliances, the aligners had an acceptance rate of 80%. Among the reasons that led to the preference for choosing aligners, 68% cited aesthetics and 42% comfort. CONCLUSION Recently, clear aligners have become a popular choice for orthodontic treatment, particularly among adults. Despite their popularity and effectiveness, many patients still need more information about aligner treatment. Over half of the respondents did not know what orthodontic aligners were. Younger participants had more knowledge about aligners than older participants. Patients still need more knowledge about the types of appliances available for orthodontic treatment. When presented with images of the kinds of devices available, almost 80% of participants showed greater satisfaction with aligners.
Collapse
Affiliation(s)
- Joice Paim
- Dental School, UNISOCIESC, Jaraguá do Sul, SC, Brazil
| | | | - Tiago Fialho
- Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | | | | | | | | | - Eduardo Ohira
- Dental School, UNISOCIESC, Jaraguá do Sul, SC, Brazil
| |
Collapse
|
24
|
Khursheed Alam M, Hajeer MY, Shqaidef A, Alswairki HJ, Alfawzan AA, Shrivastava D, Chandan Srivastava K, Cicciù M, Minervini G. Impact of various aligner auxiliaries on orthodontic activity: A systematic review and network meta-analysis. Saudi Dent J 2024; 36:199-207. [PMID: 38419986 PMCID: PMC10897539 DOI: 10.1016/j.sdentj.2023.10.013] [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: 07/10/2023] [Revised: 10/18/2023] [Accepted: 10/24/2023] [Indexed: 03/02/2024] Open
Abstract
Background It is imperative to analyze the forces and moments produced by various auxiliaries in order to select the optimal attachments and, eventually, to maximize the efficacy and efficiency of orthodontic therapy. Through this investigation, we aimed to highlight the impact of various aligner auxiliaries on orthodontic activity in patients undergoing orthodontic treatment on a pre/post treatment protocol basis. Methods After a thorough search of the online journals, a total of 482 documents were found using keywords such as "Orthodontic Treatment", "Aligner Auxiliaries", "Elastic Ligatures" and "Tooth Movement." The database research, elimination of duplicate studies, data extraction and risk of bias were performed by the authors independently. This systematic review and network meta-analysis included prospective studies and clinical trials to evaluate research that had looked at the impact of various aligner auxiliaries on orthodontic activity in patients undergoing orthodontic treatment. Results Eight investigations of varying designs were selected for this review. The majority of investigations revealed that aligner auxiliaries significantly improve anterior root torque, rotation, and mesio-distal (M-D) movement, as well as posterior anchoring. They also significantly improved anterior root rotation. However, few studies have presented inconsistent or non-statistically significant findings. Conclusion Auxiliaries for aligners also appear to improve extrusion and other orthodontic movements, but there is insufficient evidence to support these claims. No research has examined posterior bucco-lingual expansion or tilting. Clarification of the effect of attachments and their related variables requires additional clinical investigations.
Collapse
Affiliation(s)
- Mohammad Khursheed Alam
- Orthodontic Division, Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
- Department of Dental Research Cell, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India
- Department of Public Health, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, Bangladesh
| | - Mohammad Younis Hajeer
- Department of Orthodontics, University of Damascus Faculty of Dentistry, Damascus, Syria
| | - Abedalrahman Shqaidef
- Department of Clinical Sciences, Center of Medical and Bio-Allied Health Sciences Research, College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | | | - Ahmed Ali Alfawzan
- Department of Preventive Dentistry, College of Dentistry in Ar Rass, Qassim University, Ar Rass 52571, Saudi Arabia
| | - Deepti Shrivastava
- Periodontics Division, Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
| | - Kumar Chandan Srivastava
- Department of Oral & Maxillofacial Surgery & Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
- Department of Oral Medicine and Radiology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 602105, India
| | - Marco Cicciù
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123 Catania, Italy
| | - Giuseppe Minervini
- Saveetha Dental College & Hospitals, Saveetha Institute of Medical & Technical Sciences, Saveetha University, Chennai 600 077, India
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania, Luigi Vanvitelli, 80138 Naples, Italy
| |
Collapse
|
25
|
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.
Collapse
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
| |
Collapse
|
26
|
Hashemi S, Hashemi SS, Tafti KT, Khademi SS, Ariana N, Ghasemi S, Dashti M, Ghanati H, Mansourian M. Clear aligner therapy versus conventional brackets: Oral impacts over time. Dent Res J (Isfahan) 2024; 21:6. [PMID: 38425319 PMCID: PMC10899161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/12/2023] [Accepted: 11/07/2023] [Indexed: 03/02/2024] Open
Abstract
Background The objective is to compare the impact of clear aligner treatment (CAT) versus conventional fixed appliance treatment (FAT) on oral health-related quality of life (OHRQoL) among adults at five-time points: pretreatment (T0), 1 week (T1), 1 month after (T2), and 6 months after (T3) treatment initiation, and in the long-term follow-up (T4). Materials and Methods Search terms were based on Medical Subject Headings (MeSH) and non-MeSH. Potentially eligible studies compared OHRQoL in clear aligner (CA) and fixed appliance (FA) patients. In February 2023, Scopus, Web of Science, Cochrane, and PubMed were searched for published studies. Nine out of 94 shortlisted papers were eligible for a systematic review. Of these nine papers, five studies were considered for a meta-analysis. Results At T0, CA and FA patients had similar oral health impact profile (OHIP)-14 questionnaire scores with a standard mean difference (SMD) of 0.105 (confidence interval [CI]: -1.029-1.48). The SMD of the OHRQoL related to T1, T2, and T3 was -3.119 (CI: -0.145, 0.355), -1.527 (CI: -5.597, -0.64), and - 2.331 (CI: -1.906, -1.148). T4 showed no difference between groups (SMD = 0.007, CI: CI: -4.286, -0.376). Regarding the OHIP-14 domains, functional limitations remained consistent in both groups across all time intervals. Psychological discomfort exhibited a notable difference only at T2. Throughout the treatment, CAT showed significantly lower levels of physical, psychological, and social disability, as well as handicap, though these differences did not persist beyond T4. Notably, physical pain was the sole domain that remained elevated in the FAT group up to T4. Conclusion During the 1st day of the orthodontic treatment, both the CA and FA groups had comparable OHRQoL statuses. However, as time passed, the CA group notably improved their OHRQoL compared to the FA group. Interestingly, after a year or the completion of treatment, both groups eventually reached similar OHRQoL levels. Nevertheless, it is worth noting that FA patients continued to experience more physical pain even a year later.
