1
|
Wang Y, Zhou S, Zheng J, Yan L, Ngan P, Hua F, He H. Comparison of treatment effects between clear aligners and fixed appliances in patients treated with miniscrew-assisted molar distalization. Eur J Orthod 2024; 46:cjae021. [PMID: 38733349 DOI: 10.1093/ejo/cjae021] [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] [Indexed: 05/13/2024]
Abstract
OBJECTIVES The biomechanics in achieving molar distalization may differ between fixed appliances and clear aligners in the control of tooth movement. The objective of this study was to compare the treatment effects between clear aligners (CA) and fixed appliances (FA) in patients treated with miniscrew-assisted molar distalization. METHODS The sample consisted of 46 subjects with mild-to-moderate crowding. A total of 22 patients treated with clear aligners (age, 25.66 ± 6.11 years old) and 24 patients treated with fixed appliances (age, 24.04 ± 4.95 years old) for miniscrew-assisted molar distalization were included in this study. The dental and skeletal changes were evaluated by the pre- and post-treatment lateral cephalograms. RESULTS Significant changes were found with the vertical variables SN-OP angle (2.24 ± 3.22°, P < .05) and SN-MP angle (0.73 ± 1.15°, P < .05) for the FA group when compared with the CA group (SN-OP angle 0.41 ± 2.26° and SN-MP angle -0.21 ± 1.38°, P > .05). Both treatment groups achieved a 2-3 mm. molar distalization with significant intrusion of the upper molars. The CA group showed significantly less distal tipping of molars (U6^PP angle -2.29 ± 3.29° and L6^MP angle -2.92 ± 2.49°, P < .05) compared to the FA group (-5.24 ± 4.28° and -5.53 ± 5.03°, P < .05). In addition, significant retraction and lingual inclination of the upper and lower incisors were found in both groups. LIMITATIONS The changes of tooth position were evaluated by 2D lateral cephalograms, not 3D measurements. CONCLUSIONS Compared to fixed appliances, clear aligners seemed to have better control of vertical dimension and distal tipping of molars in patients treated with miniscrew-assisted molar distalization.
Collapse
Affiliation(s)
- Yunlei Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Orthodontics and Pediatric Dentistry at Optics Valley Branch, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development & Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Shunquan Zhou
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development & Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jie Zheng
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development & Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Lin Yan
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Peter Ngan
- Department of Orthodontics, West Virginia University, Morgantown, WV, United States
| | - Fang Hua
- Center for Orthodontics and Pediatric Dentistry at Optics Valley Branch, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development & Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Hong He
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development & Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| |
Collapse
|
2
|
Al-Worafi NA, Al-Aroomi MA, Al-Nasri A, Al-Balaa M, Al-Warafi LA, Al-Rokhami RK, Liu Y. Evaluation of maxillary sinus changes following molar distalization using clear aligners: A three-dimensional study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101815. [PMID: 38458547 DOI: 10.1016/j.jormas.2024.101815] [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: 02/15/2024] [Accepted: 03/05/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE To evaluate the impact of molar distalization with clear aligners (CAs) on maxillary sinus parameters and its proximity to the root apices of maxillary molars using Cone Beam Computed Tomography (CBCT). METHODS The study involved pre- and post-treatment CBCT images of 27 adult patients. MIMICS 21.0 software was used to measure maxillary sinus volume and surface area, while Invivo Dental 6.0 program was used to measure the sinus diameters and proximity of the maxillary molar root apices to the sinus floor. RESULTS Post-treatment, there was a marked increase in the average volume and surface area of the maxillary sinus on both sides; however, changes in dimensions were not statistically significant. Sinus proximity to the root apices of the maxillary molars showed statistically significant differences, particularly on the left side for all roots. Gender and age impacted the outcomes, with males and younger individuals showing more pronounced changes. No significant differences were observed between the left and right sinuses in all parameters. CONCLUSION Molar distalization with CAs increases maxillary sinus parameters, more notably in younger and male patients. All molar teeth roots moved toward the sinus, particularly the mesiobuccal root of the maxillary second molar protruded to the sinus.
Collapse
Affiliation(s)
- Naseem Ali Al-Worafi
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, Shenyang Clinical Medical Research Center of Orthodontic Disease, Shenyang 110002, PR China
| | - Maged Ali Al-Aroomi
- Department of Oral and Maxillofacial Surgery, Center of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | | | - Maher Al-Balaa
- Department of Orthodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Leena Ali Al-Warafi
- Department of Orthodontics, Faculty of Dentistry, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Remsh Khaled Al-Rokhami
- Department of Orthodontics, Affiliated Stomatological Hospital of Nanchang University, Nanchang, China
| | - Yi Liu
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, Shenyang Clinical Medical Research Center of Orthodontic Disease, Shenyang 110002, PR China.
| |
Collapse
|
3
|
Park TH, Shen C, Chung CH, Li C. Vertical Control in Molar Distalization by Clear Aligners: A Systematic Review and Meta-Analysis. J Clin Med 2024; 13:2845. [PMID: 38792385 PMCID: PMC11122287 DOI: 10.3390/jcm13102845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Molar distalization is used to correct molar relationships or to create space for mild anterior crowding. However, whether clear aligners can provide proper vertical control with the sequential distalization strategy has been highly debated. Thus, the current study aimed to systematically review the amount of dentoskeletal changes in the vertical dimension that results from sequential molar distalization in clear aligner therapy without temporary anchorage devices (TADs). Methods: Registered with PROSPERO (CRD42023447211), relevant original studies were screened from seven databases and supplemented by a manual search by two investigators independently. Articles were screened against inclusion and exclusion criteria, and a risk of bias assessment was conducted for each included article. Relevant data were extracted from the included articles and meta-analysis was performed using RStudio. Results: Eleven articles (nine for maxillary distalization and two for mandibular distalization) were selected for the final review. All studies have a high or medium risk of bias. For maxillary molar distalization, the meta-analysis revealed 0.26 mm [0.23 mm, 0.29 mm] of maxillary first molar intrusion based on post-distalization dental model analysis, as well as 0.50 mm [-0.78 mm, 1.78 mm] of maxillary first molar intrusion and 0.60 mm [-0.42 mm, 1.62 mm] of maxillary second molar intrusion based on post-treatment lateral cephalometric analysis. Skeletally, there was a -0.33° [-0.67°, 0.02°] change in the SN-GoGn angle, -0.23° [-0.30°, 0.75°] change in the SN-MP angle, and 0.09° [-0.83°, 1.01°] change in the PP-GoGn angle based on post-treatment lateral cephalometric analysis. There was insufficient data for meta-analysis for mandibular molar distalization. Conclusions: No significant changes in vertical dimension were observed, both dentally and skeletally, after maxillary molar distalization with a sequential distalization strategy. However, further studies on this topic are needed due to the high risk of bias in the currently available studies.
