Differences in finished case quality between Invisalign and traditional fixed appliances:

ABSTRACT Objectives To compare the treatment and posttreatment effects of Invisalign aligners that incorporated SmartForce features and attachments to traditional fixed appliances. Materials and Methods This randomized controlled trial included 66 patients, 32 aligners, and 34 fixed-appliance patients. The median ages of the aligner and braces patients were 26.7 (interquartile range [IQR]: 9.8) and 25.9 (IQR: 16.6) years, respectively. Pretreatment occlusion was assessed using the ABO Discrepancy Index. Posttreatment (T1) and 6-month retention (T2) occlusions were quantified using the ABO Objective Grading System (OGS) scores. Results The braces group finished treatment significantly (P < .001) earlier (0.4 years) than the aligner group. The median DI scores for the aligner and braces groups were 4.5 and 7.0, respectively, which was a statistically significant (P = .015), but clinically insignificant, difference. There were no statistically significant between-group differences for the total OGS scores or any of the individual component scores at debond (T1) or after 6 months of retention (T2). During the posttreatment period, alignment and overjet worsened significantly in the aligner group, while buccolingual inclinations and occlusal relations improved. Over the same period, alignment worsened in the braces group and buccolingual inclinations improved. There was no statistically significant between-group difference in posttreatment changes of the total OGS scores. Conclusions While patients with simple malocclusions require 4.8 months longer treatment times with aligners than traditional braces, the treatment and 6-month posttreatment occlusal outcomes are similar.

Occlusal outcome after orthodontic treatment with preadjusted straight-wire and standard edgewise appliances

Purpose Orthodontic fixed appliances have been proven to be effective in treating a wide variety of malocclusions, and different types of appliances have emerged during recent decades. However, the comparative effects of different appliances have not been adequately assessed. Thus, the aim was to assess the occlusal outcome of orthodontic treatment with preadjusted straight-wire (SWIRE) and standard edgewise (SEDGE) appliances. Methods In all, 56 patients (mean age: 13.5 years; 45% male) receiving extraction-based treatment with either SWIRE or SEDGE appliances were included. Between-group differences in the occlusal outcome assessed with the American Board of Orthodontists Objective Grading System (ABO-OGS) and treatment duration were analyzed statistically at the 5% level. Results The average ABO-OGS score was 31.3 ± 7.2 points and 34.0 ± 10.4 points in the SWIRE and SEDGE groups with no statistically significant difference between groups (P = 0.26). Treatment duration was significantly shorter in the SWIRE group compared to the SEDGE group, with an average difference of −6.8 months (95% confidence interval [95% CI] = −9.6 to −4.0 months; P < 0.001). Likewise, fewer visits were needed with SWIRE compared to SEDGE appliances with an average difference of −7.2 visits (95% CI = −10.3 to −4.2 visits; P < 0.001). Adjusting for the influence of any potential confounders did not considerably impact the results. Conclusion Similar treatment outcomes were observed after premolar extraction treatment with SWIRE and SEDGE appliances. On the other hand, SEDGE appliances were associated with prolonged treatment duration and more visits needed to complete treatment compared to SWIRE appliances.

Time-saving scoring chart for the American Board of Orthodontics’ objective grading system

Objective grading system is indispensable in contemporary orthodontic scenario to help elevate clinical proficiency and quality of care. Simplification of the format of grading system is necessary not only for easy chair side documentation but also for comparative pre- and post treatment assessment. The aim of this article is to propose a simple, practical, and time-saving scoring chart for scoring each criterion of the objective grading system.

Relación entre la calidad de los tratamientos de ortodoncia finalizados y la satisfacción en pacientes atendidos en la Universidad Santo Tomás desde 2018 hasta 2019