Collapse
Affiliation(s)
- Sara Hashemi
- Dental Students’ Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Saman Hashemi
- Private Practice, Dental Students’ Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Kioumars Tavakoli Tafti
- Dental Students’ Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Sobhan Khademi
- Department of Periodontics, School of Dentistry, Islamic Azad University, Isfahan, Iran
| | - Niyosha Ariana
- Department of Prosthodontics, School of Dentistry, Islamic Azad University, Isfahan, Iran
| | - Shohreh Ghasemi
- Department of Oral and Maxillofacial Surgery, The Dental College of Georgia, Augusta University, Augusta, Georgia
| | - Mahmood Dashti
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Ghanati
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - Marjan Mansourian
- Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Automatic Control (ESAII), Biomedical Engineering Research Centre, The Technical University of Catalonia, Barcelona, Spain
| |
Collapse
|
27
|
Bruni A, Abate A, Maspero C, Castroflorio T. Comparison of Mechanical Behavior of Clear Aligner and Rapid Palatal Expander on Transverse Plane: An In Vitro Study. Bioengineering (Basel) 2024; 11:103. [PMID: 38391589 PMCID: PMC10886082 DOI: 10.3390/bioengineering11020103] [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: 12/06/2023] [Revised: 01/09/2024] [Accepted: 01/19/2024] [Indexed: 02/24/2024] Open
Abstract
(1) Background: This study aims to investigate, within a controlled laboratory environment, the magnitude of the transversal load and the force decay over time produced by clear aligners in comparison to a Rapid Palatal Expander (RPE). (2) Methods: Resin models of a dental maxillary arch, additively manufactured from an intraoral scan, were inserted in a testing machine with uniaxial load cells to measure the force trend over time expressed by RPE and clear aligners. The mechanical load was recorded during a certain timeframe for both appliances. (3) Results: The force expressed by the RPE ranged from 30 to 50 N for each activation, decreasing with a nonlinear pattern over time. The force expressed by the clear aligner ranged from 3 to 5 N, decreasing with a linear pattern over time. In contrast, the force generated by the clear aligner fell within the range of 3 to 5 N, showing a linear reduction in force magnitude over the observed period of time. (4) Conclusions: The RPE exerted a force magnitude approximately ten times greater than that generated by clear aligners. Nevertheless, it is essential to acknowledge that the oral environment can significantly influence these results. These limitations underscore the need for caution when applying these findings to clinical settings.
Collapse
Affiliation(s)
- Alessandro Bruni
- Surgical, Medical and Dental Department, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Andrea Abate
- Department of Sciences Integrated Surgical and Diagnostic, University of Genova, 16126 Genova, Italy
| | - Cinzia Maspero
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142 Milan, Italy
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | | |
Collapse
|
28
|
Gao Y, Wang R, Liu Q, Zhou B, Qiao H. Effect of acetaminophen on relieving orthodontic pain with clear aligner based on GAD-7: A retrospective research. Heliyon 2024; 10:e23292. [PMID: 38163203 PMCID: PMC10756994 DOI: 10.1016/j.heliyon.2023.e23292] [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: 07/20/2022] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
Objectives Patients may have uncomfortable feelings during orthodontic treatment, which can directly lead to dissatisfaction. So in order to improve the patient's sense of pleasure during the treatment, it would be of great benefit if orthodontic pain can be relieved. Materials and methods We included 150 patients wearing clear aligners from 18 to 30 years old during 2018-2020. Then designed following groups to determine the effectiveness of both verbal behavior modification and combination therapy with acetaminophen in reducing treatment pain: Group A, generalized anxiety disorder 7 (GAD-7) scored 0-4; Group B, GAD-7 scored 5-9; Group C, GAD-7 scored 10-14; and Group D, GAD-7 scored 15-21. Results There was a difference in the visual analog scale (VAS) between verbal behavior modification with and without a 300-mg acetaminophen tablet oral QD in Group A (received the intervention at 8 h and 1 d), Group B at 8 h and 1 d, Group C at 8 h, 1 d, 2 d, and 3 d, and Group D at 8 h, 1 d, 2 d, 3 d, and 4 d. After 8 h, 1 d, 2 d, 3 d, and 4 d in patients with verbal behavior modification, VAS was markedly increased in Group D compared with Group A, B and C. Furthermore, after 8 h and 1 d in patients with verbal behavior modification and 300-mg acetaminophen tablet oral QD, VAS was strongly enhanced in Group D. Conclusions Dental anxiety is strongly associated with pain in orthodontic patients receiving clear aligners. Acetaminophen administration may be a benefit in orthodontic pain that results from clear aligners, especially in the group with more GAD-7.
Collapse
Affiliation(s)
- Yunan Gao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Rui Wang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Qiong Liu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Bo Zhou
- Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Hu Qiao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| |
Collapse
|
29
|
Mendes Ribeiro SM, Aragón MLSDC, Espinosa DDSG, Shibasaki WMM, Normando D. Orthodontic aligners: between passion and science. Dental Press J Orthod 2024; 28:e23spe6. [PMID: 38198351 PMCID: PMC10768648 DOI: 10.1590/2177-6709.28.6.e23spe6] [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: 10/02/2023] [Accepted: 11/10/2023] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION The benefits and safety of using orthodontic aligners have been reported more by clinical experience and expert opinion than by scientific evidence. Another important aspect is that aligners are constantly evolving. It is important to obtain evidence that allows for new updates in manufacturing technology, in the development of new movement planning protocols, in the incorporation and design of attachments, and in the aid of skeletal anchorage. METHODS Evidence retrieved from six electronic databases (CINAHL, MEDLINE, EMBASE, Psych Info, the Cochrane Library and the Joanna Briggs Library) is presented by means of questions and answers. CONCLUSIONS There is evidence that the aligners presented different levels of difficulty in performing each type of movement, with rotational and vertical movements being the most difficult to perform. Regarding perception of pain due to tooth movement, it seems to have less impact at the beginning of treatment; but dealing with more phonoarticulatory changes seems to require more treatment time in more complex cases. Aligners do not prevent the occurrence of root resorption, although the incidence and severity of resorption may be reduced, making oral hygiene easier and accepting the risk of white spots, caries and periodontal disease. Given the conflicting evidence, the release of bisphenol-A from the aligner cannot be denied. Solutions must be found to reduce the environmental impact of aligners disposal. There is an urgent need for well-designed randomized controlled trials.
Collapse
Affiliation(s)
| | | | | | | | - David Normando
- Universidade Federal do Pará (UFPA), Departamento de Ortodontia (Belém/PA, Brazil)
| |
Collapse
|
30
|
Lin G, Chen M, Guo N, Shi X. Three-dimensional measurement and analysis of Mandibular Molar Distalization assisted by micro-implant anchorage combined with clear aligner. Pak J Med Sci 2024; 40:455-460. [PMID: 38356811 PMCID: PMC10862430 DOI: 10.12669/pjms.40.3.7759] [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: 02/25/2023] [Revised: 05/15/2023] [Accepted: 11/16/2023] [Indexed: 02/16/2024] Open
Abstract
Objective To investigate the effect of micro-implant anchorage combined with a clear aligner on the efficiency of mandibular molar distalization and the protection of anterior teeth anchorage, provide reference for clinical scheme design. Methods This is a prospective study. Seventeen patients who were treated in the Orthodontics Department of the Hospital of Stomatology affiliated to Fujian Medical University from 2019 to 2021 and used Invisalign clear aligners to move mandibular molars distally were included and divided into two groups according to anchorage types: Group-A and Group-B. Group-A (ten cases) were treated without micro-implant anchorage, while Group-B (seven cases) were treated with micro-implant anchorage nails for enhanced anchorage. The effect of micro-implant anchorage on crown and root distal movement of mandibular molars and the difference in three-dimensional movement between mandibular molars and mandibular central incisors were analyzed. Results The crown distalization efficiency of mandibular first and second molars in Group-B was 68.66% and 71.02%, respectively, which were higher than those in Group-A(p<0.05). The mandibular central incisors in Group-A showed labial displacement and a small amount of elongation, while those in Group-B showed less anchorage loss(p<0.05). In Group-A, the crown was tilted in the distal direction and moved in the buccal direction during mandibular molar distalization(p<0.05). While in Group-B, the crown was tilted in the distal directio (p<0.05) and the mandibular second molar was depressed(p<0.05). Conclusion In the process of mandibular molar distalization assisted by micro-implant anchorage combined with a clear aligner, better protects the anchorage of the mandibular central incisor and improves the efficiency of the molar crown distalization.
