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Qiang R, Zhang H, Xu Y, Zhang X, Jin F, Jin Z, Qin W, Gao J. Accuracy of maxillary molar distalization with clear aligners in three-dimension: a retrospective study based on CBCT superimposition. Clin Oral Investig 2025; 29:138. [PMID: 39964527 PMCID: PMC11836081 DOI: 10.1007/s00784-025-06218-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2024] [Accepted: 02/08/2025] [Indexed: 02/21/2025]
Abstract
BACKGROUND To measure the actual moving direction and displacement of the root and crown of maxillary teeth before and after treatment in molar distalization cases using clear aligners(CAs). MATERIALS AND METHODS This retrospective study included 28 adult patients who received maxillary distalization treatment with CAs. The pre- and post-treatment CBCT were superimposed and the crown and root of all maxillary teeth were marked. Achieved and predicted three-dimensional displacement of maxillary teeth were then compared using the paired t test. Mixed-effect model was used to explore the influence of different staging design (one-molar distalization vs. two-molar distalization) and anchorage (TAD vs. Class II elastic vs. no extra anchorage management). RESULTS Labial displacement happened to the anterior teeth even the palatal displacement was prescribed. Body distalization of maxillary posterior teeth could not be fully achieved as predicted. The premolars and molars achieved greater distal tipping, buccal inclination, and less distal displacement than predicted. In buccal-palatal dimension, the greatest buccal tipping tendency happened to the 2nd premolar and decreased toward the distal portion of the aligner. In the mesial-distal dimension, the highest accuracy of molar distalization was found in the 2nd molars while the lowest in the 1st premolars. No significant difference was found between two molar distalization patterns. Extra anchorage management devices could not diminish the difference between the predicted and achieved displacement. CONCLUSIONS The achieved molar distalization displacement and anterior teeth retraction is not as good as expected using CAs. The anterior and posterior anchorage loss cannot be completely avoided despite extra anchorage management devices are adopted. The potential reason for the correction of class II malocclusion needs further exploration.
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Affiliation(s)
- Ruyue Qiang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, Hospital of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - Haolin Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, Hospital of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - Yuerong Xu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, Hospital of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - Xu Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, Hospital of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - Fang Jin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, Hospital of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - Zuolin Jin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, Hospital of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - Wen Qin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, Hospital of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China.
| | - Jie Gao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, Hospital of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China.
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Aragon MLSDC, Mendes Ribeiro SM, Fernandes Fagundes NC, Normando D. Effectiveness of dental arch expansion in the orthodontic treatment with clear aligners: a scoping review. Eur J Orthod 2024; 46:cjae059. [PMID: 39449616 DOI: 10.1093/ejo/cjae059] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2024]
Abstract
BACKGROUND The clinical protocol and effectiveness of dental expansion with Clear Aligner Therapy (CAT), especially among adults is still unclear. There is a need to map and explore knowledge gaps of dental expansion with CAT among children and adults. OBJECTIVE This scoping review explores the extent and depth of the available literature regarding the effectiveness and predictability of CAT in performing orthodontic expansion in both children and adults. METHODS The following databases were consulted as sources of information: PubMed, MEDLINE, Embase, Web of Science, Scopus, LILACS, COCHRANE Library, and ProQuest Dissertations & Thesis, in which the search was limited to studies on children or adults requiring transverse arch expansion and using clear orthodontic aligners. Two independent reviewers assessed the citations and extracted data, which was then synthesized in a narrative format. RESULTS Over all, 698 citations were retrieved, and 33 were included. Among these, 3 were systematic reviews, 4 were cohort studies, 2 were case-control studies, and 24 were case series. Eighty-five percent of the included studies were published in the last 5 years. Despite different protocols and measurement methods, aligners were effective for arch expansion in adults and children, and the expansion predictability was greater for the lower arch than for the upper arch. The evidence suggests that arch width increment is more predictable in the premolar region and less predictable in the canine and second molar areas, with high variability across studies. CONCLUSIONS Orthodontic aligners have demonstrated effectiveness in expanding arches in both adults and children. However, the literature suggests a decrease in arch width toward the posterior region, and there is no evidence of skeletal gains. To provide more conclusive evidence, randomized controlled clinical studies are warranted. REGISTRATION This review was registered in the Open Science Framework database (DOI: https://doi.org/10.17605/OSF.IO/6EG8F).