Collapse
Affiliation(s)
- Tiffany H. Park
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Christie Shen
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (C.S.); (C.-H.C.)
| | - Chun-Hsi Chung
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (C.S.); (C.-H.C.)
| | - Chenshuang Li
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (C.S.); (C.-H.C.)
| |
Collapse
|
4
|
AlMogbel A, Alshawy ES, Alhusainy A. Efficacy of clear aligner therapy over conventional fixed appliances in controlling orthodontic movement: A systematic review. J Orthod Sci 2024; 13:23. [PMID: 38784075 PMCID: PMC11114459 DOI: 10.4103/jos.jos_176_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/10/2023] [Accepted: 01/03/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE The purpose of the current systematic review was to answer the clinical research question "Is Clear Aligner Therapy (CAT) effective in controlling the orthodontic movement?" by bringing together the most up-to-date information about the available evidence for CAT. METHODOLOGY On January 1, 2023, a search was conducted in PubMed, ERIC, Embase, and CINHAL for any research papers published in the previous 10 years that provided an overview of the PICO questions. Both the titles and abstracts of the selected studies were evaluated independently by two different authors, and if there was any disagreement between the two review authors, a third reviewer was brought in to settle it. RESULTS Among included studies, three were retrospective non-randomized and two studies were prospective randomized clinical trials. Various authors reported better outcome for fixed orthodontic appliances than for clear aligner treatment (CAT) in relation to mandibular incisor proclination. The mean objective grading system score was better for braces (17) than for CAT (12) with no clinically significant difference, while staging had a significant impact on treatment efficacy. CONCLUSION The results of this study suggest that clear aligners may be an effective alternative to traditional braces, but more research is needed to confirm these findings and determine the optimal size of future prospective studies evaluating this treatment.
Collapse
Affiliation(s)
- AbdulMajeed AlMogbel
- Department of Orthodontics and Pediatric Dentistry, College of Dentistry, Qassim University, Buraydah 52571, Saudi Arabia
| | - Ebrahim S. Alshawy
- Department of Orthodontics and Pediatric Dentistry, College of Dentistry, Qassim University, Buraydah 52571, Saudi Arabia
| | - Abdulmageed Alhusainy
- Department of Conservative Dentistry, College of Dentistry, Qassim University, Buraydah 52571, Saudi Arabia
| |
Collapse
|
5
|
Keilig L, Fittgen A, Schneider H, Sifa R, Schwarze J, Bourauel C, Konermann A. Accuracy of Digital Orthodontic Treatment Planning: Assessing Aligner-Directed Tooth Movements and Exploring Inherent Intramaxillary Side Effects. J Clin Med 2024; 13:2298. [PMID: 38673571 PMCID: PMC11051260 DOI: 10.3390/jcm13082298] [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: 03/18/2024] [Revised: 04/03/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Background: The attainment of precise posterior occlusion alignment necessitates a deeper understanding of the clinical efficacy of aligner therapy. This study aims to determine whether the treatment goals defined in the virtual planning of aligner therapy are effectively implemented in clinical practice, with a particular focus on the influence of distalization distances on potential vertical side effects. Methods: In this retrospective, non-interventional investigation, a cohort of 20 individuals undergoing Invisalign® treatment was examined. Pre- and post-treatment maxillary clinical and ClinCheck® casts were superimposed utilizing a surface-surface matching algorithm on palatal folds, median palatine raphe, and unmoved teeth as the stable references. The effectivity of planned versus clinical movements was evaluated. Groupings were based on distalization distances, planned vertical movements, and Class II elastic prescription. Statistics were performed with a two-sample t-test and p-value < 0.05. Results: Clinically achieved distalization was significantly lower than virtually planned distalization, regardless of additional vertical movements, where a lack of implementation was contingent upon the extent of distalization, with no mitigating effects observed with the application of Class II elastics. Intriguingly, no adverse vertical side effects were noted; however, the intended intrusions or extrusions, as per the therapeutic plans, remained unattainable regardless of the magnitude of distalization. Conclusions: These findings underscore the imperative for future investigations to delve deeper into the intricacies surrounding translational mesio-distal and vertical movements, thereby enhancing predictability within orthodontic practice. To facilitate successful clinical implementation of vertical and translational movements via aligners, the incorporation of sliders emerges as a promising strategy for bolstering anchorage reinforcement.
Collapse
Affiliation(s)
- Ludger Keilig
- Oral Technology, University Hospital Bonn, 53111 Bonn, Germany
- Department of Prosthodontics, University Hospital Bonn, 53111 Bonn, Germany
| | - Anna Fittgen
- Department of Orthodontics, University Hospital Bonn, 53111 Bonn, Germany
| | - Helen Schneider
- Fraunhofer-Institute for Intelligent Analysis- and Informationsystems IAIS, 53757 Sankt Augustin, Germany
| | - Rafet Sifa
- Bonn-Aachen International Center for Information Technology (B-IT), LAMARR Institute for Machine Learning and Artificial Intelligence, University of Bonn, 53115 Bonn, Germany
| | | | | | - Anna Konermann
- Department of Orthodontics, University Hospital Bonn, 53111 Bonn, Germany
| |
Collapse
|
6
|
Castroflorio T, Parrini S, Rossini G. Aligner biomechanics: Where we are now and where we are heading for. J World Fed Orthod 2024; 13:57-64. [PMID: 38228450 DOI: 10.1016/j.ejwf.2023.12.005] [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: 11/16/2023] [Accepted: 12/07/2023] [Indexed: 01/18/2024]
Abstract
Aligner orthodontics has gained significant popularity as an alternative to traditional braces because of its aesthetic appeal and comfort. The biomechanical principles that underlie aligner orthodontics play a crucial role in achieving successful outcomes. The biomechanics of aligner orthodontics revolve around controlled force application, tooth movement, and tissue response. Efficient biomechanics in aligner orthodontics involves consideration of attachment design and optimized force systems. Attachments are tooth-colored shapes bonded to teeth, aiding in torque, rotation, and extrusion movements. Optimized force systems ensure that forces are directed along the desired movement path, reducing unnecessary strain on surrounding tissues. Understanding and manipulating the biomechanics of aligner orthodontics is essential for orthodontists to achieve optimal treatment outcomes. This approach requires careful treatment planning, considering the mechanics required for each patient's specific malocclusion. As aligner orthodontics continues to evolve, advances in material science and treatment planning software contribute to refining biomechanical strategies, enhancing treatment efficiency, and expanding the scope of cases that can be successfully treated with aligners.