Collapse
Affiliation(s)
- Gengbing Lin
- Gengbing Lin, Department of Stomatology, Fujian Provincial People’s Hospital, Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou 350004, Fujian, China
| | - Mengwei Chen
- Mengwei Chen, Department of Orthodontics, Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University & Institute of Stomatology, Fujian Medical University, Fuzhou 350004, Fujian, China
| | - Nan Guo
- Nan Guo, Department of Stomatology, Fujian Provincial People’s Hospital, Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou 350004, Fujian, China
| | - Xie Shi
- Xie Shi, Department of Orthodontics, Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University & Institute of Stomatology, Fujian Medical University, Fuzhou 350004, Fujian, China
| |
Collapse
|
31
|
Harandi MT, Abu Arqub S, Warren E, Kuo CL, Da Cunha Godoy L, Mehta S, Feldman J, Upadhyay M, Yadav S. Assessment of clear aligner accuracy of 2 clear aligners systems. Am J Orthod Dentofacial Orthop 2023; 164:793-804. [PMID: 37498253 DOI: 10.1016/j.ajodo.2023.05.028] [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: 03/01/2023] [Revised: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 07/28/2023]
Abstract
INTRODUCTION This study compared treatment efficacy for specific tooth movements between 2 clear aligner systems (Clarity [3M Oral Care Solutions, St Paul, Minn] and Invisalign [Align Technology, San Jose, Calif]). METHODS The study sample included 47 patients (7 males, 40 females; mean age, 36.57 ± 15.97 years) treated with Invisalign and 37 (4 males, 33 females; mean age, 34.30 ± 16.35 years) treated with Clarity aligners who completed their first set of aligners and had an initial refinement scan. Initial and predicted models were obtained from the initial simulated treatment plan. The first model of the refinement scan was labeled as achieved. SlicerCMF software (version 3.1; http://www.slicer.org) was used to superimpose the achieved and predicted digital models over the initial ones with regional superimposition on the relatively stable first molars. Nine hundred forty teeth in the Invisalign system were measured for horizontal, vertical, and angular movements and transverse width and compared with similar measurements of 740 teeth for the Clarity aligners. The deviation from the predicted was calculated and compared between both systems. RESULTS The deviation achieved from the predicted was significant between the groups for the mandibular interpremolar and intercanine widths (P <0.05). Clarity aligners significantly undercorrected rotations compared with Invisalign for the mandibular first premolars, mandibular canines, maxillary canines, and maxillary central incisors. There was no statistically significant difference between the groups for the achieved vs predicted movements in the horizontal and vertical planes (P >0.05). CONCLUSIONS The efficacy of clear aligner therapy systems (Clarity and Invisalign) in treating mild and moderate malocclusions was comparable. Deviation of the achieved movements from the predicted was greatest for rotational and vertical movements.
Collapse
Affiliation(s)
| | - Sarah Abu Arqub
- Department of Orthodontics, University of Florida, Gainesville, Fla.
| | - Emma Warren
- Division of Orthodontics, UConn Health, School of Dental Medicine, Farmington, Conn
| | - Chia-Ling Kuo
- Connecticut Convergence Institute for Translation in Regenerative Engineering, UConn Health, Farmington, Conn
| | - Lucas Da Cunha Godoy
- Connecticut Convergence Institute for Translation in Regenerative Engineering, UConn Health, Farmington, Conn
| | - Shivam Mehta
- Department of Developmental Sciences/Orthodontics, Marquette University School of Dentistry, Milwaukee, Wis
| | - Jonathan Feldman
- Department of Orthodontics, University of Connecticut School of Dental Medicine, Farmington, Conn
| | | | - Sumit Yadav
- Department of Growth and Development, University of Nebraska Medical Center College of Dentistry, Lincoln, Nebr
| |
Collapse
|
32
|
Zhang Y, Hui S, Gui L, Jin F. Effects of upper arch expansion using clear aligners on different stride and torque: a three-dimensional finite element analysis. BMC Oral Health 2023; 23:891. [PMID: 37986060 PMCID: PMC10662809 DOI: 10.1186/s12903-023-03655-y] [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: 08/15/2023] [Accepted: 11/10/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND During maxillary arch expansion with a clear aligner (CA), buccal tipping of the posterior teeth often occurs, resulting in an unsatisfactory arch expansion effect. The aim of this study was to analyze the appropriate maxillary arch expansion stride length and torque compensation angle for maxillary dentition to achieve an ideal moving state when a CA was used for upper arch expansion. METHODS This study established a three-dimensional (3D) finite element model including a CA, maxilla, periodontal ligament (PDL), and maxillary dentition. The stress distribution, stress situation, expansion efficiency, and movement trends of the maxillary dentition during upper arch expansion of different stride (0.1 mm, 0.2 mm, and 0.3 mm) and torque compensation (0°, 0.5°, 1°, and 1.5°) were measured. RESULTS Maxillary arch expansion lead to buccal tilt of the posterior teeth, lingual tilt of the anterior teeth, and extrusion of the incisors. As the angle of compensation increased, the degree of buccal tilt on the posterior teeth decreased, with this reducing the efficiency of upper arch expansion. When the stride length was 0.1 mm, the torque compensation was 1.2°, and when stride length was 0.2 mm and the torque compensation was approximately 2°, there was a tendency for the posterior teeth to move bodily. However, when the stride length was 0.3 mm, the increase in torque compensation could not significantly improve the buccal tilt phenomenon. In addition, the equivalent von-Mises stress values of the maxillary root, PDL, and alveolar bone were in the same order of magnitude. CONCLUSIONS This study indicated that the posterior teeth cause a degree of buccal tilt when maxillary arch expansion is ensured. The specific torque compensation angle should be determined based on the patient's situation and the desired effect.
