Clear Aligners Treatment of Class III Subdivision with an Extraction of a Lower Bicuspid

Predictability of Orthodontic Space Closure Using Invisalign Clear Aligners: A Retrospective Study

Introduction Clear aligners have demonstrated success in achieving complex tooth movements. However, orthodontists have faced challenges related to the predictability of clear aligners. This retrospective study aimed to assess the predictability of ClinCheck® accuracy in space closure before and after Invisalign® treatment and to identify factors associated with the need for refinement. Methods Patient records from one private clinic in Makkah, Saudi Arabia, were analyzed, and a sample of 55 adult patients who had spacing and underwent Invisalign treatment were included. Data on demographic and orthodontic variables were collected, and a chi-square test was conducted to examine the association between the requirement for refinement and demographic as well as clinical/orthodontic factors. Furthermore, the initial and final space measurements were compared using paired t-tests across various demographic and clinical/orthodontic variables. Results After completing the treatment, 70.9% (N=39) of the cases did not require any orthodontic refinement. The mean final space measurement was higher for males compared to females (0.7 mm and 0.4 mm, respectively), individuals who received treatment in the upper compared to lower arch (0.5 and 0.4 mm, respectively), those with moderate compared to mild spacing (0.5 and 0.1 mm, respectively), and those with class III compared to class I Angle classification (0.9 and 0.3 mm, respectively). Additionally, patients with severe spacing had a significantly higher probability of requiring refinement compared to patients with mild spacing (adjusted odds ratio = 20.9; p < 0.05). Conclusion The study emphasizes the significance of careful patient selection and treatment planning, suggesting that orthodontists should consider overcorrecting in space closure when using clear aligners, especially in cases with more significant spacing.

The incidence of dental fractures in the Italian population during the COVID-19 pandemic: An observational study

Background

The COVID-19 infection has become a pandemic after breaking out in China in the past months of 2019 and spreading rapidly worldwide. To counter this pandemic, several governments worldwide have taken several drastic measures to try to stop the spread of the virus, including a very strict lockdown that has caused a sudden and, in many cases, negative change in people's daily lives. In the literature, several studies have shown how the pandemic has significantly impaired many people's mental health, causing short- and long-term stress, anxiety, and sleep disturbances.

Introduction

This study aims to analyze the correlation between the stress caused by the COVID-19 pandemic and the parafunctions of the temporomandibular joint and masticatory muscles, which in turn, have led to an increase in the incidence of fractures and dental injuries. The ultimate goal is to understand the best choice the dentist must make in the preventive and therapeutic fields.

Materials and Methods

A questionnaire called "Incidence of tooth fractures during the COVID-19 pandemic" was prepared using the Google® Forms platform. This questionnaire consists of 13 questions. This electronic questionnaire was addressed to all dentists in the Campania Region (ITA) and disseminated through social networks such as WhatsApp® or Facebook® or E-mail.

Results

A total of 730 dentists completed the survey. Of these, 450 (61.7%) stated that the number of patients reporting muscle and joint pain in the morning had increased during the COVID-19 pandemic. 414 (56.7%) dentists noted an increase in parafunction and 392 (53.6%) an increase in dental fractures during the pandemic period.

Discussion and Conclusions

As can be seen from the study results, an important correlation was found between the stress resulting from the COVID-19 pandemic and dental fractures. The dental elements treated endodontically, depending on the extent of the damage, require restoration, which is also the best preventive strategy in the case of dental fractures.

Impact of Clear Aligners versus Fixed Appliances on Periodontal Status of Patients Undergoing Orthodontic Treatment: A Systematic Review of Systematic Reviews

The present umbrella review of four systematic reviews with meta-analysis aimed to assess whether clear aligners are associated with better periodontal conditions compared with fixed appliances in patients undergoing orthodontic treatment. The present study protocol was developed in accordance with the PRISMA statement before the literature search, data extraction, and analysis and was registered on PROSPERO (CRD42023401808). The question formulation, search, and study selection strategies were developed according to the PICO model. Systematic reviews with a meta-analysis published in English without date restriction were electronically searched across the Cochrane Library, Web of Science (Core Collection), Scopus, EMBASE, and MEDLINE/PubMed databases until 10 February 2023. An assessment of study quality was performed using the AMSTAR 2 tool. Differences in the PI, GI, and BOP in the short- and medium-term follow-ups, in the PPD in long-term follow-up, and the gingival recessions in the short-term follow-up were found between subjects with clear aligners and fixed appliances, revealing a slight tendency for clear aligners to be associated with healthier periodontal conditions. However, even if statistically significant, such differences would be negligible in a clinical environment. Therefore, the impact of orthodontic treatment with clear aligners and fixed appliances on periodontal health status should be considered comparable.

The Predictability of Transverse Changes in Patients Treated with Clear Aligners

Arch expansion might be used to correct buccal corridors, improve smile aesthetics, resolve dental cross bite, and gain space to resolve crowding. In clear aligner treatment, the predictability of the expansion is still unclear. The purpose of this study was to evaluate the predictability of dentoalveolar expansion and molar inclination with clear aligners. In the study, 30 adult patients (27 ± 6.1 years old) treated with clear aligners were selected (treatment time: 8.8 ± 2.2 months). The upper and lower arch transverse diameters were measured for canines, first and second premolars, and first molars on two different sides (gingival margins and cusp tips); moreover, molar inclination was measured. A paired t-test and Wilcoxon test were used to compare prescription (planned movement) and achieved movement. In all cases, except for molar inclination, a statistically significant difference was found between achieved movement and prescription (p < 0.05). Our findings showed a total accuracy of 64% for the lower arch, 67% at the cusp level, and 59% at the gingival level, with a total accuracy of 67% for the upper arch, 71% at the cusp level, and 60% at the gingival level. The mean accuracy for molar inclination was 40%. Average expansion was greater at cusps of canines than for premolars, and it was lowest for molars. The expansion achieved with aligners is mainly due to the tipping of the crown rather than bodily movement of the tooth. The virtual plan overestimates the expansion of the teeth; thus, it is reasonable to plan an overcorrection when the arches are highly contracted.