scholarly journals Accuracy of interproximal enamel reduction during clear aligner treatment

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Maria Elena De Felice ◽  
Ludovica Nucci ◽  
Adriana Fiori ◽  
Carlos Flores-Mir ◽  
Letizia Perillo ◽  
...  
Keyword(s):  
Clear Aligner ◽  
Enamel Reduction

scholarly journals Predictability of rotational tooth movement with orthodontic aligners comparing software-based and achieved data: A systematic review and meta-analysis of observational studies

2021 ◽  
pp. 146531252110272
Author(s):  
Despina Koletsi ◽  
Anna Iliadi ◽  
Theodore Eliades
Keyword(s):  
Effect Size ◽  
Tooth Movement ◽  
Data Extraction ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Patient Treatment ◽  
Qualitative Synthesis ◽  
Meta Analyses ◽  
Enamel Reduction

Objective: To evaluate all available evidence on the prediction of rotational tooth movements with aligners. Data sources: Seven databases of published and unpublished literature were searched up to 4 August 2020 for eligible studies. Data selection: Studies were deemed eligible if they included evaluation of rotational tooth movement with any type of aligner, through the comparison of software-based and actually achieved data after patient treatment. Data extraction and data synthesis: Data extraction was done independently and in duplicate and risk of bias assessment was performed with the use of the QUADAS-2 tool. Random effects meta-analyses with effect sizes and their 95% confidence intervals (CIs) were performed and the quality of the evidence was assessed through GRADE. Results: Seven articles were included in the qualitative synthesis, of which three contributed to meta-analyses. Overall results revealed a non-accurate prediction of the outcome for the software-based data, irrespective of the use of attachments or interproximal enamel reduction (IPR). Maxillary canines demonstrated the lowest percentage accuracy for rotational tooth movement (three studies: effect size = 47.9%; 95% CI = 27.2–69.5; P < 0.001), although high levels of heterogeneity were identified (I2: 86.9%; P < 0.001). Contrary, mandibular incisors presented the highest percentage accuracy for predicted rotational movement (two studies: effect size = 70.7%; 95% CI = 58.9–82.5; P < 0.001; I2: 0.0%; P = 0.48). Risk of bias was unclear to low overall, while quality of the evidence ranged from low to moderate. Conclusion: Allowing for all identified caveats, prediction of rotational tooth movements with aligner treatment does not appear accurate, especially for canines. Careful selection of patients and malocclusions for aligner treatment decisions remain challenging.

scholarly journals Enamel interproximal reduction during treatment with clear aligners: digital planning versus OrthoCAD analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Giuseppina Laganà ◽  
Arianna Malara ◽  
Roberta Lione ◽  
Carlotta Danesi ◽  
Simonetta Meuli ◽  
...  
Keyword(s):  
Treatment Plan ◽  
End Of Treatment ◽  
The Mean ◽  
The Difference ◽  
Dependent Sample ◽  
University Of Rome ◽  
The University ◽  
Enamel Reduction ◽  
Lower Arch

Abstract Background The aim of the study was to compare the amount of interproximal enamel reduction (IPR) provided on ClinCheck software with the amount of IPR carried out by the orthodontist during treatment with clear aligners. Methods 30 subjects (14 males, 16 females; mean age of 24.53 ± 13.41 years) randomly recruited from the Invisalign account of the Department of Orthodontics at the University of Rome “Tor Vergata” from November 2018 to October 2019, were collected according to the following inclusion criteria: mild to moderate dento-alveolar discrepancy (1.5–6.5 mm); Class I canine and molar relationship; full permanent dentition (excluding third molars); both arches treated only using Comprehensive Package by Invisalign system; treatment plan including IPR. Pre- (T0) and post-treatment (T1) digital models (.stl files), created from an iTero scan, were collected from all selected patients. The OrthoCAD digital software was used to measure tooth mesiodistal width in upper and lower arches before (T0) and at the end of treatment (T1) before any refinement. The widest mesio-distal diameter was measured for each tooth excluding molars by “Diagnostic” OrthoCAD tool. The total amount of IPR performed during treatment was obtained comparing the sum of mesio-distal widths of all measured teeth at T0 and T1. Significant T1–T0 differences were tested with dependent sample t-test (P < 0.05). Results In the upper arch, IPR was digitally planned on average for 0.62 mm while in the lower arch was on average for 1.92 mm. As for the amount of enamel actually removed after IPR performing, it was on average 0.62 mm in the maxillary arch. In the mandibular arch, the mean of IPR carried out was 1.93 mm. The difference between planned IPR and performed IPR is described: this difference was on average 0.00 mm in the upper arch and 0.01 in the lower arch. Conclusions The amount of enamel removed in vivo corresponded with the amount of IPR planned by the Orthodontist using ClinCheck software.