Collapse
Affiliation(s)
- Yanqi Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases & Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, Shaanxi, 710032, China
| | - Shuoyi Hui
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases & Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, Shaanxi, 710032, China
| | - Linyuan Gui
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases & Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, Shaanxi, 710032, China
| | - Fang Jin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases & Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, Shaanxi, 710032, China.
| |
Collapse
|
33
|
Rocha AS, Gonçalves M, Oliveira AC, Azevedo RMS, Pinho T. Efficiency and Predictability of Coronal Maxillary Expansion Repercussion with the Aligners System: A Retrospective Study. Dent J (Basel) 2023; 11:258. [PMID: 37999022 PMCID: PMC10670576 DOI: 10.3390/dj11110258] [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: 08/14/2023] [Revised: 10/29/2023] [Accepted: 10/31/2023] [Indexed: 11/25/2023] Open
Abstract
The Invisalign® system (SmartForce® G8) aims to guarantee aesthetics and provide good orthodontic treatment results. Dentoalveolar expansion is possible with clear aligners and can be used to correct dentoalveolar crossbite, resolve crowding or modify the arch shape. Despite the treatment's effectiveness, there is still disagreement among professionals concerning its true clinical potential. This study aimed to analyze the effectiveness and predictability of coronal tooth expansion movement in permanent dentition in patients who had completed the first phase of treatment with Invisalign® orthodontic aligners. MATERIALS AND METHODS The tooth movement tables of 75 previously selected cases were analyzed in terms of dental-arch width and expansion efficiency, through the Invisalign® platform, considering the pre-treatment (T0), planned treatment (TP) and post-treatment models (T1) using ClinCheck Pro® 6.0 software. All patients were treated by an orthodontic specialist and Invisalign® Diamond Provider in a private practice (T.P.). RESULTS Difference between T1 and T0: for each maxillary and mandibular measurement, there was a statistically significant difference between pre- and post-aligner treatment values. The greatest amount of expansion occurred in both the upper and the lower premolars. Difference between TP and T1: for each maxillary measurement, statistically significant differences were verified for the molar and canine. At the mandibular level, statistically significant differences were only verified in the first molar. CONCLUSIONS The Invisalign® clear aligners are effective for simultaneous intra-arch expansion in both jaws.
Collapse
Affiliation(s)
- Ana Sofia Rocha
- Oral Pathology and Rehabilitation Research Unit (UNIPRO)—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Science (IUCS), CESPU, 4585-116 Gandra, Portugal; (A.S.R.); (A.C.O.)
| | - Maria Gonçalves
- TOXRUN—Toxicology Research Unit, University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal; (M.G.)
| | - Ana Catarina Oliveira
- Oral Pathology and Rehabilitation Research Unit (UNIPRO)—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Science (IUCS), CESPU, 4585-116 Gandra, Portugal; (A.S.R.); (A.C.O.)
| | - Rui M. S. Azevedo
- TOXRUN—Toxicology Research Unit, University Institute of Health Sciences (IUCS), CESPU, CRL, 4585-116 Gandra, Portugal; (M.G.)
| | - Teresa Pinho
- Oral Pathology and Rehabilitation Research Unit (UNIPRO)—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Science (IUCS), CESPU, 4585-116 Gandra, Portugal; (A.S.R.); (A.C.O.)
- IBMC—Molecular and Cellular Biology Institute, i3S—Health Innovation and Research Institute, University of Porto, 4200-135 Porto, Portugal
| |
Collapse
|
34
|
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.
Collapse
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
| |
Collapse
|
35
|
Dahhas FY, Al-Saif EM, Alqahtani AM, Al Farraj NF, Alshaikh MA, Almadhi BS, Albuolayan N, Alhayaza HH, Asiri NA, Alshaya KH. The Potency of Invisalign® in Class II Malocclusion in Adults: A Narrative Review. Cureus 2023; 15:e49664. [PMID: 38161838 PMCID: PMC10756397 DOI: 10.7759/cureus.49664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 01/03/2024] Open
Abstract
In recent years, a greater number of adult patients are seeking orthodontic treatment, not only for esthetics but for better functioning and hygiene purposes. However, they are more focused on comfortable and invisible treatment alternatives to conventional metal brackets. This abstract is a multifaceted interplay between Invisalign® and different treatments of class II malocclusion, which embarks on the potency of Invisalign® in treating this condition in adult patients. The review delves into analyzing the efficacy of Invisalign® in molar distalization, class II elastics, extraction treatment, class II division 2 patients, their limitations, challenges, and future prospects. This article aspires the orthodontists understand the complex nature of class II malocclusion treatment in adults with Invisalign® and its application in clinical practice with improved patient outcomes.
Collapse
Affiliation(s)
| | - Eman M Al-Saif
- Orthodontics, King Fahd University of Petroleum and Minerals, Qatif, SAU
| | | | | | | | | | | | | | - Nada A Asiri
- General Dentistry, Magrabi Dental Center, Jeddah, SAU
| | | |
Collapse
|
36
|
Chou B, Nickel JC, Choi D, Garfinkle JS, Freedman HM, Iwasaki LR. Outcome assessment of orthodontic clear aligner vs fixed appliance treatment in adolescents with moderate to severe malocclusions. Angle Orthod 2023; 93:644-651. [PMID: 37407511 PMCID: PMC10633795 DOI: 10.2319/020923-94.1] [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: 02/01/2023] [Accepted: 05/01/2023] [Indexed: 07/07/2023] Open
Abstract
OBJECTIVE To compare the efficacy and efficiency of treatment with clear aligners (CAT) vs fixed appliances (FAT) in adolescents with Class I and II moderate to severe malocclusions. MATERIALS AND METHODS One operator's (Garfinkle) cases from 2014 to 2019, started at age 12-18 years, with pre- and posttreatment records were identified and used according to an institutional review board-approved protocol. Records were measured by two calibrated, blinded investigators, aided by software (OrthoCAD [Cadent, Fairview, N.J.], Dolphin Imaging & Management Solutions [Chatsworth, Calif]). Discrepancy index (DI) and cast radiograph evaluation (CRE) scores, treatment duration, number of scheduled and emergency visits, and reported appliance and interarch elastic wear compliance were compared between groups using Wilcoxon rank sum and Fisher's exact tests. Cephalometric superimpositions were completed to evaluate craniofacial growth and dental changes. RESULTS Records from 72 cases met the criteria and were included. For the 47 CAT and 25 FAT cases, mean DI (21 ± 5 and 24 ± 8, respectively; P = .20) and CRE (35 ± 10 and 34 ± 9, respectively; P = .90) scores were not significantly different. Other case attributes and reported appliance and interarch elastic wear compliance were also not significantly different. CAT vs FAT cases had significantly smaller treatment durations (24 ± 6 vs 27 ± 5 months; P = .01) and visit numbers (16 ± 5 vs 24 ± 4; P < .01), but emergency visit numbers were not significantly different (2 ± 2 vs 3 ± 2; P = .08). CONCLUSIONS In adolescents with Class I and II malocclusions and moderate to severe DI scores, on average, CAT vs FAT cases were completed 3 months faster with eight fewer visits, but treatment efficacy was not significantly different.
Collapse
Affiliation(s)
- Byron Chou
- Corresponding author: Dr Byron Chou, Division of Orthodontics, Department of Oral and Craniofacial Sciences, School of Dentistry, Oregon Health & Science University, SD-ORTH 2730 S Moody Ave., Portland OR, 97201-5042, USA (e-mail: )
| | | | | | | | | | | |
Collapse
|
37
|
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.
Collapse
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
| |
Collapse
|
38
|
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.
