Clear Aligner Therapy: Up to date review article

Class II Correction and Crowding Treatment Using In-House Direct Printed Clear Aligners: A Literature Review and Case Report

Clear aligner therapy has significantly improved orthodontic treatment by offering patients a more aesthetically pleasing option compared to traditional braces. This literature review and case report specifically focus on the effectiveness of directly printed clear aligners in treating Class II malocclusions and crowding. Class II malocclusions are characterized by excessive overjet, which often results from skeletal or dental discrepancies between the upper and lower jaws. Crowding refers to the lack of space for teeth within the dental arch, leading to misalignment and potential functional issues. The review and case report highlight the increasing importance of directly printed clear aligners in modern orthodontics and provide clinicians with a valuable tool to effectively address complex malocclusions and crowding while also meeting patient needs for discretion and comfort. Further research is necessary to validate the long-term stability and outcomes of directly printed clear aligner therapy in various orthodontic cases. A detailed case report demonstrates the successful treatment of a patient with Class II malocclusion and mild crowding using directly printed clear aligners. Treatment outcomes include improvements in dental alignment, occlusion, and facial aesthetics, showcasing the effectiveness of this innovative approach.

Awareness and Perception of Dental, Medical, and Paramedical Students Toward the Use of Clear Aligners in Orthodontic Treatment in Belagavi, India

Background The advent of clear aligners represents a significant shift in orthodontic treatment, offering an aesthetic and convenient alternative to traditional braces and helping maintain better oral hygiene as it is removable. This study investigates the awareness and perception of clear aligners among dental, medical, and paramedical students in Belagavi, India. Methodology A cross-sectional, observational study was conducted in February 2024 among students from a private medical university in Belagavi. A validated questionnaire (content validity ratio = 0.88; Cronbach's alpha coefficient = 0.86), developed through expert consultation and pilot testing, assessed the awareness and perception of students on clear aligners. Simple random sampling was used to select 480 participants. Data were analyzed using the chi-square test, analysis of variance, Pearson correlation coefficient, and binary logistic regression. Results The study found that awareness and perception of clear aligners were the lowest among medical and paramedical students in comparison with dental students. A positive linear correlation was seen between awareness and perception scores. When specialty was taken into consideration, medical/dental students were 2.55 times more aware and had 2.78 times more positive perceptions toward clear aligners compared to paramedical students. Conclusions There was a notable disparity in the awareness and perception of clear aligners among dental, medical, and paramedical students. Medical and paramedical students displayed lower awareness and unfavorable perception toward clear aligners in comparison with dental students.

Evaluating the Therapeutic Properties of Natural Products in Orthodontic and Surgical Treatment of Dentofacial Deformities: A Systematic Review of Clinical Trials

The use of natural products as alternatives to traditional pharmacological treatments in orthodontics is gaining interest due to their anti-inflammatory, antibacterial, and antioxidant properties. This systematic review synthesizes evidence from clinical trials to evaluate the efficacy of natural products in reducing inflammation and bacterial presence in orthodontic and orthognathic treatment settings. The database search was conducted across PubMed, Scopus, and Embase up to January 2024. The review focused on randomized controlled trials only. The selected studies centered on the anti-inflammatory, antibacterial, and antioxidant effects of natural products, adhering to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines for data extraction. Nine studies, totaling 358 participants, were included. Significant findings demonstrated a reduction in gingival inflammation by over 40% with the use of Aloe vera compared to chlorhexidine. Another study noted a decrease in bleeding on probing by 13.6 points in the treatment group over placebo. Additionally, honey showed a rapid modulation of plaque pH and significantly reduced bacterial counts of Streptococcus mutans. Furthermore, the use of resveratrol emulgel was linked to substantial improvements in gingival health, with a reduction in the gingival index and probing pocket depth. The results indicate that natural products can significantly enhance orthodontic treatment outcomes by reducing inflammation and bacterial levels. These products offer effective alternatives to traditional treatments and show potential for integration into routine orthodontic care protocols. Further research is encouraged to standardize application methods and dosages to maximize clinical benefits and patient satisfaction.