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Affiliation(s)
- Monica Lídia Santos de Castro Aragon
- Post-Graduate program in Dentistry, Faculty of Dentistry, Federal University of Pará (UFPA), Rua Augusto Correa 01, Belém, Pará 66075-110, Brazil
| | - Suelly Maria Mendes Ribeiro
- Post-Graduate program in Dentistry, Faculty of Dentistry, Federal University of Pará (UFPA), Rua Augusto Correa 01, Belém, Pará 66075-110, Brazil
| | - Nathalia Carolina Fernandes Fagundes
- Post-Graduate program in Dentistry, Faculty of Dentistry, Federal University of Pará (UFPA), Rua Augusto Correa 01, Belém, Pará 66075-110, Brazil
| | - David Normando
- Post-Graduate program in Dentistry, Faculty of Dentistry, Federal University of Pará (UFPA), Rua Augusto Correa 01, Belém, Pará 66075-110, Brazil
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Ahn HW. READER'S FORUM. Korean J Orthod 2024; 54:343-345. [PMID: 39582331 PMCID: PMC11602251 DOI: 10.4041/kjod54.0006rf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2024] Open
Affiliation(s)
- Hyo-Won Ahn
- Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, Korea
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Meade MJ, Weir T, Byrne G. Comparison of digital study model superimposition methods using implant-supported crowns and best-fit algorithms. Am J Orthod Dentofacial Orthop 2024; 166:384-392.e2. [PMID: 39046381 DOI: 10.1016/j.ajodo.2024.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 06/01/2024] [Accepted: 06/01/2024] [Indexed: 07/25/2024]
Abstract
INTRODUCTION Research regarding orthodontic changes using the superimposition of digital study models (DSMs) is commonplace. Information regarding the accuracy of data processing by superimposition software is limited. The study aimed to compare different methods of superimposing DSMs using implant-supported crowns (ISC) as a stable reference structure. METHODS DSMs containing ISCs were sourced from a database of patients treated with clear aligner therapy. The DSM representing the planned treatment outcome was superimposed on the pretreatment DSM. Three tooth points were selected for comparison on the contralateral side of each ISC. Differences in Cartesian coordinates for each tooth point for each arch superimposition method, used by the Geomagic Control X (3D systems, Rock Hill, NC) software system, were recorded. Paired t tests for the reference standard superimposition method best-fit high-resolution using the entire dental arch compared with initial, best-fit low-resolution, and best-fit high-resolution using the ISC only were calculated. RESULTS The DSMs of 54 dental arches containing ISCs were evaluated. All mean differences for displacements of selected points on the contralateral side to the ISC in the 3 Cartesian planes were <0.05 mm (P <0.05) and below the threshold of clinical significance. In addition, the standard superimposition techniques (initial, best-fit low-resolution, and best-fit high-resolution) resulted in nonstatistically significant and nonclinically significant differences in the position of the ISC. CONCLUSIONS Researchers can be confident that the described superimposition methodologies, with and without ISCs as a stable reference structure, are a valid method for accurately assessing most intraarch dental changes.