Collapse
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;
| |
Collapse
|
39
|
Shivlani V, Niranjane P, Paul P. Assessment of Awareness and Perceptions of Healthcare Professional Graduates Regarding the Use of Clear Aligners in Orthodontic Treatment. Cureus 2023; 15:e46348. [PMID: 37920637 PMCID: PMC10618842 DOI: 10.7759/cureus.46348] [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: 08/25/2023] [Accepted: 10/02/2023] [Indexed: 11/04/2023] Open
Abstract
Background Clear aligners have been one of the most recent advancements in the field of orthodontics. With an increasing demand for aesthetics, the use of clear aligners has progressed, but knowledge is still lacking among the population. Therefore, this study aims to evaluate the perception and awareness of health professional graduates regarding the use of clear aligners in orthodontic treatment. Materials and methods A draft questionnaire was formulated and validated consisting of eight open-ended questions assessing the perception of respondents and two close-ended questions assessing awareness of clear aligners. A web-based survey was performed. The sample (n=438) population included graduates of different health professions including medical (248), Ayurveda (114), nursing (18) and physiotherapy(58). A Google form was prepared and the link was circulated to all. The response was sought in terms of Likert scales. Results A total of 438 graduates responded to the questionnaire, of which 56% were from medical faculty, 26% from Ayurveda, 13.20% from physiotherapy, and 4.1% from nursing. On average, the awareness and perception of health professional graduates regarding the use of clear aligners in orthodontics was average to low. Among all the health professions, the graduates from the medical faculty showed maximum knowledge regarding clear aligners, whereas the awareness amongst the nursing students was the least. Conclusion On assessing the knowledge of health professional graduates from different faculties regarding clear aligners, statistically different results were found for responses from all faculties. Since it is one of the most recent advancements in the field of orthodontics, there is a need to bridge this knowledge gap among health professionals, which would help them guide their patients to seek the best treatment modality at the appropriate age.
Collapse
Affiliation(s)
- Vinus Shivlani
- Public Health Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Priyanka Niranjane
- Orthodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Priyanka Paul
- Public Health Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| |
Collapse
|
40
|
Özsoy S, Pamukçu H, Polat-Özsoy Ö, Ateş EM. Color changes of nanocomposites used for clear aligner attachments: an in vitro study. J Orofac Orthop 2023; 84:266-275. [PMID: 36912962 DOI: 10.1007/s00056-023-00461-7] [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: 06/26/2022] [Accepted: 01/25/2023] [Indexed: 03/14/2023]
Abstract
PURPOSE The purpose of this study was to compare the color changes of two different nanocomposites used for two different designs of clear aligner attachments. METHODS In all, 120 human premolars were embedded in 12 upper dental models with 10 premolars in each model. Models were scanned and attachments were digitally designed. Conventional attachments (CA) were prepared for the first six models and optimized multiplane attachments (OA) were prepared for the other six models with packable composite (PC) on the right quadrant and flowable composite (FC) on the left quadrant of each model. The models were subjected to 2000 thermal cycles at 5 °C/55 °C and then consecutively immersed in the five different staining solutions each for 48 h to simulate external discoloration. Color measurements were taken with a spectrophotometer. Color changes (∆E*ab) of the attachments before and after immersion were compared with the Commission Internationale de l'Éclairage L*a*b* (CIELAB) color space approach. RESULTS When ∆E*ab values were examined, no significant difference was observed between the groups according to the attachment type (P > 0.05). After the coloration process, the flowable composite group showed less coloration than the packable composite group for both attachment designs (P < 0.05). Color difference values after the staining procedure were significantly higher in the CA-PC and OA-PC groups compared to the CA-FC and OA-FC groups (P < 0.05). CONCLUSION Color change of the packable nanocomposite was more pronounced than that of the flowable nanocomposite for both attachment designs. Therefore, clear aligner attachments created using flowable nanocomposite can be recommended, especially in the anterior region where esthetics are important for the patient.
Collapse
Affiliation(s)
| | - Hande Pamukçu
- Department of Orthodontics, Faculty of Dentistry, Başkent University, Yukarıbahçelievler Mah. 82. Sokak No:26, 06490, Bahçelievler Ankara, Turkey.
| | - Ömür Polat-Özsoy
- Private practice, Ankara, Turkey
- Department of Orthodontics, Faculty of Dentistry, İzmir Tınaztepe University, Aydoğdu Mah. 1267/1 Sokak No:4, Buca, İzmir, Turkey
| | - Ece Mersan Ateş
- Department of Orthodontics, Faculty of Dentistry, Başkent University, Yukarıbahçelievler Mah. 82. Sokak No:26, 06490, Bahçelievler Ankara, Turkey
| |
Collapse
|
41
|
Putrino A, Marinelli E, Zaami S. The Power of Customized Clear Aligners in Closing Molar Edentulous Spaces: Clinical and Medico-Legal Considerations in a Scoping Review and Case Report. J Pers Med 2023; 13:1389. [PMID: 37763156 PMCID: PMC10532605 DOI: 10.3390/jpm13091389] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/12/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
Successful closure of edentulous spaces with clear aligners (CAs) is influenced by many factors. CAs are tailored orthodontic devices whose predictability may have relevant medico-legal implications. This study presents a scoping review about missing molar space closure (MMSC) with CAs and a clinical case. This study aims to highlight the feasibility of molar space closure by mesialization with CAs without hybrid supports. Following PRISMA Sc-review guidelines, English-written randomized/non-randomized/observational clinical studies on PubMed, Scopus, Cochrane and Lilacs were searched. An 18-year-old patient, with upper and lower edentulous spaces due to the loss of two first molars, was rehabilitated with CAs (Sorridi®, Sorridi srl, Latina, Italy) without hybrid supports and attachments. The therapy was carried out over 10 months. Currently, there are no studies documenting MMSC by mesialization with only CAs. Existing articles document the closure of premolar or incisor spaces. The upper and lower left second molars replaced the missing first molars, and erupting third molars replaced adjacent teeth. The biomechanical effects in space closure with CAs related to extraction cases appear as priorities of clinical/medico-legal interest. Our case turns attention to this movement of CAs without attachments/hybrid supports, indicating that even such a complex treatment can be comfortable for patients and safely predictable for specialists.
Collapse
Affiliation(s)
- Alessandra Putrino
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy;
| | - Enrico Marinelli
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy;
| | - Simona Zaami
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy;
| |
Collapse
|
42
|
Ma S, Wang Y. Clinical outcomes of arch expansion with Invisalign: a systematic review. BMC Oral Health 2023; 23:587. [PMID: 37620781 PMCID: PMC10464440 DOI: 10.1186/s12903-023-03302-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/10/2023] [Indexed: 08/26/2023] Open
Abstract
OBJECTIVE This study aims to assess the scientific evidence regarding the clinical outcomes of Invisalign therapy in controlling orthodontic tooth movement. MATERIALS AND METHODS An electronic search was conducted on PubMed, Cochrane Library, Web of Science, Embase, and Scopus from November 2015 to November 2022 to identify relevant articles. Methodological shortcomings were highlighted, and an evaluation of the quality of the included studies was completed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. RESULTS Fifteen non-randomized controlled trials were included in the analysis. Most non-randomized controlled trials (n=11; 73%) were rated with a moderate risk of bias according to the ROBINS-I tool. There were statistically significant differences between the pretreatment and posttreatment arches. The average expansion was significantly different from that predicted for each type of tooth in both the maxilla and mandible. Furthermore, the efficiency decreased from the anterior area to the posterior area in the upper arch. CONCLUSION Despite the fact that arch expansion with Invisalign® is not entirely predictable, clear aligner treatment is a viable option for addressing dentition crowding. The efficacy of expansion is greatest in the premolar area. More research focusing on treatment outcomes with different materials of aligners should be conducted in the future. Overcorrection should be considered when planning arch expansion with Invisalign. In the maxilla, the expansion rate decreases from the anterior to the posterior, and presetting sufficient buccal root torque of posterior teeth may result in improved efficiency of expansion.
