The predictability of maxillary curve of Wilson leveling with the Invisalign appliance

Clinical Efficacy of Nasoalveolar Moulding Using Aligner NAM During Presurgical Infant Orthopaedics (PSIO) in Infants With Unilateral Cleft Lip and Palate (UCLP): A Retrospective Study

OBJECTIVE

The study compares and evaluates planned virtual outcomes with actual post-treatment outcomes to assess the accuracy and predictability of clinical results during presurgical infant orthopaedics (PSIO) with AlignerNAM in infants with unilateral cleft lip and palate.

SETTING

Institutional study.

PARTICIPANTS

14 UCLP patients.

MATERIALS AND METHODS

Digital models for infants with unilateral cleft lip and palate (UCLP) who had undergone PSIO with AlignerNAM between 1 and 6 weeks were obtained at three stages-pretreatment (To), planned (Tp) and post-treatment (T1). Linear and angular measurements were made on these using the OrthoAnalyser software (3Shape, Copenhagen, Denmark). A paired t-test and Bland-Altman analysis assessed the accuracy between predicted and achieved movements, while inter- and intra-rater reliabilities were also calculated using digital records of seven patients.

RESULTS

The study found no significant difference (p > 0.05) between the clinical outcome (post-treatment) values and the predicted values (obtained from the virtual post-treatment simulation/planned movement). The sagittal reduction in the cleft defect demonstrated the highest accuracy (97.71%), followed by the transverse reduction (95.1%). Overall, linear measurements achieved an accuracy of 94.57% and angular measurements an accuracy of 93.64%. All measurements were within the limits of agreement based on the Bland-Altman plots. The widths of limits of agreement were narrow and similar for both linear and angular measurements showing high levels of agreement.

CONCLUSION

AlignerNAM showed high accuracy in reducing cleft size and aligning alveolar segments in UCLP patients, achieving accuracy rates above 90% in both linear and angular dimensions. AlignerNAM appliance is a suitable alternative to conventional PSIO techniques.

A Cross-Sectional Survey of the Use of Clear Aligners by General Dentists in Australia

OBJECTIVES

The primary aim of the investigation was to survey clear aligner therapy (CAT) use among general dentists in Australia. A secondary aim was to evaluate the factors that influenced general dentists in Australia not to provide CAT.

MATERIAL AND METHODS

General dentists registered with the Australian Health Practitioner Regulation Agency were invited to participate in a structured cross-sectional electronic survey. The survey covered demographics, preferred CAT systems and practices, relevant treatment planning and retention protocols, patient-reported CAT issues, pertinent respondent opinions, and reasons for not providing CAT. Descriptive statistics were computed via GraphPad Prism v10 (GraphPad Software Inc., La Jolla, CA, USA).

RESULTS

Most of the 264 (n = 172; 65.2%) respondents indicated that they provided CAT. The majority (n = 82; 58.6%) reported that they treated between 1 and 20 patients with CAT annually. Invisalign was the most used system (n = 83; 61.2%), with 55 (41.7%), indicating that they used more than one system. Most (n = 124; 98.4%) were comfortable using CAT for mild crowding, whereas 73.4% (n = 94) were not comfortable in treating severe crowding with CAT. The median (IQR) number of patients per respondent treated with extraction of a permanent incisor or premolar was 0 (0). Issues regarding tooth positions were reportedly always or mostly in need of change in the initial treatment plan by 68.7%. Problems regarding patient compliance with CAT wear protocols (n = 67; 45.6%) and the predictability of treatment outcomes (n = 31; 21.1%) were the most identified themes of the free-text comments. Over 80% of those who did not provide CAT indicated that they preferred to refer to an orthodontist for management.

CONCLUSION

Almost two-thirds of the respondents provided CAT. Invisalign was the most used system. The majority use CAT combined with nonextraction treatment. Most of those who did not provide CAT preferred to refer to an orthodontist for patient management.

Unplanned tooth movement in deepbite correction with Invisalign: A retrospective study

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.

Invisalign Lite: a cross-sectional investigation of orthodontist treatment-planning practices

OBJECTIVES

To survey treatment-planning practices of orthodontists related to the Invisalign Lite clear aligner appliance (Align Technology, San Jose, Calif).

MATERIALS AND METHODS

Patients satisfying inclusion and exclusion criteria and treated with Invisalign Lite were selected from a database containing more than 17,000 patients. Relevant data regarding treatment-planning practices were obtained from Align Technology's treatment-planning facility, ClinCheck, and evaluated.

RESULTS

Most (n = 135; 79.9%) patients were female and had a median (interquartile range [IQR]) age of 30.5 (23.8, 43.1) years. The median (IQR) number of aligners for the sample was 23.0 (14, 28) for the maxilla and 24 (14, 28) for the mandible. Most (n = 122; 72.2%) patients required at least one additional series of aligners. More locations for interproximal reduction (IPR) were prescribed in the mandible (mean 1.91 [1.78]) than in the maxilla (1.03 [1.78]; P < .024) in the initial accepted plan of all patients. More teeth were prescribed composite resin (CR) attachments in the maxilla (P < .0001) in the initial accepted plan of all patients. Issues regarding tooth position protocols (n = 50; 53.3%) and requirement for additional IPR (n = 68; 45.3%) were reasons for treatment plan changes before acceptance of the initial treatment plan by orthodontists.

CONCLUSIONS

More than 7 of 10 patients required at least one additional series of aligners after the initial series of Invisalign Lite aligners was completed. Prescription of IPR was more common in the mandible, and prescription of CR attachments was more common in the maxilla.