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Affiliation(s)
- Maurice J Meade
- Orthodontic Unit, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia.
| | - Tony Weir
- Orthodontic Unit, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - Graeme Byrne
- La Trobe University Statistics Consultancy Platform, Melbourne, Victoria, Australia
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Lione R, De Razza FC, Gazzani F, Cozza P, Pavoni C. Wilson curve modification in permanent dentition: a retrospective comparison between clear aligners and continuous archwire treatment. Angle Orthod 2024; 94:400-407. [PMID: 39229947 PMCID: PMC11210517 DOI: 10.2319/101123-691.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 02/01/2024] [Indexed: 09/05/2024] Open
Abstract
OBJECTIVES To evaluate leveling of the Curve of Wilson (COW) by two different treatment appliances (clear aligners [CA] and continuous archwire fixed appliances [FA]) in a permanent dentition sample of patients. MATERIALS AND METHODS Digital casts of 40 patients (CA group = 20 patients; FA group = 20 patients) were collected. Angular values for COW, right and left vertical height difference of lower first molars, and linear distance between lower teeth and the WALA ridge were analyzed for pre- (T1), posttreatment (T2) and on final virtual (ClinCheck) models (T2-CC) of the CA group. An unpaired t-test was used to evaluate significant intergroup differences (P < .05), while a paired t-test was used for posttreatment CA intragroup comparison. RESULTS FA group showed better control of second molar crown positions compared to CA group (47-WALA = -0.2 ± 0.1 mm, 37-WALA = -0.6 ± 0.3 mm). No significant difference was detected for linear distance of lower first molars and the WALA ridge or for vertical height difference. CA group showed a greater reduction of distance between lower premolars and the WALA ridge (mean difference: -0.5 mm for both 45-WALA and 35-WALA; mean difference: -0.5 mm for 44-WALA, -0.6 mm for 34-WALA). Predictability for the CA group was high for every measurement (87% Right COW, 89% Left COW, 88% 46 Vertical Diff, 87% 36 Vertical Diff). CONCLUSIONS Clear aligner and continuous archwire mechanics were effective in leveling COW. FA was more effective in changing crown position of lower second molars with respect to the WALA ridge, while CA provided a greater distance reduction between lower premolars and WALA ridges compared to FA.
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Affiliation(s)
| | - Francesca Chiara De Razza
- Corresponding author: Dr Francesca Chiara De Razza, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 1 Rome, Italy 00133 (e-mail: )
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Ghislanzoni LH, Kalemaj Z, Manuelli M, Magni C, Polimeni A, Lucchese A. How well does Invisalign ClinCheck predict actual results: A prospective study. Orthod Craniofac Res 2024; 27:465-473. [PMID: 38205876 DOI: 10.1111/ocr.12752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2023] [Indexed: 01/12/2024]
Abstract
INTRODUCTION This study aimed to compare achieved movements with predicted movements after 28-week use of Invisalign Lite aligners. SETTINGS AND SAMPLE POPULATION The digital impressions of 21 subjects treated with Invisalign Lite at a private practice and in the dental clinic (Milan, Italy) were taken and analysed. Subjects were Caucasian with a mean age of 20.1 years. METHODS Patients were analysed at two time points: at T0, before starting therapy, and at T1, after 28 weeks of treatment with Invisalign clear aligners, with a 2-week change interval. The changes that occurred between T0 and T1 were compared to the predicted changes between T0 and Ts (setup/ClinCheck). Tooth movement performance was estimated through variables calculated as the difference between obtained and planned movements. RESULTS In both maxillary and mandibular arches, the teeth that exhibited the least accurate expression of torque were the central incisors. Tip was not accurate on maxillary central incisors and canines, mandibular central incisors, lateral incisors, first premolars, second premolars and first molars. Rotations were under-expressed on maxillary lateral incisors, canines and second premolars and on mandibular central incisors, canines, first premolars, second premolars and first molars. The overall angular changes showed a tendency to underperformance. Transverse linear changes were accurate with a significant overperformance on maxillary and mandibular first molars. CONCLUSIONS Torque correction of maxillary central incisors, as well as rotational correction of most of the teeth, showed significant differences between what was planned and what was obtained.