Collapse
Affiliation(s)
| | - Simone Parrini
- Research Assistant, Department of Orthodontics, Dental School, University of Turin, Turin, Italy
| | - Gabriele Rossini
- Board Director, Clear Aligner Academy Italia, Turin, Italy; Private Practice, Milan, Italy
| |
Collapse
|
7
|
Abdelemam AA, Abdelrahman HH, Hassan MG. #clearaligners and social media: An in-depth analysis of clear aligners' content on Instagram. Orthod Craniofac Res 2024; 27:259-266. [PMID: 37854022 DOI: 10.1111/ocr.12722] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND AND OBJECTIVES Clear aligners-related posts are popularized on social media platforms to educate patients and peers and to market aligners in dental practices. This study aimed to characterize the account credentials and content of the top-performing posts to understand the spread of clear aligners-related information on Instagram. MATERIALS AND METHODS This cross-sectional web-based study analysed 13 Instagram clear aligners-related hashtags. Content analysis was performed for the "Top 10 posts" listed under the "Top" section for each hashtag within Instagram, as sorted by Instagram's algorithm. Data were analysed for the poster's background, credentials, role, post format, content, and engagement level ratio. Duplicate posts and those not relevant to clear aligners were excluded. Quantitative and qualitative analyses of the collected data were conducted. RESULTS A total of 29 192 596 posts mentioned the selected hashtags, of which 130 posts were screened in this study. Most posts were authored by dentists (n = 84), 79.8% of them were orthodontic specialists. Self-promotional posts comprised 90.2%, while educational posts accounted for only 8.9%. Interestingly, the number of likes and comments received on posts by patients (n = 19, median = 112, IQR = 340) was significantly higher than those posted by dentists (n = 84, median = 93, IQR = 81.75) (P = .004). CONCLUSION More than 29 million posts about clear aligners were identified on Instagram. Orthodontists are the leading authors of aligners hashtags. However, the majority of the posts are self-promotional and have nonfactual information. Social media awareness among orthodontic specialists may help provide more evidence-based content about clear aligners and can act as an interactive networking and health communication platform.
Collapse
Affiliation(s)
- Ahmed A Abdelemam
- Department of Orthodontics, Faculty of Dentistry, Assiut University, Assiut, Egypt
| | - Hams H Abdelrahman
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Mohamed G Hassan
- Department of Orthodontics, Faculty of Dentistry, Assiut University, Assiut, Egypt
- Division of Bone and Mineral Diseases, Department of Medicine, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
| |
Collapse
|
8
|
Song JH, Lee JH, Joo BH, Choi YJ, Chung CJ, Kim KH. Treatment outcome comparison of Invisalign vs fixed appliance treatment in first premolar extraction patients. Am J Orthod Dentofacial Orthop 2024; 165:399-413. [PMID: 38142394 DOI: 10.1016/j.ajodo.2023.10.014] [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: 01/01/2023] [Revised: 10/01/2023] [Accepted: 10/01/2023] [Indexed: 12/25/2023]
Abstract
INTRODUCTION In this study, we compared the dentitional changes after Invisalign and conventional orthodontic treatment with 4 first premolar extractions. METHODS This retrospective study included 57 patients whose orthodontic treatment involved the extraction of 4 first premolars because of bialveolar protrusion. A total of 27 patients were treated with Invisalign (mean age, 25.5 ± 5.2 years) and 30 patients with the fixed appliance (mean age, 24.4 ± 5.8 years). The angular and linear changes of the maxillary and mandibular central incisors, second premolars, first molars, and second molars were measured from the recordings on the basis of the lateral cephalograms taken before and after treatment. The angular changes of the canines and second premolars were measured using panoramic radiographs. RESULTS The overbite and interincisal angle increased significantly in the Invisalign group compared with in the conventional fixed appliance group (P <0.05). The maxillary central incisors showed increased lingual tipping in the Invisalign group (P <0.05), whereas there was no statistically significant difference in the angular change of the mandibular incisors between groups (P >0.05). The maxillary first and second molars showed mesial tipping in the Invisalign group (P <0.05). The maxillary second premolars, first and second molars, and the mandibular second molars showed mesial movement in the Invisalign group (P <0.05). CONCLUSIONS The Invisalign group showed more statistically significant lingual tipping of the maxillary central incisors, distal tipping of the maxillary canines, and mesial tipping of the maxillary first and second molars after maximum retraction of the anterior teeth compared with the fixed appliance group.
Collapse
Affiliation(s)
- Ji-Hye Song
- Department of Orthodontics, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, South Korea
| | - Ji-Hyun Lee
- Department of Orthodontics, Gangnam Severance Dental Hospital, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, South Korea
| | - Bo-Hoon Joo
- The Institute of Clear Aligner Center of The STAR 28 Dental Group, Seoul, South Korea
| | - Yoon Jeong Choi
- Department of Orthodontics, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, South Korea
| | - Chooryung J Chung
- Department of Orthodontics, Gangnam Severance Dental Hospital, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, South Korea
| | - Kyung-Ho Kim
- Department of Orthodontics, Gangnam Severance Dental Hospital, The Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, South Korea.
| |
Collapse
|
9
|
Wang X, Gao J. Clear aligner treatment assisted by mini screw for an adult with Class II division 2 malocclusion and a right upper canine completely outside of the dental arch: A case report. Int Orthod 2024; 22:100837. [PMID: 38160659 DOI: 10.1016/j.ortho.2023.100837] [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: 11/03/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 01/03/2024]
Abstract
This case report describes a 19-year-old man presented with a 5.7-mm deep overbite, Class II division 2 malocclusion with the right upper maxillary canine completely buccal ectopia, deviated midline in the upper arch, severe crowding and retroclination of the maxillary and mandibular incisors. The patient was treated with clear aligners to correct the Class II relationship and the deep overbite. A series of clear aligners were used to move bilateral maxillary molars distally with unilateral mini-screw anchorage. The final results showed that clear aligners with mini-screws could effectively achieve the required upper distal molar movement thanks to a reasonable design of the stages and anchorage. The treatment was completed in 19 months and the patient was satisfied with the treatment outcome in this context of mild to moderate Class II division 2 malocclusion.