Collapse
Affiliation(s)
- Songyang Ma
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, People's Republic of China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, People's Republic of China
| | - Yunji Wang
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, People's Republic of China.
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, People's Republic of China.
| |
Collapse
|
43
|
Dotzer B, Stocker T, Wichelhaus A, Janjic Rankovic M, Sabbagh H. Biomechanical simulation of forces and moments of initial orthodontic tooth movement in dependence on the used archwire system by ROSS (Robot Orthodontic Measurement & Simulation System). J Mech Behav Biomed Mater 2023; 144:105960. [PMID: 37348170 DOI: 10.1016/j.jmbbm.2023.105960] [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: 04/21/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/24/2023]
Abstract
OBJECTIVES Aim of this study was to determine the forces and moments during simulated initial orthodontic tooth movements using a novel biomechanical test setup. METHODS The test setup consisted of an industrial precision robot with a force-torque sensor, a maxillary model and a control computer and software. Forces and moments acting on the corresponding experimental tooth during the motion simulations were dynamically measured for two 0.016" NiTi round archwires (Sentalloy Light/Sentalloy Medium). Intrusive (#1), rotational (#2) and angular (#3) tooth movements were simulated by a control program based on the principle of force control and executed by the robot. The results were statistically analysed using K-S-test and Mann-Whitney U test with a significance level of α = 5%. RESULTS Sentalloy Medium archwires generated higher forces and moments than the Sentalloy Light archwires in all simulations. In simulation #1 the mean initial forces/moments reached 1.442 N/6.781 Nmm for the Light archwires and 1.637 N/9.609 Nmm for the Medium archwires. In movement #2 Light archwires generated mean initial forces/moments of 0.302 N/-8.271 Nmm whereas Medium archwires generated 0.432 N/-9.653 Nmm. Simulation #3 showed mean initial forces/moments of -0.122 N/8.477 Nmm from the Light archwires compared to -0.300 N/11.486 Nmm for the Medium archwires. SIGNIFICANCE The measured forces and moments were suitable for initial orthodontic tooth movement in simulations #2 and #3, however inadequate in simulation #1. Reduced archwire dimensions (<0.016″) should be selected for initial leveling of vertical malocclusions.
Collapse
Affiliation(s)
- Benedikt Dotzer
- Department of Orthodontics and Dentofacial Orthopedics, University Hospital, LMU Munich, Goethestrasse 70, Munich 80336, Germany
| | - Thomas Stocker
- Department of Orthodontics and Dentofacial Orthopedics, University Hospital, LMU Munich, Goethestrasse 70, Munich 80336, Germany
| | - Andrea Wichelhaus
- Department of Orthodontics and Dentofacial Orthopedics, University Hospital, LMU Munich, Goethestrasse 70, Munich 80336, Germany
| | - Mila Janjic Rankovic
- Department of Orthodontics and Dentofacial Orthopedics, University Hospital, LMU Munich, Goethestrasse 70, Munich 80336, Germany
| | - Hisham Sabbagh
- Department of Orthodontics and Dentofacial Orthopedics, University Hospital, LMU Munich, Goethestrasse 70, Munich 80336, Germany.
| |
Collapse
|
44
|
Elkholy F, Weber S, Repky S, Jäger R, Schmidt F, Lapatki BG. Are aligners capable of inducing palatal bodily translation or palatal root torque of upper central incisors? A biomechanical in vitro study. Clin Oral Investig 2023; 27:4289-4300. [PMID: 37243819 PMCID: PMC10415518 DOI: 10.1007/s00784-023-05046-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 04/26/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVES Previous studies have shown that aligners have limited ability to control root movements. The purpose of this study was to investigate which modification geometry and foil thickness are optimal for generating the force-moment (F/M) systems required for palatal root torque of maxillary central incisors. MATERIALS AND METHODS Tooth 11 was separated from a maxillary acrylic model and connected to a movement unit via a 3D F/M sensor. Different modification geometries (crescent, capsular, double-spherical) with different depths were digitally implemented in the labio-cervical region of tooth 11 to induce an increased contact force. We evaluated the F/M systems exerted by aligners with thicknesses of 0.4-1.0 mm. F/M measurements were taken with tooth 11 in the neutral position and during palatal displacement of tooth 11 (simulating its initial clinical movement). RESULTS The mechanical requirements of palatal root torque are a palatally directed force (- Fy) and a palatal root torquing moment (- Mx). These requirements were reliably achieved with modification depths > 0.5 mm. The modification depth and foil thickness had a significant influence on - Fy magnitudes (linear mixed-effect models, p < 0.01). With the 0.75-mm aligners combined with 1.5-mm deep modifications, the palatal root torque range (palTR) started after an initial palatal crown displacement of 0.09, 0.12, and 0.12 mm for the capsular, crescent, and double-spherical modification geometries, respectively. CONCLUSIONS A relatively early start of the palatal torque range (after a 0.1-mm palatal crown displacement) and appropriate - Fy magnitudes were achieved with 0.75-mm-thick aligners containing 1.5-mm deep capsular or crescent pressure regions. Subsequent clinical trials are required to confirm the clinical effects of these modifications. CLINICAL RELEVANCE In vitro testing indicated that modified aligners are capable of generating the F/M components required for palatal root torque of upper central incisors.
Collapse
Affiliation(s)
- Fayez Elkholy
- Department of Orthodontics, Universitätsklinikum Ulm/University Hospital Ulm, Ulm, Germany
| | - Sophia Weber
- Department of Orthodontics, Universitätsklinikum Ulm/University Hospital Ulm, Ulm, Germany
| | - Stefan Repky
- Institute of Statistics, Ulm University, Helmholtzstr. 20, 89081, Ulm, Germany
| | - Rudolf Jäger
- Department of Orthodontics, Universitätsklinikum Ulm/University Hospital Ulm, Ulm, Germany
| | - Falko Schmidt
- Department of Orthodontics, Universitätsklinikum Ulm/University Hospital Ulm, Ulm, Germany
| | - Bernd G Lapatki
- Department of Orthodontics, Universitätsklinikum Ulm/University Hospital Ulm, Ulm, Germany.