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Affiliation(s)
- Luis Huanca Ghislanzoni
- Department of Orthodontics, University of Geneva, Geneva, Switzerland
- Private Practice, Lausanne, Switzerland
| | | | - Maurizio Manuelli
- Unit of Orthodontics, Division of Dentistry, IRCCS Ospedale San Raffaele Scientific Institute, Milan, Italy
- Department of Orthodontics, School of Dentistry, Vita-Salute San Raffaele University, Milan, Italy
- Unit of Dentistry, Division of Orthodontics, Research Center for Oral Pathology and Implantology, IRCCS Ospedale San Raffaele Scientific Institute, Milan, Italy
- Private Practice Milano, Pavia, Bologna, Italy
| | | | - Antonella Polimeni
- Department of Oral and Maxillo-Facial Science, 'Sapienza' University of Rome, Rome, Italy
| | - Alessandra Lucchese
- Unit of Orthodontics, Division of Dentistry, IRCCS Ospedale San Raffaele Scientific Institute, Milan, Italy
- Department of Orthodontics, School of Dentistry, Vita-Salute San Raffaele University, Milan, Italy
- Unit of Dentistry, Division of Orthodontics, Research Center for Oral Pathology and Implantology, IRCCS Ospedale San Raffaele Scientific Institute, Milan, Italy
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Sadek MM, Alhashmi R. Unplanned tooth movement in deepbite correction with Invisalign: A retrospective study. J World Fed Orthod 2024; 13:136-144. [PMID: 38402054 DOI: 10.1016/j.ejwf.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/24/2023] [Accepted: 12/13/2023] [Indexed: 02/26/2024]
Abstract
BACKGROUND This study aimed to investigate unplanned tooth movements in deepbite correction with Invisalign. METHODS The sample consisted of 34 adult patients with deepbite malocclusion treated with Invisalign. Pretreatment and predicted digital models were exported from ClinCheck software, while the post-treatment model was obtained from an intraoral scan taken at the end of the first set of aligners. Digital models' superimposition was done using the eModel "Compare" software. Frequency and percentage of occurrence of unplanned linear and angular movements, their magnitude, and direction were then determined. In addition, comparison of unplanned movements was performed between anterior and posterior teeth as well as between linear and angular measurements. RESULTS The percentage of unplanned movements ranged from 1.68% to 25.63% in the maxilla and 3.36% to 23.95% in the mandible, being most evident in the first and second molars. Unplanned movements were statistically significantly more frequent in posterior teeth compared with the anterior teeth (P > 0.05). In addition, the frequency of angular movements was statistically significantly higher for each tooth than linear movement (P < 0.05) with a higher mean value. Unplanned mesiodistal movements were the least frequent. CONCLUSIONS Unplanned linear as well as angular movements were evident in almost all teeth. Unplanned faciolingual inclination and mesiodistal angulation movements were the most frequently observed. Unplanned vertical movements can affect the predictability of deepbite correction and thus merit particular attention in those cases.
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Affiliation(s)
- Mais M Sadek
- Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt; Assistant Professor of Orthodontics, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates.
| | - Reem Alhashmi
- Orthodontic Resident, College of Dental Medicine, University of Sharjah, United Arab Emirates
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Albertini E, Albertini P, Colonna A, Lombardo L. Invisible treatment with lingual appliance for the correction of an adult class II subdivision with asymmetrical Wilson and Spee curves: A case report. Int Orthod 2024; 22:100825. [PMID: 38035872 DOI: 10.1016/j.ortho.2023.100825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 12/02/2023]
Abstract
This article describes a class II subdivision malocclusion successfully treated by an invisible lingual appliance. The combination of en-masse distalization by interradicular palatal mini-screws and inner unilateral class II auxiliaries, first by intermaxillary elastic, later by a class II coil spring, resulted in a dento-alveolar correction, allowing one to maintain the appliance completely invisible. At the same time, the inclination of buccal sectors was normalized by a correct torque expression with set-up overcorrections, resulting in a significant improvement of the buccal corridors. This case report demonstrates the possibility of successfully solving class II division 2 subdivision malocclusion in adult patients without surgery by means of a completely invisible appliance. It also demonstrates that correct levelling and torque expression, for the correction of asymmetrical Spee and Wilson curves, are achievable with an accurate set-up planning. On the other hand, it underlines the necessity of mini-screws, auxiliaries and set-up overcorrections in order to obtain the best results.