Collapse
Affiliation(s)
- Xian Wang
- 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, School of Stomatology, The Fourth Military Medical University, 710032 Xi'an, 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, School of Stomatology, The Fourth Military Medical University, 710032 Xi'an, China.
| |
Collapse
|
10
|
Martina H, Stefano Adriana AD, Ernesto B, Alessandra I, Roberto AV, Gabriella G. Lower molar distalization using clear aligners: Is it effective? A systematic review. J Orthod Sci 2024; 13:11. [PMID: 38516119 PMCID: PMC10953721 DOI: 10.4103/jos.jos_174_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/09/2024] [Accepted: 01/24/2024] [Indexed: 03/23/2024] Open
Abstract
Distalization is one of the most useful movements in orthodontic treatments. The aim of this systematic review is to analyze the effectiveness of lower molar distalization using clear aligner therapy (CAT). An electronic search was made from January 2012 to October 2022 using PubMed, Scopus, and LILACS databases without language limitations. This systematic review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses checklist. The search strategy resulted in 151 studies. A screening was performed to remove duplicates, and all the studies that did not respond to our questions for the title or abstract. Three studies underwent full text analysis. From the evaluation of the studies included in this review, it is possible to state that lower molar distalization is a clinical solution, but it is not a full bodily movement. CAT can provide more specifically a distal tipping movement. This is confirmed analyzing the discrepancy between expected movement and obtained movement. CAT can be considered a valid therapeutic option in patients with dental class III malocclusion, but it is obtained as a tipping movement instead of a body movement. Over-correction should be considered during the planning of the therapy.
Collapse
Affiliation(s)
- Horodynski Martina
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Roma RM, Italy
| | - A. De Stefano Adriana
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Roma RM, Italy
| | - Bottone Ernesto
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Roma RM, Italy
| | | | - A. Vernucci Roberto
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Roma RM, Italy
| | - Galluccio Gabriella
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Roma RM, Italy
| |
Collapse
|
11
|
Al-Worafi NA, Zheng B, Al-Warafi LA, Alyafrusee ES, Alsomairi MAA, Liu Y. Impact of molar teeth distalization by clear aligners on maxillary alveolar bone thickness and root resorption: a three‑dimensional study. BMC Oral Health 2024; 24:237. [PMID: 38355506 PMCID: PMC10868040 DOI: 10.1186/s12903-024-03987-3] [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: 10/06/2023] [Accepted: 02/05/2024] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVE This study aimed to evaluate the impact of molar teeth distalization movement by clear aligners on changes in the alveolar bone thickness and orthodontically induced inflammatory root resorption (OIIRR) in maxillary molars using conebeam computed tomography (CBCT). MATERIALS AND METHODS Three-dimensional CBCT scans of 35 adult patients (one hundred forty maxillary molars) with pre-designed selection criteria and a mean age of 24.4 ± 7.1 years were included. The measured parameters, including alveolar bone thickness for maxillary molars and root resorption (OIIRR), were analyzed using pre-and post-treatment CBCT (T0 and T1, respectively) with Invivo 6.0 software. RESULT Post-treatment, relevant statistically significant changes included deposition of bone in the average palatal surface of the 1st molars. The reduction of bone was seen in the average buccal surface of the first molars and both surfaces of the second molars. Regarding root length after treatment, the average maxillary 1st molar roots showed significant OIIRR (p < 0.001). CONCLUSION Clear aligner treatment could effectively reduce the incidence of alveolar bone thickness reduction and OIIRR in treating Class II malocclusions compared to conventional braces, as shown in previous studies. This research will aid in fully grasping the benefits of clear aligners.
Collapse
Affiliation(s)
- Naseem Ali Al-Worafi
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, Clinical Medical Research Center of Orthodontic Disease, Shenyang 110002, P.R. China
| | - Bowen Zheng
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, Clinical Medical Research Center of Orthodontic Disease, Shenyang 110002, P.R. China
| | - Leena Ali Al-Warafi
- Department of Orthodontics, Faculty of Dentistry, First Affiliated Hospital of Zhengzhou University, Zhengzhou, P.R. China
| | - Enas Senan Alyafrusee
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, Clinical Medical Research Center of Orthodontic Disease, Shenyang 110002, P.R. China
| | - Majedh Abdo Ali Alsomairi
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, Clinical Medical Research Center of Orthodontic Disease, Shenyang 110002, P.R. China
| | - Yi Liu
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, Clinical Medical Research Center of Orthodontic Disease, Shenyang 110002, P.R. China.
| |
Collapse
|
12
|
Gao Y, Sun X, Yan X, Tang Z, Lai W, Long H. Orthodontic Practitioners' Knowledge and Education Demand on Clear Aligner Therapy. Int Dent J 2024; 74:81-87. [PMID: 37500450 PMCID: PMC10829360 DOI: 10.1016/j.identj.2023.07.001] [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: 03/10/2023] [Revised: 06/14/2023] [Accepted: 07/03/2023] [Indexed: 07/29/2023] Open
Abstract
OBJECTIVES Clear aligner therapy (CAT) has been gaining popularity amongst the orthodontic community. No systematic course on CAT has been reported to date. The objectives of this study were to determine practitioners' knowledge and to offer insights for future tailored courses on CAT. METHODS An online questionnaire was distributed. The questionnaire comprised personal background information, predictability of tooth movement through CAT, and CAT knowledge that practitioners demanded to learn. Four senior expert orthodontists' answers to the predictability of tooth movement through CAT were averaged to be a standard reference. Descriptive statistics, 1-way analysis of variance (ANOVA), principal component analysis, Student t test, and multivariate logistics regression analysis were performed with significance set at P < .05. RESULTS In total, 190 practitioners participated in this study. As compared to the standard reference, participants overestimated the predictability of difficult-to-be-achived tooth movements (eg, molar mesialisation; P < .0001). Strategy of managing troubleshooting cases and extraction cases ranked the highest CAT knowledge that participants requested to learn. Practice type, number of completed CAT cases, number of undergoing CAT cases, years of practice, education background, and time of using CAT were the influencing factors of the questions regarding the predictability of tooth movement through CAT and CAT knowledge that were demanded to be learned. CONCLUSIONS The predictability of difficult-to-be-achieved tooth movement through CAT is often overestimated by practitioners with limited clinical experience. Tailored education on CAT, especially managing troubleshooting cases and extraction cases, should be designed for all practitioners.
