Complete Maxillary Crossbite Correction with a Rapid Palatal Expansion in Mixed Dentition Followed by a Corrective Orthodontic Treatment

Digital Workflow for Indirect Bonding with 2D Lingual Brackets: A Case Report and Procedure Description

OBJECTIVE

During orthodontic therapy, accuracy in bonding procedures makes it easier to correct tooth alignment by decreasing the need for midcourse corrections by changing bracket positions. Indirect bonding allows the transfer of the appliance components from model casts to patient's teeth potentially meaning shorter appointments for bracket bonding and rebonding and best comfort during chairside practice. At the same time, there has been a steady increase in requests for invisible lingual orthodontic treatment.

CLINICAL CONSIDERATIONS

Accordingly, the aim of the present report is to illustrate the workflow to realize a complete digital indirect bonding for lingual brackets (2D, Forestadent). The procedure starts with intraoral digital scans, digital 3D model, and virtual bracket positioning, ending with the realization of a CAD-CAM prototyped transfer tray. A 3D intraoral scanner (True Definition, 3M) is used to create digital scans and digital models. A virtual bracket positioning is performed using software (NemoCast, Dentaurum), and a prototyped transfer tray is created by a CAD-CAM device. 2D lingual brackets were positioned inside the tray, so the appliance was bonded to the dental surface using light curing adhesive resin.

CONCLUSIONS

During orthodontic treatment, CAD/CAM technology could help clinicians. Computer-constructed transfer trays can reduce clinician error and improve the everyday workflow in the office.

Soft-tissue cone-beam computed tomography (ST-CBCT) technique for the analysis of skeletal, dental and periodontal effects of orthopedic rapid maxillary expansion

BACKGROUND

Orthopedic rapid maxillary expansion (RME) is a common treatment of choice for managing transverse deficiency of the maxilla. This approach may have desired and undesired skeletal, dental and periodontal effects that may be assessed clinically or through imaging techniques. This study aims to investigate the dental, skeletal and periodontal effects of orthopedic RME using the soft-tissue cone-beam computed tomography (CBCT) technique.

MATERIAL AND METHODS

The sample consisted of 10 patients (5males and 5 females) aged between 10 and 14 years (mean age: 12.5 years) treated with Hyrax orthopedic device. CBCT scans set for the registration of soft tissue (ST-CBCT) were taken from each patient before (T1) and 120 days after (T2) RME. Skeletal (n=10), dental (n=1) and periodontal (n=4) parameters measured in ST-CBCT were compared between T1 and T2 using t-test within a significance level of 5%.

RESULTS

The skeletal parameters with statistically significant increase (p<0.05) in T2 were the width of the buccal alveolar bone crest, the external width of the dental arch at the level of buccal cusps, and the width of the dental arch at the level of most prominent dental surface contour. Representing the dental parameter, the inclination of the anchor teeth was statistically significant for premolars (p<0.05). The only statistically significant outcome in periodontal parameters was the decrease in buccal bone plate thickness of first molars (p<0.05).

CONCLUSIONS

Dentists must be aware of the ST-CBCT technique for the analysis of hard and soft tissue after orthodontic and orthopedic treatments. This technique revealed that the RME reached optimal skeletal and dental effects with minimal periodontal side effects. Key words:Cone-beam computed tomography, imaging, orthodontics, orthopedics.