Introducción: el aumento en la prestación de los servicios de ortodoncia exige resultados de alta calidad para lograr la satisfacción del paciente, pero son escasos los estudios que abordan el tema. Objetivo: determinar la relación entre la calidad de los tratamientos de ortodoncia finalizados con la satisfacción del paciente en las Clínicas del Ortodoncia de una universidad colombiana. Métodos: se realizó un estudio observacional de corte transversal con una muestra de 67 pacientes que completaron su tratamiento de ortodoncia entre febrero de 2018 y junio de 2019. La satisfacción se evaluó con un cuestionario de 17 ítems. La calidad de los tratamientos de ortodoncia se analizó según los ocho criterios del Objective Grading System (OGS) de la American Board of Orthodontics sobre modelos de estudio y radiografías panorámicas tomadas al finalizar el tratamiento. Se calcularon frecuencias y proporciones para variables cualitativas y medidas de tendencia central y dispersión para las cuantitativas. Se utilizaron la prueba chi-cuadrado, exacta de Fisher y el coeficiente de correlación de Pearson según fuera apropiado. Un valor de p <0,05 se consideró estadísticamente significativo. Resultados: entre los 67 participantes, 49 (73,1%) eran mujeres, la edad promedio fue 21,4 ± 9,1 años, la duración promedio del tratamiento fue 32,3 ± 5,0 meses y el número promedio de defectos fue 28,8 ± 9,2. El 38.8% respondió que estaba muy satisfecho con los resultados. No se observó una relación entre la satisfacción del paciente y la calidad de los tratamientos de ortodoncia agrupados en excelentes, aceptables y deficientes de acuerdo con los criterios del OGS. Conclusiones: no se encontró relación entre la calidad de los resultados del tratamiento de ortodoncia según los criterios del OGS y la satisfacción del paciente. Estos resultados mostraron que es necesario proponer planes de mejora continua en el centro universitario.

Cephalometric and occlusal changes of Class III malocclusion treated with or without extractions

ABSTRACT Objective: The aim of this retrospective study was to evaluate the cephalometric and occlusal changes of orthodontically treated Class III malocclusion patients. Methods: The experimental groups comprised 37 Class III patients treated: G1) without (n=19) and G2) with extractions (n=18) . The control group (G3), matched by age and sex with the experimental groups, consisted of 18 subjects with untreated Class III malocclusion. Cephalometric (radiographs) and occlusal (study models) changes were assessed between the beginning (T1) and the end (T2) of treatment. Intergroup comparisons were performed with one-way ANOVA followed by Kruskal-Wallis tests (p< 0.05). Occlusal changes were evaluated by the peer assessment rating (PAR) index (ANOVA and Kruskal-Wallis tests), and the treatment outcomes were evaluated by the Objective Grading System (OGS) (t-tests). Results: The experimental groups showed a restrictive effect on mandibular anterior displacement and a discrete improvement in the maxillomandibular relationship. Extraction treatment resulted in a greater retrusive movement of the incisors and significant improvements in the overjet and molar relationship in both groups. The PAR indexes were significantly reduced with treatment, and the OGS scores were 25.6 (G1) and 28.6 (G2), with no significant intergroup difference. Conclusions: Orthodontic treatment of Class III malocclusion patients with fixed appliances improved the sagittal relationships, with greater incisor retrusion in the extraction group. Both the extraction and non-extraction treatments significantly decreased the initial malocclusion severity, with adequate and similar occlusal outcomes of treatment.

Objective Grading System Scores After the Use of a New Finishing Protocol

Objective: This non-randomized controlled clinical trial compared a new finishing protocol UDEA2 with the UDEA1 finishing protocol, according to the Objective Grading System (ogs).Methods: Forty-one patients treated in the postgraduate orthodontics clinic were included. Twenty patients served as intervention group (ig) with whom was used the UDEA2 protocol which includes dental positioners, and were compared to twenty-one patients that served as control group (cg) with whom was used the UDEA1 finishing protocol. An orthodontist (gold standard) determined the required movements with positioners used in the UDEA2 protocol. Eight ogs variables were measured by a calibrated clinician.Results: Both groups were comparable in gender, age and severity, but not in type of treatment applied. The total ogs for gc was 28.9±10.0, for ig at T1 (before the positioner) was 20.4±6.0 and the score for ig at T2 (after the positioner) was 19.2±6.0, with statistically significant differences (P≤0.05). The ogs score was principally increased for “alignment” in gc and ig-T1 groups. This variable decreased significantly in the ig-T2 group. There were no patients with more than 30 points in the ig-T2. The regression analysis showed an association (P=0.002) between the finishing protocol applied and the final ogs score. Possibility of belonging to the ig-T2 decreases as the ogs score increases (odds ratio [or] 0.83; 95% confidence interval [CI] 0.738, 0.933).Conclusions: The implementation of the UDEA2 finishing protocol, which includes an orthodontics student’s constant training, a Finishing Protocol Guide application, and a dental positioner in the finishing phase, showed an improvement in quality of orthodontic treatments.