scholarly journals Poor information on clear aligner websites

BDJ ◽  
2021 ◽  
Vol 230 (7) ◽  
pp. 397-397
Author(s):  
Paul Hellyer
Keyword(s):  
Clear Aligner

Optimized Attachment to Achieve Different Buccolingual Movement of Maxillary Molars in Clear Aligner Orthodontic System: Biomechanical Analysis

2020 ◽  
Vol 12 (11) ◽  
pp. 1249-1254
Author(s):  
Long Qin ◽  
Qiao Wang ◽  
Dongliang Zhang ◽  
Xin He ◽  
Binbin Wu
Keyword(s):  
Tooth Movement ◽  
Biomechanical Analysis ◽  
Occlusal Surface ◽  
Tooth Surface ◽  
Force System ◽  
Maxillary Molars ◽  
Clear Aligner

The different positions and angles of attachment affecting the buccolingual movement of the maxillary molars, especially lingual tipping and negative torque movements, were biomechanically analyzed in order to determine how to better control and prevent unwanted movement of clear aligners. The aligner can be designed and placed appropriately to improve expected tooth movement. Based on mechanical principles, the force system of attachment was analyzed, and the optimum attachment position and angle for tipping and negative torque movement was determined. Attachment close to the enamel-cementum junction (ECJ) was found to achieve the best F (M/L) during negative torque movement; however, the angle should also be adjusted. Attachment close to the occlusal surface achieved greater tipping force at specific angles. When more tipping movement is required, it is recommended to place the attachment 3–5 mm from the ECJ. The angle of the attachment should be 110–120 degrees from the tooth surface. When place the attachment 4–5 mm from the ECJ, the angle of the attachment should be between 145 and 146.5 degrees.

scholarly journals Maxillary arch development with Invisalign system:

2021 ◽  
Author(s):  
Roberta Lione ◽  
Valeria Paoloni ◽  
Lorenzo Bartolommei ◽  
Francesca Gazzani ◽  
Simonetta Meuli ◽  
...  
Keyword(s):  
Treatment Protocol ◽  
European Ancestry ◽  
Inclusion Criteria ◽  
Maxillary Canine ◽  
End Of Treatment ◽  
Angular Measurements ◽  
Permanent Molars ◽  
Level Of Significance ◽  
Clear Aligner ◽  
Maxillary Arch

ABSTRACT Objectives To evaluate tooth movements during maxillary arch expansion with clear aligner treatment. Materials and Methods The study group included 28 subjects (16 females, 12 males, mean age 31.9 ± 5.4 years) collected prospectively from January 2018 to May 2019. Inclusion criteria were European ancestry, posterior transverse discrepancy of 3–6 mm, permanent dentition stage, presence of second permanent molars, mild or moderate crowding, and good compliance with aligners. Treatment protocol included nonextraction strategies, application of Invisalign clear aligner system, and no auxiliaries other than Invisalign attachments. Linear and angular measurements were performed before treatment (T1), at the end of treatment (T2), and on final virtual models (T2 ClinCheck). A paired t-test was used to compare T2-T1 and T2-T2 ClinCheck changes. The level of significance was set at 5%. Results Statistically significant differences were found for all measurements, except for ones at the upper second molars. The greatest increase in maxillary width was detected at the upper first and second premolars: +3.5 mm for the first premolar and +3.8 mm for the second premolar at T2. Comparison of T2-T1 angular outcomes showed statistically significant changes in the inclinations of all teeth except for the second permanent molars. T2-T2 ClinCheck showed significant differences for both linear and angular measurements for maxillary canines, resulting in poor predictability. Conclusions Maxillary arch development revealed a progressive reduction of the expansion rate and buccal tipping in the anterior, lateral, and posterior regions, with the greatest net increase at the first and second premolars. Clinical attention should be paid to maxillary canine movements, and overcorrection should be planned for them during dentoalveolar expansion.