| |
Collapse
|
45
|
Tang Z, Chen W, Mei L, Abdulghani EA, Zhao Z, Li Y. Relative anchorage loss under reciprocal anchorage in mandibular premolar extraction cases treated with clear aligners. Angle Orthod 2023; 93:375-381. [PMID: 37343197 PMCID: PMC10294577 DOI: 10.2319/102222-727.1] [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: 10/01/2022] [Accepted: 02/01/2023] [Indexed: 03/25/2024] Open
Abstract
OBJECTIVES To compare mandibular relative anchorage loss (RAL) under reciprocal anchorage between first and second premolar extraction cases in bimaxillary protrusion mild crowding cases treated using clear aligner therapy (CAT). MATERIALS AND METHODS Adult patients who met the following criteria were included: treated using CAT with bilateral mandibular premolar extractions and space closure using intra-arch reciprocal anchorage. RAL was defined as the percent molar mesial movement relative to the sum of molar mesial plus canine distal movement. Movements of the mandibular central incisor (L1), canine (L3), and first molar (L6) were measured based on superimposition of the pre- and post-treatment dentition and jaw models. RESULTS Among the 60 mandibular extraction quadrants, 38 had lower first premolar (L4) and 22 had lower second premolar (L5) extracted. L6 mesial movement was 2.01 ± 1.11 mm with RAL of 25% in the L4 extraction group vs 3.25 ± 1.19 mm with RAL of 40% in the L5 extraction group (P < .001). Tooth movement efficacy was 43% for L1 occlusogingival movement, 75% for L1 buccolingual inclination, 60% for L3 occlusogingival movement, and 53% for L3 mesiodistal angulation. L1 had unwanted extrusion and lingual crown torquing whereas L3 had unwanted extrusion and distal crown tipping, on which the power ridges or attachments had little preventive effect. CONCLUSIONS The average mandibular reciprocal RAL is 25% or 40% for extraction of L4 or L5, respectively, in CAT cases. A RAL-based treatment planning workflow is proposed for CAT extraction cases.
Collapse
|
46
|
Gonçalves A, Collard A, Monteiro F, Matos D, Carvalho Ó, Azevedo R, Silva FS, Pinho T. Accuracy of Invisalign ® on Upper Incisors: A Systematic Review. Turk J Orthod 2023; 36:126-133. [PMID: 37346374 PMCID: PMC10318852 DOI: 10.4274/turkjorthod.2022.2021.0254] [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: 12/27/2021] [Accepted: 06/04/2022] [Indexed: 02/22/2023]
Abstract
The current systematic review appraises the effectiveness of the types of tooth movements performed with Invisalign® clear aligner on the maxillary incisors. An electronic literature search of published trials was performed through PubMed, LILACS, Scopus, Cochrane Library, and Web of Science databases, and selected journals, from 2009 to 2020. Out of 291 references, five relevant publications were identified for analysis: four studies were performed retrospectively and one prospectively, all non-randomized. Despite the limited set of selected articles, the sample size is significant, with 148 subjects included in the reviewed studies involving the orthodontic treatment of upper incisors. We concluded that movements with the Invisalign® clear aligner on the upper incisors present distinct accuracy, possibly related with movement complexity; intrusion of the incisors has low accuracy (in some cases, 0% of accuracy was reported when the tooth extruded), while incisor extrusion exhibit some of the highest accuracy values reported in the included studies (45%-142%, when the achieved movement was greater than the predicted). Besides, axial (i.e., torque and tip) and horizontal (i.e., translation and rotation) movements are usually effective, with accuracy values between 39%-156% and 42%-79%, respectively. Overall, we determined that the efficiency of aligner to reach the desired movements in the upper incisors was low, as often refinements were required in the included studies. The use of aligner features must be more often considered to improve movement accuracy.
Collapse
Affiliation(s)
- Aline Gonçalves
- UNIPRO - Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, Gandra, Portugal
- Center for Microelectromechanical Systems (CMEMS), University of Minho, Campus Azurém, Guimarães, Portugal
| | - Athénaïs Collard
- UNIPRO - Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, Gandra, Portugal
| | - Francisca Monteiro
- Center for Microelectromechanical Systems (CMEMS), University of Minho, Campus Azurém, Guimarães, Portugal
- Life and Health Sciences Research Institute (ICVS), Medical School, University of Minho, Campus Gualtar, Braga, Portugal
- LABBELS - Associate Laboratory, Braga, Guimarães, Portugal
| | - David Matos
- UNIPRO - Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, Gandra, Portugal
| | - Óscar Carvalho
- Center for Microelectromechanical Systems (CMEMS), University of Minho, Campus Azurém, Guimarães, Portugal
- LABBELS - Associate Laboratory, Braga, Guimarães, Portugal
| | - Rui Azevedo
- TOXRUN, Toxicology Research Unit, University Institute of Health Sciences, CESPU, CRL, Gandra, Portugal
| | - Filipe S. Silva
- Center for Microelectromechanical Systems (CMEMS), University of Minho, Campus Azurém, Guimarães, Portugal
- LABBELS - Associate Laboratory, Braga, Guimarães, Portugal
| | - Teresa Pinho
- UNIPRO - Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, Gandra, Portugal
- IBMC - Instituto Biologia Molecular e Celular, i3S - Inst. Inovação e Investigação em Saúde, Universidade do Porto, Porto, Portugal
| |
Collapse
|
47
|
Bouchant M, Saade A, El Helou M. Is maxillary arch expansion with Invisalign® efficient and predictable? A systematic review. Int Orthod 2023; 21:100750. [PMID: 36989750 DOI: 10.1016/j.ortho.2023.100750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 03/12/2023] [Accepted: 03/13/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND The main objective of this review is to assess the effectiveness and predictability of the transverse expansion movement performed by Invisalign®. The secondary objectives are to determine whether the expansion is of a dentoalveolar or skeletal nature, and to locate the areas of expansion on the dental arch. METHODS Two investigators used the PubMed database to search for articles related to the subject. After using a research equation, specific inclusion and exclusion criteria were applied and the final selection of articles was done after being read in full. The ROBINS-I tool for non-randomized studies was applied to assess risk of bias in the results of each included study. RESULTS After reading the articles in full, 12 articles were included. Regarding effectiveness, most studies showed an increase in all measured interdental distances, with a maximum expansion at the premolar level. As for predictability, significant differences were found between post-treatment models and Clincheck® models, making it generally weak. Concerning the nature and areas of expansion, increase of arch width was due to buccal tipping of the crowns following a decreasing gradient from anterior to posterior. CONCLUSIONS Invisalign® treatment is effective in achieving a maxillary transverse expansion. However, this expansion is mainly dentoalveolar, with a facial crown tipping of the posterior teeth. Clincheck® software tends to overestimate the expansion movement when compared to the clinical outcome, therefore the predictability of movement is low.
Collapse
|
48
|
Alsaeed S, Afrashtehfar KI, Alharbi MH, Alfarraj SS, Alluhaydan SA, Abahussain FA, Alotaibi GM, Awawdeh MA. Impact of Orthodontic Appliances on Hiring Prospects in Saudi Arabia: A Cross-Sectional Study. Cureus 2023; 15:e40173. [PMID: 37431341 PMCID: PMC10329810 DOI: 10.7759/cureus.40173] [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: 06/09/2023] [Indexed: 07/12/2023] Open
Abstract
This study provides valuable insights into the cosmetic impact of orthodontic appliances on job-hiring prospects in Saudi Arabia. Both ceramic braces and clear aligners are considered cosmetic corrective devices compared to traditional metallic braces. This survey-based, cross-sectional study used two models, one male, and one female. Four standardized smiling frontal photographs were taken for each model: one without any appliance and three with different orthodontic appliances (i.e., metal braces, ceramic braces, and clear aligners). The photographs of each model were shown to potential employers, followed by three questions for each photo to assess the employers' views on the applicants' professionalism, communication skills, and the likelihood of being hired. The survey was distributed via an electronic questionnaire to employers in Saudi Arabia, collecting feedback from 189 participants. The sample was collected from October 2022 to February 2023. The models' scores while wearing metal and ceramic bracket appliances were significantly lower than when the models were wearing clear aligners or were not wearing any appliance in each domain. In conclusion, orthodontic appliances have cosmetic implications that affect job-hiring prospects, with a higher chance of being hired if the candidate does not have an orthodontic appliance.