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Affiliation(s)
- Enrico Albertini
- Postgraduate School of Orthodontics, University of Ferrara, Via Luigi Borsari 46, Ferrara, Italy.
| | - Paolo Albertini
- Postgraduate School of Orthodontics, University of Ferrara, Via Luigi Borsari 46, Ferrara, Italy
| | - Anna Colonna
- Postgraduate School of Orthodontics, University of Ferrara, Via Luigi Borsari 46, Ferrara, Italy
| | - Luca Lombardo
- Postgraduate School of Orthodontics, University of Ferrara, Via Luigi Borsari 46, Ferrara, Italy
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Mendes Ribeiro SM, Aragón MLSDC, Espinosa DDSG, Shibasaki WMM, Normando D. Orthodontic aligners: between passion and science. Dental Press J Orthod 2024; 28:e23spe6. [PMID: 38198351 PMCID: PMC10768648 DOI: 10.1590/2177-6709.28.6.e23spe6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/10/2023] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION The benefits and safety of using orthodontic aligners have been reported more by clinical experience and expert opinion than by scientific evidence. Another important aspect is that aligners are constantly evolving. It is important to obtain evidence that allows for new updates in manufacturing technology, in the development of new movement planning protocols, in the incorporation and design of attachments, and in the aid of skeletal anchorage. METHODS Evidence retrieved from six electronic databases (CINAHL, MEDLINE, EMBASE, Psych Info, the Cochrane Library and the Joanna Briggs Library) is presented by means of questions and answers. CONCLUSIONS There is evidence that the aligners presented different levels of difficulty in performing each type of movement, with rotational and vertical movements being the most difficult to perform. Regarding perception of pain due to tooth movement, it seems to have less impact at the beginning of treatment; but dealing with more phonoarticulatory changes seems to require more treatment time in more complex cases. Aligners do not prevent the occurrence of root resorption, although the incidence and severity of resorption may be reduced, making oral hygiene easier and accepting the risk of white spots, caries and periodontal disease. Given the conflicting evidence, the release of bisphenol-A from the aligner cannot be denied. Solutions must be found to reduce the environmental impact of aligners disposal. There is an urgent need for well-designed randomized controlled trials.
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Affiliation(s)
| | | | | | | | - David Normando
- Universidade Federal do Pará (UFPA), Departamento de Ortodontia (Belém/PA, Brazil)
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Castroflorio T, Sedran A, Parrini S, Garino F, Reverdito M, Capuozzo R, Mutinelli S, Grybauskas S, Vaitiekūnas M, Deregibus A. Correction to: Predictability of orthodontic tooth movement with aligners: effect of treatment design. Prog Orthod 2023; 24:47. [PMID: 37874472 PMCID: PMC10597921 DOI: 10.1186/s40510-023-00499-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023] Open
Affiliation(s)
- Tommaso Castroflorio
- Department of Surgical Sciences, Dental School of the University of Torino, Via Nizza 230, 10126, Turin, Italy
| | - Ambra Sedran
- Department of Surgical Sciences, Dental School of the University of Torino, Via Nizza 230, 10126, Turin, Italy.