scholarly journals Effects of Composite Attachments on Orthodontic Clear Aligners Therapy: A Systematic Review

Materials ◽  
2022 ◽  
Vol 15 (2) ◽  
pp. 533
Author(s):  
Riccardo Nucera ◽  
Carolina Dolci ◽  
Angela Mirea Bellocchio ◽  
Stefania Costa ◽  
Serena Barbera ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Data Extraction ◽  
Risk Of Bias ◽  
Bias Assessment ◽  
Bodily Movement ◽  
Study Selection ◽  
Medium Risk ◽  
Clear Aligner ◽  
Anterior Root

This systematic review aims to highlight the differences between different clear aligner therapies that differ in the presence of attachments or in attachment configuration. Eight electronic databases were searched up to March 2020. Two authors independently proceeded to study selection, data extraction, and risk of bias assessment. The analysis of the results was carried out examining six groups of movements (mesio-distal tipping/bodily movement; anterior bucco-lingual tipping/root torque; posterior bucco-lingual tipping/expansion; intrusion; extrusion; rotation). Five clinical trials were selected and all of them showed a medium risk of bias. Literature showed that attachments mostly increase the effectiveness of orthodontic treatment with clear aligners, improving anterior root torque, rotation, and mesio-distal (M-D) movement; they are also important to increase posterior anchorage. However, some articles showed contradictory or not statistically significant results. Attachments also seem to improve intrusion, but the evidence about this movement, as well as extrusion, is lacking. No studies evaluated posterior bucco-lingual tipping/expansion. Further clinical trials are strongly suggested to clarify the influence of attachments and their number, size, shape, and position on each orthodontic movement.

scholarly journals Bimaxillary protrusion and gummy smile treated with clear aligners: Closing premolar extraction spaces with bone screw anchorage

2020 ◽  
Vol 10 ◽  
pp. 120-131
Author(s):  
Lexie Y Lin ◽  
Chris H Chang ◽  
W. Eugene Roberts
Keyword(s):  
Treatment Plan ◽  
Current Case ◽  
Anterior Crowding ◽  
Excellent Outcome ◽  
Premolar Extraction ◽  
Treatment Analysis ◽  
Anterior Segments ◽  
Clear Aligner ◽  
Bimaxillary Protrusion ◽  
Gummy Smile

Inadequate posterior anchorage is a serious limitation for aligner treatment involving extraction of four first premolars. Inappropriate axial inclinations may compromise intermaxillary occlusion and stability. OrthoBoneScrew® (OBS) anchorage is designed to augment the Invisalign® clear aligner G6 solution to produce more predictable outcomes as illustrated by the current case report. An 18-year-old female presented with two chief complains: (1) Protrusive, incompetent lips, and (2) excessive gingival exposure when smiling (“gummy smile”). Clinical evaluation revealed bimaxillary protrusion, hypermentalis activity, anterior crowding, and excessive anterior axial inclinations, particularly of the lower incisors (116°). The American Board of Orthodontic (ABO) discrepancy index (DI) was 21. The treatment plan was extraction of all four first premolars, and clear aligner (Invisalign®) therapy anchored with four OBSs: Infra-zygomatic crest (IZC), and between the roots of the upper central and lateral incisors (Incisal) bilaterally. Eighteen months of initial treatment with 45 aligners retracted and intruded the anterior segments in both arches by closing the extraction spaces with supplemental anchorage provided by IZC and Incisal OBSs. The final series of 20 refinement aligners achieved an excellent outcome as evidenced by an ABO cast-radiograph evaluation (CRE) score of 10, and a pink and white (P&W) dental esthetic score of 3. Post-treatment analysis revealed multiple opportunities for improvement. The patient was well satisfied with the final outcome.

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