Collapse
Affiliation(s)
- Yanzi Gao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xuejun Sun
- Department of Biostatistics, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, North Carolina, USA
| | - Xinyu Yan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ziwei Tang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wenli Lai
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hu Long
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| |
Collapse
|
13
|
Khursheed Alam M, Hajeer MY, Shqaidef A, Alswairki HJ, Alfawzan AA, Shrivastava D, Chandan Srivastava K, Cicciù M, Minervini G. Impact of various aligner auxiliaries on orthodontic activity: A systematic review and network meta-analysis. Saudi Dent J 2024; 36:199-207. [PMID: 38419986 PMCID: PMC10897539 DOI: 10.1016/j.sdentj.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/18/2023] [Accepted: 10/24/2023] [Indexed: 03/02/2024] Open
Abstract
Background It is imperative to analyze the forces and moments produced by various auxiliaries in order to select the optimal attachments and, eventually, to maximize the efficacy and efficiency of orthodontic therapy. Through this investigation, we aimed to highlight the impact of various aligner auxiliaries on orthodontic activity in patients undergoing orthodontic treatment on a pre/post treatment protocol basis. Methods After a thorough search of the online journals, a total of 482 documents were found using keywords such as "Orthodontic Treatment", "Aligner Auxiliaries", "Elastic Ligatures" and "Tooth Movement." The database research, elimination of duplicate studies, data extraction and risk of bias were performed by the authors independently. This systematic review and network meta-analysis included prospective studies and clinical trials to evaluate research that had looked at the impact of various aligner auxiliaries on orthodontic activity in patients undergoing orthodontic treatment. Results Eight investigations of varying designs were selected for this review. The majority of investigations revealed that aligner auxiliaries significantly improve anterior root torque, rotation, and mesio-distal (M-D) movement, as well as posterior anchoring. They also significantly improved anterior root rotation. However, few studies have presented inconsistent or non-statistically significant findings. Conclusion Auxiliaries for aligners also appear to improve extrusion and other orthodontic movements, but there is insufficient evidence to support these claims. No research has examined posterior bucco-lingual expansion or tilting. Clarification of the effect of attachments and their related variables requires additional clinical investigations.
Collapse
Affiliation(s)
- Mohammad Khursheed Alam
- Orthodontic Division, Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
- Department of Dental Research Cell, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India
- Department of Public Health, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, Bangladesh
| | - Mohammad Younis Hajeer
- Department of Orthodontics, University of Damascus Faculty of Dentistry, Damascus, Syria
| | - Abedalrahman Shqaidef
- Department of Clinical Sciences, Center of Medical and Bio-Allied Health Sciences Research, College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | | | - Ahmed Ali Alfawzan
- Department of Preventive Dentistry, College of Dentistry in Ar Rass, Qassim University, Ar Rass 52571, Saudi Arabia
| | - Deepti Shrivastava
- Periodontics Division, Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
| | - Kumar Chandan Srivastava
- Department of Oral & Maxillofacial Surgery & Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
- Department of Oral Medicine and Radiology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 602105, India
| | - Marco Cicciù
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123 Catania, Italy
| | - Giuseppe Minervini
- Saveetha Dental College & Hospitals, Saveetha Institute of Medical & Technical Sciences, Saveetha University, Chennai 600 077, India
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania, Luigi Vanvitelli, 80138 Naples, Italy
| |
Collapse
|
14
|
Cheng L, Feng Z, Hao Z, Si M, Yuan R, Feng Z. Molar distalization in orthodontics: a bibliometric analysis. Clin Oral Investig 2024; 28:123. [PMID: 38286861 PMCID: PMC10824817 DOI: 10.1007/s00784-024-05520-w] [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: 09/26/2023] [Accepted: 01/17/2024] [Indexed: 01/31/2024]
Abstract
OBJECTIVES The study endeavors to undertake a bibliometric analysis on molar distalization, with the objective of illuminating its evolutionary trajectory, current status, and prognosticating future research hotspots and trends. MATERIAL AND METHODS A comprehensive exploration of the literature on molar distalization was carried out by conducting a search in the Web of Science (WOS) core database of the University of Hong Kong Electronic Library. The search for topic terms employed included "molar distalization," "molar distalisation," "move molar distally," "molar distal movement," and "molar backwards." The search results were subsequently subjected to meticulous analysis using CiteSpace software. This analysis encompassed various facets such as the citation count; the geographical distribution of the countries, institutions, and journals responsible for publishing the articles; the distribution of the authors; the utilization of keywords within the articles; and the analysis of references. RESULTS A total of 516 articles were included in the analysis. The top 5 countries in terms of the number of published papers were the United States (USA), South Korea, Turkey, Italy, and Germany, and the top 5 institutions in terms of the number of published papers were Kyung Hee University, A.T. Still University of Health Sciences, Catholic University of Korea, Seoul St. Mary's Hospital, and Universidade de Sao Paulo. The top 5 authors in terms of the number of published papers were Park, Kook, Bayome, Janson, and Lee. There was little cooperation overall. The top 3 journals in terms of the most published related articles were all orthodontic-related journals. After molar distalization and anchorage, the most frequently used keywords were distalization, movement, and pendulum appliance. Kinzinger GSM is the most frequently cited author in references, and one of his articles also has the highest centrality score in references. CONCLUSIONS As the tides of time shift and scholars display an ever-growing dedication to unraveling the intricacies of this therapeutic modality, the realm of molar distalization has undergone notable advancements in technology. Initially, the traditional appliance suffered from aesthetic drawbacks and discomfort. However, contemporary iterations of the appliance have transcended these limitations, boasting enhanced elegance and convenience while concurrently elevating their efficacy. Nevertheless, limitations of current appliances, including their durability and propensity for recurrence post-treatment, continue to necessitate further advancement. Hence, the ongoing scientific inquiry aims to delve deeper into refining treatment modalities and fabricating cutting-edge appliances within this realm. CLINICAL RELEVANCE This study holds the potential to significantly enhance the ability of orthodontists to devise treatment protocols and offer state-of-the-art clinical recommendations, thereby empowering them to deliver advanced and refined orthodontic interventions.