| | | | | | | | | | - Sabrina Mutinelli
- Department of Neuroscience, School of Dentistry, Section of Pedodontics, University of Padova, Via VII Febbraio 2, 35122, Padua, Italy
| | | | | | - Andrea Deregibus
- Department of Surgical Sciences, Dental School of the University of Torino, Via Nizza 230, 10126, Turin, Italy
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Yi WJ, Zhang JY, Kong WD, Mai AD, Duan JH. Clinical research on the relationship between the curve of Wilson and temporomandibular joint disorders. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101496. [PMID: 37182758 DOI: 10.1016/j.jormas.2023.101496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/18/2023] [Accepted: 05/10/2023] [Indexed: 05/16/2023]
Abstract
OBJECTIVE The aim of this study was to examine the relationship between the curve of Wilson (COW) and temporomandibular joint disorder (TMD). METHODS The study cohort comprised patients aged 19-55 with malocclusion treated at our institution from January to July 2021. They were divided into a malocclusion with TMD group (TMD group) and a malocclusion without TMD group (non-TMB group) based on the diagnostic criteria of TMD. The study outcome was the differences in COW, measured via cone beam computed tomography (CBCT), and statistical analysis was performed using one-way analysis of variance and t-test. RESULTS A total of 250 adult individuals were enrolled, including 162 females (age: 36.43 ± 11.00 years) and 88 males (age: 36.33 ± 9.88 years). Compared with the non-TMB group (n = 125), the TMD group (n = 125) had a significantly greater angle of COW (first molars: P = 0.002; second molars: P < 0.001), higher buccal inclination angle of molars in those with same side temporomandibular joint (TMJ) sounds than those with TMJ sounds (first molar: P = 0.000; second molar: P = 0.006) and greater the side with TMJ sounds (first molar: P < 0.001; second molar: P = 0.016). However, no difference was observed in the buccolingual axial inclination angle of molars between patients with and without TMJ sounds. CONCLUSION The study reported the differences in malocclusion patients with and without TMB, which could be used as a reference by dentists to improve the treatment outcomes of these patients.
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Affiliation(s)
- Wen-Jing Yi
- Shenzhen Stomatology Hospital (Pingshan) of Southern Medical University, Shenzhen, Guangdong 518118, China
| | - Jing-Ya Zhang
- Shenzhen Stomatology Hospital (Pingshan) of Southern Medical University, Shenzhen, Guangdong 518118, China
| | - Wen-da Kong
- Shenzhen Stomatology Hospital (Pingshan) of Southern Medical University, Shenzhen, Guangdong 518118, China
| | - Ai-Die Mai
- Shenzhen Stomatology Hospital (Pingshan) of Southern Medical University, Shenzhen, Guangdong 518118, China
| | - Jiao-Hong Duan
- Shenzhen Stomatology Hospital (Pingshan) of Southern Medical University, Shenzhen, Guangdong 518118, China.
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Lim ZW, Weir T, Meade MJ. The predictability of maxillary curve of Wilson leveling with the Invisalign appliance. J World Fed Orthod 2023; 12:207-212. [PMID: 37357088 DOI: 10.1016/j.ejwf.2023.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/27/2023] [Accepted: 05/31/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND This retrospective study aims to evaluate the predictability of the Invisalign appliance (Align Technology, Santa Clara, CA) in leveling the maxillary curve of Wilson (COW). METHODS 53 adult subjects treated by orthodontists who are experienced Invisalign providers, between 2013 and 2019 were selected. All patients had either Angle Class I or II malocclusions and were treated by non-extraction in the maxillary arch with a minimum of 14 Invisalign aligners with no bite ramps or auxiliaries. Initial, predicted, and actual outcomes were analyzed with Geomagic Control X software (3D systems, Rock Hill, SC; Version 2017.0.3). RESULTS Despite planning mean (SD) COW leveling of 0.25 mm (1.91), the curve became significantly more pronounced by 1.15 mm (0.85) (P < .001). There was a significant overexpression of buccal inclinations between mean prescribed versus actual values from 0.10 mm (0.39) (P = .007) to 0.29 mm (0.47) (P < .001) from the first premolars to the second molars, respectively. These differences were more pronounced posteriorly. The differences between the predicted and actual arch width values were underexpressed for all teeth except the second molars; a mean underexpression between 0.28 mm (0.92) and 0.60 mm (1.14). The second molars were the only teeth to overexpress with a mean of 0.42 mm (1.02). CONCLUSIONS Overall mean maxillary COW was not predictably controlled with Invisalign. The appliance tends to overexpress the buccal crown tip regardless of prescribed direction, especially posteriorly. Arch expansion was underexpressed at all levels of the arch except for second molars which overexpressed by almost four times.