Clear Aligners in the Growing Patient: A Systematic Review

Mixed dentition represents a critical phase in the oral development of pediatric patients, characterized by the simultaneous presence of primary and permanent teeth. This article proposes a comprehensive systematic review of the application of aligners as an innovative methodology in managing mixed dentition. The primary objective is to explore the efficacy, safety, and acceptability of this emerging orthodontic technology in the evolving age group. This systematic review focuses on randomized controlled trials, cohorts, and observational studies investigating the use of aligners in patients with mixed dentition. Clinical, radiographic, and psychosocial parameters will be considered to assess the overall impact of aligner therapy in this critical phase of dental development. An in-depth analysis of such data aims to provide a comprehensive overview of the potential of this technology in pediatric orthodontics. Expected outcomes may contribute to outlining practical guidelines and targeted therapeutic strategies for orthodontists involved in managing mixed dentition. Furthermore, this article aims to identify gaps in the current research and suggest future directions for studies exploring the use of transparent aligners in patients with mixed dentition, thereby contributing to the ongoing evolution of evidence-based orthodontic practices.

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.

Evaluation of Patient Acceptance and Compliance with Clear Aligners vs. Lingual Braces: A Randomized Trial

Background

The efficacy of orthodontic treatments is often influenced by patient acceptance and compliance. This study aims to compare patient acceptance and compliance between clear aligners and lingual braces in a randomized clinical trial.

Materials and Methods

A total of 100 patients requiring orthodontic treatment were randomly allocated into two groups: clear aligners (n = 50) and lingual braces (n = 50). Data on patient acceptance and compliance were collected through self-reported questionnaires and clinical observations over a period of 12 months.

Results

Patient acceptance was significantly higher in the clear aligner group, with 80% reporting high levels of comfort, compared to 60% in the lingual braces group (P < 0.05). Compliance rates were 92% for clear aligners and 85% for lingual braces (P = 0.1).

Conclusion

Clear aligners showed a higher level of patient acceptance and a slightly better compliance rate, although the difference was not statistically significant. These findings suggest that clear aligners may be a preferable option for patients prioritizing comfort.

Influence of Post-Processing on the Degree of Conversion and Mechanical Properties of 3D-Printed Polyurethane Aligners

BACKGROUND

This study explores how different post-processing methods affect the mechanical properties and degree of conversion of 3d-printed polyurethane aligners made from Tera Harz TC-85 resin.

METHODS

Using Fourier-transform infrared (FTIR) spectroscopy, the degree of conversion of liquid resin and post-processed materials was analyzed. This investigation focused on the effects of various post-curing environments (nitrogen vs. air) and rinsing protocols (centrifuge, ethanol, isopropanol, and isopropanol + water). The assessed mechanical properties were flexural modulus and hardness.

RESULTS

The degree of conversion showed no significant variance across different groups, though the polymerization environment influenced the results, accounting for 24.0% of the variance. The flexural modulus varied considerably, depending on both the rinsing protocol and the polymerization environment. The standard protocol (centrifugation followed by nitrogen polymerization) exhibited the highest flexural modulus of 1881.22 MPa. Hardness testing revealed significant differences, with isopropanol treatments showing increased resistance to wear in comparison to the centrifuge and ethanol rinse treatments.

CONCLUSIONS

This study conclusively demonstrates the adverse effects of oxygen on the polymerization process, underscoring the critical need for an oxygen-free environment to optimize material properties. Notably, the ethanol rinse followed by nitrogen polymerization protocol emerged as a viable alternative to the conventional centrifuge plus nitrogen method.

Predictability of Dental Distalization with Clear Aligners: A Systematic Review

The current review aims to evaluate the scientific evidence relating to the effectiveness of treatment with clear aligners (CAs) in controlling distalization orthodontic tooth movement. "Orthodontics, aligners" and "distalization" were the search terms used on the Scopus, Web of Science and Pubmed databases with the Boolean operator "AND". The results of the last ten years of research were 146 studies; of these, 19 publications were included for this review. The distalization movement is possible with invisible masks alone, but the risk of losing anchorage in the anterior sectors is very probable. The stability of the results and the reduction of unwanted effects can be guaranteed by the use of skeletal anchoring devices and interproximal enamel reduction (IPR), with which compensations are obtained to reduce the initial overjet. Temporary anchorage devices (TADs) can be used to manage posterior anchorage after distalization of maxillary molars with aligners. This hybrid approach has demonstrated the greatest orthodontic success. TADs are useful aids to provide direct and indirect skeletal anchorage. The opposite effect must be considered when planning dental distalization, especially of the molars, in patients with large overjet, and corrective measures or the use of auxiliaries may be necessary to prevent midcourse corrections. This systematic review provides a critical evidence-based assessment of the predictability of dental distalization with CAs, an ever-evolving orthodontic technique.