Collapse
Affiliation(s)
- Lin Cheng
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Zezhou Feng
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, China
| | - Zhaonan Hao
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, China
| | - Minmin Si
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, China
| | - Rui Yuan
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, China
| | - Zhiyuan Feng
- Department of Orthodontics, Shanxi Provincial People's Hospital, The Fifth Clinical Medical College of Shanxi Medical University, Taiyuan, China.
| |
Collapse
|
15
|
Caruso S, De Felice ME, Valenti C, Pagano S, Caruso S, Gatto R, Lombardo G. An evaluation of the Invisalign® Aligner Technique and consideration of the force system: a systematic review. Syst Rev 2024; 13:43. [PMID: 38281057 PMCID: PMC10821231 DOI: 10.1186/s13643-023-02437-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 12/13/2023] [Indexed: 01/29/2024] Open
Abstract
OBJECTIVE Since its introduction 25 years ago, the Invisalign® system has undergone multiple digital and biomechanical evolutions and its effectiveness is often compared to traditional systems without considering the many differences which characterize them. The main aim of this systematic review is to look at the literature dealing with studies on teeth movements using the Invisalign® system and the management of these movements through digital planning and artificial intelligence. MATERIALS AND METHODS The following electronic databases were searched: MEDLINE, Embase, the Cochrane Oral Health Group's Trials Register, and CENTRAL. Unpublished studies were searched on ClinicalTrials.gov, the National Research Register, and Pro-Quest Dissertation Abstracts and Thesis database. RESULTS Twenty-four studies (15 retrospective, 5 prospective, 2 pilot, and 2 case-control) were included. The results of the analysis carried out on the available literature show that the Invisalign® system is recognized to be a valid alternative to conventional orthodontic treatment in no-extraction cases. The results are influenced by the methods for assessing the effectiveness of this technique and by the comparison bias of the traditional system with the innovative digital system. CONCLUSIONS Since the introduction of SmartForce and SmartTrack material, the efficacy of the treatment has improved. There is still a shortage of high-quality evidence concerning the treatment modality. In order to make the treatment with the aligners more efficient, a correct management of the ClinCheck® software and a proper use of the biomechanics are necessary. The aligned force-driven system should be taken into account when developing the digital planning.
Collapse
Affiliation(s)
- Silvia Caruso
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100, L'Aquila, Italy
| | - Maria Elena De Felice
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100, L'Aquila, Italy.
| | - Chiara Valenti
- CISAS "Giuseppe Colombo", University of Padua, Via Venezia, 15, 35131, Padua, Italy
- Department of Medicine and Surgery, Faculty of Dentistry, University of Perugia, S. Andrea delle Fratte, 06156, Perugia, Italy
| | - Stefano Pagano
- Department of Medicine and Surgery, Faculty of Dentistry, University of Perugia, S. Andrea delle Fratte, 06156, Perugia, Italy
| | - Sara Caruso
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100, L'Aquila, Italy
| | - Roberto Gatto
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100, L'Aquila, Italy
| | - Guido Lombardo
- Department of Medicine and Surgery, Faculty of Dentistry, University of Perugia, S. Andrea delle Fratte, 06156, Perugia, Italy
| |
Collapse
|
16
|
Guo R, Lam X, Zhang L, Li W, Lin Y. Biomechanical analysis of miniscrew-assisted molar distalization with clear aligners: a three-dimensional finite element study. Eur J Orthod 2024; 46:cjad077. [PMID: 38134411 PMCID: PMC10783155 DOI: 10.1093/ejo/cjad077] [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] [Indexed: 12/24/2023]
Abstract
BACKGROUND/OBJECTIVES To compare the biomechanical characteristics of maxillary molar distalization with clear aligners in conjunction with three types of miniscrew anchorage. MATERIALS/METHODS Three-dimensional (3D) finite element models of maxillary molar distalization with clear aligners and three types of miniscrew anchorage were established, including (A) control group, (B) direct buccal miniscrew anchorage group, (C) direct palatal miniscrew anchorage group, and (D) indirect buccal miniscrew anchorage group. The 3D displacement of maxillary teeth and the principal stress (maximum tensile and compressive stress) on the root and periodontal ligament (PDL) during molar distalization were recorded. RESULTS The tooth displacement pattern during maxillary molar distalization in the four groups showed similarities, including labial tipping of anterior teeth, mesial and buccal tipping of premolars, and distal and buccal tipping of molars, but with varying magnitudes. Group C exhibited the greatest molar distalization, with the first molar achieving 0.1334 mm of crown distalization. Group D demonstrated a notable buccal crown movement (0.0682 mm) and intrusion (0.0316 mm) of the first premolar. Compared to Groups A and B, Groups C and D showed less labial crown tipping of the central incisor. Group B showed the greatest amount of maxillary incisor intrusion (central incisor: 0.0145 mm, lateral incisor: 0.0094 mm). Moreover, Groups C and D displayed significantly lower levels of compressive and tensile stress in the roots and PDL of the maxillary central and lateral incisors. LIMITATION Molar distalization is a dynamic process involving sequential tooth movement stages; however, our research primarily examined the tooth movement patterns in the initial aligner. CONCLUSIONS/IMPLICATIONS The use of miniscrew anchorage, especially direct palatal miniscrew anchorage, may enhance the treatment efficacy of maxillary molar distalization with clear aligners, leading to increased molar distalization, reduced mesial movement of premolars, and minimized labial tipping of anterior teeth.
Collapse
Affiliation(s)
- Runzhi Guo
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiang Yao Lam
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China
| | - Liwen Zhang
- Department of Dental Medical Center, China-Japan Friendship Hospital, Beijing, China
| | - Weiran Li
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yifan Lin
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
17
|
Bargellini A, Castroflorio T, Graziano V, Cugliari G, Deregibus A. Effects on Sleep Bruxism Activity of Three Different Oral Appliances: One Year Longitudinal Cohort Study. Curr Drug Deliv 2024; 21:1151-1159. [PMID: 35598244 DOI: 10.2174/1567201819666220519123754] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/08/2022] [Accepted: 04/11/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Different oral appliances (OAs) have been proposed to control sleep bruxism (SB) detrimental effects on the stomatognathic system. OBJECTIVE The aim of the study was to evaluate the effect of different OAs on SB activity and masticatory muscle activity (sMMA) measured by EMG. METHODS This longitudinal cohort study was conducted on 51 patients (21 M, 30 F, mean age 26,5 ± 3,5) suffering from SB diagnosed with a validated portable EMG-ECG holter and wearing different OAs: occlusal splints, functional appliance with metallic bites and clear aligners followed after 1 week, 1 month, 3 months, 6 months and 12 months from delivery. A control group of 16 non-treated SB patients (6 M, 10 F mean age 27,1 ± 1,4) was used as a reference. A multiple regression analysis was performed to estimate the differences between groups. The level of significance was set as P value <0,05. RESULTS Occlusal splint reduced sleep bruxism index after 1 week, 3, 6 and 12 months from delivery while functional appliance only after 12 months. Occlusal splints reduced general phasic contractions only in the first week and sleep bruxism-related phasic contractions at 1 week, 3 and 6 months after delivery with no significant reductions after 12 months. Patients wearing clear aligners showed a reduction in general tonic contractions after 6 and 12 months. CONCLUSION Resin and metal bites can reduce sleep bruxism index, while resin bites can reduce sleep bruxism-related phasic contractions. Clear aligners do not influence sleep bruxism index but can reduce tonic contractions.