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Affiliation(s)
- Zi Wei Lim
- Orthodontic Resident, Department of Orthodontics, Adelaide Dental School, The University of Adelaide, South Australia, Australia.
| | - Tony Weir
- Honorary Clinical Senior Lecturer, Department of Orthodontics, Adelaide Dental School, The University of Adelaide, South Australia, Australia
| | - Maurice J Meade
- Associate Professor, Department of Orthodontics, Adelaide Dental School, The University of Adelaide, South Australia, Australia
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Echarri-Nicolás J, González-Olmo MJ, Echarri-Labiondo P, Romero M. Changes in Molar Tipping and Surrounding Alveolar Bone with Different Designs of Skeletal Maxillary Expanders. Biomedicines 2023; 11:2380. [PMID: 37760821 PMCID: PMC10525421 DOI: 10.3390/biomedicines11092380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023] Open
Abstract
This study compared the buccolingual angulation (BLA) of the upper and lower first permanent molars before and after using the different methods of microimplant-assisted expansion in adults and its influence on bone insertion loss. METHODS Cone-beam computed tomography scans taken before and after the expansion in 36 patients (29.9 ± 9.4 years) were used to assess dental and periodontal changes and compare changes between the groups. RESULTS This research shows a statistically significant increase in the BLA of the upper first molars. An increase of the BLA of the lower molars is also observed in MARPE. Regarding the comparison between cases treated with MARPE (4.42° ± 10.25°; 3.67° ± 9.56°) and BAME (-0.51° ± 4.61°; 2.34° ± 4.51°), it was observed that upper molar torque increased significantly less in cases treated with BAME. In cases with CWRU < 96° at T0, a slight bone insertion gain was observed at T1, whereas if CWRU ≥ 96°, a slight bone insertion loss was observed. Regarding the labial cortical bone loss, a slight gain of CBW was observed in all cases. This labial cortical enlargement (T0-T1) is greater in cases where the CWRU < 96° at T0. CONCLUSIONS Patients treated with MARPE show torque increase in the teeth selected to support the expansion appliance compared to cases treated with BAME. In cases where the BLA at T0 < 96°, an increase in thickness and cortical insertion is observed in the upper molars after treatment with disjunction appliances assisted with microscrews.
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Affiliation(s)
- Javier Echarri-Nicolás
- Doctoral Program in Health Sciences, International PhD School, Rey Juan Carlos University (URJC), 28922 Alcorcón, Spain;
| | | | | | - Martín Romero
- Department of Orthodontics, Rey Juan Carlos University, 28922 Alcorcón, Spain;
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Ma S, Wang Y. Clinical outcomes of arch expansion with Invisalign: a systematic review. BMC Oral Health 2023; 23:587. [PMID: 37620781 PMCID: PMC10464440 DOI: 10.1186/s12903-023-03302-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/10/2023] [Indexed: 08/26/2023] Open
Abstract
OBJECTIVE This study aims to assess the scientific evidence regarding the clinical outcomes of Invisalign therapy in controlling orthodontic tooth movement. MATERIALS AND METHODS An electronic search was conducted on PubMed, Cochrane Library, Web of Science, Embase, and Scopus from November 2015 to November 2022 to identify relevant articles. Methodological shortcomings were highlighted, and an evaluation of the quality of the included studies was completed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. RESULTS Fifteen non-randomized controlled trials were included in the analysis. Most non-randomized controlled trials (n=11; 73%) were rated with a moderate risk of bias according to the ROBINS-I tool. There were statistically significant differences between the pretreatment and posttreatment arches. The average expansion was significantly different from that predicted for each type of tooth in both the maxilla and mandible. Furthermore, the efficiency decreased from the anterior area to the posterior area in the upper arch. CONCLUSION Despite the fact that arch expansion with Invisalign® is not entirely predictable, clear aligner treatment is a viable option for addressing dentition crowding. The efficacy of expansion is greatest in the premolar area. More research focusing on treatment outcomes with different materials of aligners should be conducted in the future. Overcorrection should be considered when planning arch expansion with Invisalign. In the maxilla, the expansion rate decreases from the anterior to the posterior, and presetting sufficient buccal root torque of posterior teeth may result in improved efficiency of expansion.