Collapse
Affiliation(s)
- Suliman Alsaeed
- Preventive Dental Sciences - College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
- Research Center, King Abdullah International Medical Research Center, Riyadh, SAU
- Dental Center, Ministry of the National Guard - Health Affairs, Riyadh, SAU
| | - Kelvin I Afrashtehfar
- Reconstructive Dentistry and Gerodontology, University of Bern, Bern, CHE
- Clinical Sciences Department, College of Dentistry, Ajman University, Ajman, ARE
| | - Muneerah H Alharbi
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Shaden S Alfarraj
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Shahad A Alluhaydan
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Fai A Abahussain
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Ghaida M Alotaibi
- College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Mohammed A Awawdeh
- Preventive Dental Sciences - College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
- Research Center, King Abdullah International Medical Research Center, Riyadh, SAU
- Dental Center, Ministry of the National Guard - Health Affairs, Riyadh, SAU
| |
Collapse
|
49
|
Khashashneh M, Ratnayake J, Choi JJE, Mei L, Lyons K, Brunton P. The Effect of 10% Carbamide Peroxide Dental Bleaching on the Physical Properties of Invisalign Aligners: An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16114125. [PMID: 37297258 DOI: 10.3390/ma16114125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/16/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023]
Abstract
The high aesthetic demands of patients have increased their requests to align their teeth using clear aligners, including Invisalign. Patients also want to have their teeth whitened for the same purpose; the use of Invisalign as a bleaching tray at night has been reported in few studies. However, whether 10% carbamide peroxide affects the physical properties of Invisalign is unknown. Therefore, the objective of this study was to evaluate the effect of 10% carbamide peroxide on the physical properties of Invisalign when used as a bleaching tray at night. Twenty-two unused Invisalign aligners (Santa Clara, CA, USA) were used to prepare 144 specimens to test their tensile strength, hardness, surface roughness, and translucency. The specimens were divided into four groups: a testing group at baseline (TG1), a testing group after application of bleaching material at 37 °C for 2 weeks (TG2), a control group at baseline (CG1), and a control group after immersion in distilled water at 37 °C for 2 weeks (CG2). Statistical analysis was conducted using a paired t-test, Wilcoxon signed rank test, independent samples t-test, and Mann-Whitney test to compare samples in CG2 to CG1, TG2 to TG1, and TG2 to CG2. Statistical analysis showed no statistically significant difference between the groups for all physical properties, except for hardness (p-value < 0.001) and surface roughness (p-value = 0.007 and p-value < 0.001 for the internal and external surface roughness, respectively), which revealed a reduction in hardness values (from 4.43 ± 0.86 N/mm2 to 2.2 ± 0.29 N/mm2) and an increase in surface roughness (from 1.6 ± 0.32 Ra to 1.93 ± 0.28 Ra and from 0.58 ± 0.12 Ra to 0.68 ± 0.13 Ra for the internal and external surface roughness, respectively) after 2 weeks of dental bleaching. Results showed that Invisalign can be used for dental bleaching without excessive distortion or degradation of the aligner material. However, future clinical trials are required to further assess the feasibility of using Invisalign for dental bleaching.
Collapse
Affiliation(s)
- Majd Khashashneh
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
- Faculty of Dentistry, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Jithendra Ratnayake
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Joanne Jung Eun Choi
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Li Mei
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Karl Lyons
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand
| | - Paul Brunton
- DVCA, Curtin Perth, Curtin University, Bentley, WA 6102, Australia
| |
Collapse
|
50
|
Al-Warafi LA, Al-Worafi NA, Al-Aroomi MA, Alhashimi N, Alsomairi MAA, Al-Rokhami RK, Chen X, Alhammadi MS. Alveolar bone changes following bi-maxillary vertical molars' movements using clear aligners. BMC Oral Health 2023; 23:326. [PMID: 37231473 DOI: 10.1186/s12903-023-03028-5] [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: 01/31/2023] [Accepted: 05/09/2023] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVE This study aimed to assess the alveolar bone changes following maxillary and mandibular molars' intrusion and extrusion movements using Clear Aligners using Cone-Beam Computed Tomography (CBCT). MATERIALS AND METHODS This is a retrospective clinical study in which 24 adult patients with pre-designed selection criteria and a mean age of 31.1 + 9.9 years were enrolled. The alveolar bone changes around one hundred thirty-three maxillary and mandibular molars intruded or extruded by Clear Aligners therapy were analyzed from CBCT using Invivo 6.0 software. Intra- and inter-examiner reliability analysis was performed using the intra-class correlation coefficient (ICC) and Cronbach's Alpha statistics. The paired t-test was used to analyze significant differences before and after treatment (T0-T1). The significance level was considered at P < 0.05. RESULT The patients were divided into two groups: extrusion (48.9%, n = 65 molars' root) and intrusion (51.1%, n = 68 molars' root) group. There was a significant decrease in the alveolar bone changes in the buccal surface of the mandibular right and left 1st molars in the extrusion group (-1.05 ± 0.97, -0.76 ± 1.12 mm, respectively) and the maxillary left 2nd molars in intrusion group (-0.42 ± 0.77 mm), and the lingual surface of intrusion of the mandibular left 1st molar (-0.64 ± 0.76 mm). Comparing the mean maxillary and mandibular changes (T0-T1) of both studied groups showed that the buccal alveolar bone changes for the left 1st and right 2nd molars showed a significant difference in extrusion and intrusion groups, respectively. CONCLUSIONS The buccal alveolar bone changes is considered the most affected surface following maxillary and mandibular molars' intrusion and extrusion movements using clear aligners, with mandibular molars being more affected than the maxillary ones.
Collapse
Affiliation(s)
- Leena Ali Al-Warafi
- Department of Stomatology, The First Affiliated Hospital of Xi'an JiaotongUniversity, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Naseem Ali Al-Worafi
- Department of Orthodontics, School of Stomatology, China Medical University, Shenyang, China
| | - Maged Ali Al-Aroomi
- Department of Oral and maxillofacial surgery, Faculty of dentistry, IBB University, IBB, Yemen
| | - Najah Alhashimi
- College of Dental Medicine, Chief of orthodontics division at Hamad Medical Corporation, Qatar University, Doha, Qatar
| | - Majedh Abdo Ali Alsomairi
- Department of Stomatology, The First Affiliated Hospital of Xi'an JiaotongUniversity, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Remsh Khaled Al-Rokhami
- Department of Orthodontics, School of Stomatology, China Medical University, Shenyang, China
| | - Xi Chen
- Department of Stomatology, The First Affiliated Hospital of Xi'an JiaotongUniversity, Xi'an, 710061, Shaanxi, People's Republic of China.
| | - Maged Sultan Alhammadi
- Division of Orthodontics and Dentofacial Orthopedics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| |
Collapse
|