Collapse
Affiliation(s)
- Andrea Bargellini
- Department of Surgical Sciences, Specialization School of Orthodontics, Dental School, University of Torino, Torino, Italy
- Department of Surgical Sciences, Gnathology Unit, Dental School, University of Torino, Torino, Italy
| | - Tommaso Castroflorio
- Department of Surgical Sciences, Specialization School of Orthodontics, Dental School, University of Torino, Torino, Italy
- Department of Surgical Sciences, Gnathology Unit, Dental School, University of Torino, Torino, Italy
| | - Vanessa Graziano
- Department of Surgical Sciences, Dental School, University of Torino, Torino, Italy
| | | | - Andrea Deregibus
- Department of Surgical Sciences, Specialization School of Orthodontics, Dental School, University of Torino, Torino, Italy
- Department of Surgical Sciences, Gnathology Unit, Dental School, University of Torino, Torino, Italy
| |
Collapse
|
18
|
Miao Z, Zhang H, Yang Y, Han Y, Leng J, Wang S. Influence of maxillary molar distalization with clear aligners on three-dimensional direction: molar distal movement, intrusion, distal tip and crown buccal torque. Prog Orthod 2023; 24:48. [PMID: 38151662 PMCID: PMC10752857 DOI: 10.1186/s40510-023-00500-4] [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: 08/10/2023] [Accepted: 10/22/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND The aim of this study was to evaluate the distal movement, vertical movement, distal tipping and crown buccal torque of maxillary molars after the completion of distalization by comparing the predicted movement with the achieved movement using palatal rugae registration. METHODS The study included 22 clear aligner patients (7 males and 15 females), and 79 molars were measured. Two digital models were generated before treatment and after molar distalization and were superimposed after selecting the palatal rugae area for registration in GOM inspect suite software 2022 (GOM; Braunschweig, Germany). The predicted and achieved movements of molar distalization, intrusion, distal tip and crown buccal torque were measured and compared. RESULT The achieved distalization (1.25 ± 0.79 mm vs. 2.17 ± 1.03 mm, P < 0.001; 1.41 ± 1.00 mm vs. 2.66 ± 1.15 mm, P < 0.001), intrusion (0.47 ± 0.41 mm vs. 0.18 ± 0.54 mm, P < 0.01; 0.58 ± 0.65 mm vs. 0.10 ± 1.12 mm, P < 0.01), distal tip (5.30 ± 4.56° vs. 1.53 ± 2.55°, P < 0.001; 4.87 ± 4.50° vs. - 1.95 ± 4.32°, P < 0.001) and crown buccal torque (1.95 ± 4.18° vs. - 1.15 ± 4.75°, P < 0.001; 0.43 ± 4.39° vs. - 4.27 ± 6.42°, P < 0.001) were significantly different from the predicted values in the two groups (first molar, second molar). Significant regression relationships were found between the achieved distal movement and deviational intrusion (R2 = 0.203, P < 0.0001), distal tip (R2 = 0.133, P < 0.001) and crown buccal torque (R2 = 0.067, P < 0.05). There was a significant correlation between the deviational movements of intrusion and the distal tip (R = 0.555, P < 0.0001). CONCLUSION Approximately 2 mm maxillary molar distalization was achieved in this study. Deviational movement of intrusion, distal tip and crown buccal torque beyond the clear aligner virtual design appeared to a certain degree after distalization. Thus, more attention should be given to molar intrusion and distal tip and crown buccal torque as the designed distalization increases.
Collapse
Affiliation(s)
- Zeyao Miao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Haijuan Zhang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yuxuan Yang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yandong Han
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jing Leng
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Shuang Wang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
- Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
| |
Collapse
|
19
|
Mao B, Tian Y, Xiao Y, Liu J, Liu D, Zhou Y, Li J. Effect of Different Anchorage Reinforcement Methods on Long-Term Maxillary Whole Arch Distalization with Clear Aligner: A 4D Finite Element Study with Staging Simulation. Bioengineering (Basel) 2023; 11:3. [PMID: 38275571 PMCID: PMC10813679 DOI: 10.3390/bioengineering11010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/20/2023] [Accepted: 12/19/2023] [Indexed: 01/27/2024] Open
Abstract
The objective of this study was to examine how various anchorage methods impact long-term maxillary whole arch distalization using clear aligners (CAs) through an automated staging simulation. Three different anchorage reinforcement methods, namely, Class II elastics, buccal temporary anchorage device (TAD), and palatal TAD, were designed. Orthodontic tooth movement induced by orthodontic forces was simulated using an iterative computation method. Additionally, the automatic adjustment of the CA was simulated through the application of the thermal expansion method. The results indicated that the palatal TAD group had the largest retraction of incisors, followed by the buccal TAD group and the Class II elastic group, while the least was in the control group. The largest distal displacements and efficiency of molar distalization for the first and the second molars were noticed in the palatal TAD group. Arch width increased at the molar and premolar levels in all groups. The FEM results suggested palatal TAD had the best performance considering anterior teeth anchorage maintenance, both sagittally and vertically. However, attention should be paid to the possible increasement of arch width.