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Affiliation(s)
- Songyang Ma
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, People's Republic of China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, People's Republic of China
| | - Yunji Wang
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, People's Republic of China.
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, People's Republic of China.
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15
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Castroflorio T, Sedran A, Parrini S, Garino F, Reverdito M, Capuozzo R, Mutinelli S, Grybauskas S, Vaitiekūnas M, Deregibus A. Predictability of orthodontic tooth movement with aligners: effect of treatment design. Prog Orthod 2023; 24:2. [PMID: 36642743 PMCID: PMC9840984 DOI: 10.1186/s40510-022-00453-0] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 12/17/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUNDS The present study was designed to define: (1) which are the less predictable OTM with Invisalign aligners when the treatment plan is designed by expert operators, (2) if the presence and shape of attachments influence the predictability of OTM and (3) if patients' demographics influence OTM predictability. The sample comprises 79 prospectively recruited patients (mean age 30.8 years; SD 12.0; 23 M, 56 F), treated by expert operators with an average of 27 aligners (SD 15) in the maxillary arch and 25 aligners (SD 11) in the mandibular arch. Post-treatment digital models and final virtual treatment plan models were exported from ClinCheck® software as STL files and subsequently imported into Geomagic Qualify ®software, to compare final teeth positions. The differences were calculated and tested for statistical significance for each tooth in the mesial-distal, vestibular-lingual and occlusal-gingival directions, as well as for angulation, inclination and rotation. In addition, the statistical significance of categorical variables was tested. RESULTS The lack of correction was significant for all movements and in all group of teeth (P < 0.01) except for the rotation of maxillary first molar. The prescribed OTM, the group of teeth and movement, the frequency of aligner change and the use of attachment influence the outcome. The greatest discrepancies in predicted and achieved tooth position were found for angular movements and rotation of teeth characterized by round-shaped crowns, for a ratio of approximately 0.4° per 1° prescribed. Optimized attachments for upper canines and lower premolar rotation seem not working properly. Second molar movements are mostly unexpressed. Furthermore, changing the aligner every 14 days will reduce the lack of correction of the 12% with respect to 7 days aligner change. CONCLUSIONS Predictability of orthodontic movement with aligners still has limitations related to the biomechanics of the system: the shape of some attachments and the characteristics of aligner material need to be redefined. However, the results of this study allow to properly design the virtual treatment plan, revealing how much overcorrection is needed and which attachments are most effective.
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Affiliation(s)
- Tommaso Castroflorio
- Department of Surgical Sciences, Dental School of the University of Torino, Via Nizza 230, 10126, Turin, Italy
| | - Ambra Sedran
- Department of Surgical Sciences, Dental School of the University of Torino, Via Nizza 230, 10126, Turin, Italy.
| | | | | | | | | | - Sabrina Mutinelli
- Department of Neuroscience, School of Dentistry, Section of Pedodontics, University of Padova, Via VII Febbraio 2, 35122, Padua, Italy
| | | | | | - Andrea Deregibus
- Department of Surgical Sciences, Dental School of the University of Torino, Via Nizza 230, 10126, Turin, Italy
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