Clear Aligner Therapy: Up to date review article

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.