Collapse
Affiliation(s)
- Bochun Mao
- Department of Orthodontics, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing 100081, China; (B.M.); (Y.X.); (J.L.); (D.L.); (Y.Z.)
| | - Yajing Tian
- Center of Stomatology, China–Japan Friendship Hospital, Beijing 100013, China;
| | - Yujia Xiao
- Department of Orthodontics, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing 100081, China; (B.M.); (Y.X.); (J.L.); (D.L.); (Y.Z.)
| | - Jiayi Liu
- Department of Orthodontics, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing 100081, China; (B.M.); (Y.X.); (J.L.); (D.L.); (Y.Z.)
| | - Dawei Liu
- Department of Orthodontics, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing 100081, China; (B.M.); (Y.X.); (J.L.); (D.L.); (Y.Z.)
| | - Yanheng Zhou
- Department of Orthodontics, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing 100081, China; (B.M.); (Y.X.); (J.L.); (D.L.); (Y.Z.)
| | - Jing Li
- Department of Orthodontics, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing 100081, China; (B.M.); (Y.X.); (J.L.); (D.L.); (Y.Z.)
| |
Collapse
|
20
|
Gao J, Guo D, Zhang X, Cheng Y, Zhang H, Xu Y, Jin Z, Ma Y. Biomechanical effects of different staging and attachment designs in maxillary molar distalization with clear aligner: a finite element study. Prog Orthod 2023; 24:43. [PMID: 38044352 PMCID: PMC10694119 DOI: 10.1186/s40510-023-00493-0] [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: 05/04/2023] [Accepted: 09/26/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND In the present study, the effects of distalizations of one and two molars with different step distances and attachment designs have been analyzed. METHODS A 3D finite element analysis model has been developed in order to determine the tendency of tooth displacement and stress distribution with clear aligner treatment. RESULTS Under the condition of single-molar distalization, when the step distance was set to 0.25 mm, the total displacement was 0.086 mm for central incisors, 0.080 mm for lateral incisors, 0.084 mm for canines, 0.102 mm for the first premolar and 0.076 mm for the second premolar. The von Mises stress of roots and the principal stress of the periodontal ligament was slightly lower than in the control group when the step distance was set to 0.130 mm. Under the condition of two-molar distalization, when the step distance was set to 0.130 mm, the total displacements for central incisors, lateral incisors and canines as well as both the first and second maxillary molars were basically the same as with a distance of 0.250 mm for one-molar distalization. In addition, when the step distance was 0.130 mm with two-molar distalization, the rotation center of the first and second molar was closer to the apex of the root indicating that the smaller step distance led to more bodily movement during the two-molar distalization. However, displacement tendencies of the first molar and the second molar were basically the same whether horizontal or vertical rectangular attachments were added. CONCLUSIONS A step distance of moving two molars to 0.130 mm can achieve the same reaction force on the anterior teeth as moving one molar 0.250 mm without effects on horizontal or vertical rectangular attachments. CLINICAL RELEVANCE Our results provide a theoretical basis and guidance for simultaneously moving two molars backward in clinical practice using a clear aligner.
Collapse
Affiliation(s)
- 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, School of Stomatology, The Fourth Military Medical University, No. 169 Changle West Road, Xi'an, 710032, China
| | - Donghui Guo
- 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, School of Stomatology, The Fourth Military Medical University, No. 169 Changle West Road, 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, School of Stomatology, The Fourth Military Medical University, No. 169 Changle West Road, Xi'an, 710032, China
| | - Yuxun Cheng
- 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, School of Stomatology, The Fourth Military Medical University, No. 169 Changle West Road, Xi'an, 710032, China
| | - Hao 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, School of Stomatology, The Fourth Military Medical University, No. 169 Changle West Road, 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, School of Stomatology, The Fourth Military Medical University, No. 169 Changle West Road, 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, School of Stomatology, The Fourth Military Medical University, No. 169 Changle West Road, Xi'an, 710032, China.
| | - Yanning Ma
- 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, School of Stomatology, The Fourth Military Medical University, No. 169 Changle West Road, Xi'an, 710032, China.
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China.
| |
Collapse
|
21
|
Inchingolo AM, Inchingolo AD, Carpentiere V, Del Vecchio G, Ferrante L, Di Noia A, Palermo A, Di Venere D, Dipalma G, Inchingolo F. Predictability of Dental Distalization with Clear Aligners: A Systematic Review. Bioengineering (Basel) 2023; 10:1390. [PMID: 38135981 PMCID: PMC10740623 DOI: 10.3390/bioengineering10121390] [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: 10/05/2023] [Revised: 11/02/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
The current review aims to evaluate the scientific evidence relating to the effectiveness of treatment with clear aligners (CAs) in controlling distalization orthodontic tooth movement. "Orthodontics, aligners" and "distalization" were the search terms used on the Scopus, Web of Science and Pubmed databases with the Boolean operator "AND". The results of the last ten years of research were 146 studies; of these, 19 publications were included for this review. The distalization movement is possible with invisible masks alone, but the risk of losing anchorage in the anterior sectors is very probable. The stability of the results and the reduction of unwanted effects can be guaranteed by the use of skeletal anchoring devices and interproximal enamel reduction (IPR), with which compensations are obtained to reduce the initial overjet. Temporary anchorage devices (TADs) can be used to manage posterior anchorage after distalization of maxillary molars with aligners. This hybrid approach has demonstrated the greatest orthodontic success. TADs are useful aids to provide direct and indirect skeletal anchorage. The opposite effect must be considered when planning dental distalization, especially of the molars, in patients with large overjet, and corrective measures or the use of auxiliaries may be necessary to prevent midcourse corrections. This systematic review provides a critical evidence-based assessment of the predictability of dental distalization with CAs, an ever-evolving orthodontic technique.
Collapse
Affiliation(s)
- Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (A.M.I.); (A.D.I.); (V.C.); (G.D.V.); (L.F.); (A.D.N.); (D.D.V.); (F.I.)
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (A.M.I.); (A.D.I.); (V.C.); (G.D.V.); (L.F.); (A.D.N.); (D.D.V.); (F.I.)
| | - Vincenzo Carpentiere
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (A.M.I.); (A.D.I.); (V.C.); (G.D.V.); (L.F.); (A.D.N.); (D.D.V.); (F.I.)
| | - Gaetano Del Vecchio
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (A.M.I.); (A.D.I.); (V.C.); (G.D.V.); (L.F.); (A.D.N.); (D.D.V.); (F.I.)
| | - Laura Ferrante
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (A.M.I.); (A.D.I.); (V.C.); (G.D.V.); (L.F.); (A.D.N.); (D.D.V.); (F.I.)
| | - Angela Di Noia
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (A.M.I.); (A.D.I.); (V.C.); (G.D.V.); (L.F.); (A.D.N.); (D.D.V.); (F.I.)
| | - Andrea Palermo
- College of Medicine and Dentistry, Birmingham B4 6BN, UK;
| | - Daniela Di Venere
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (A.M.I.); (A.D.I.); (V.C.); (G.D.V.); (L.F.); (A.D.N.); (D.D.V.); (F.I.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (A.M.I.); (A.D.I.); (V.C.); (G.D.V.); (L.F.); (A.D.N.); (D.D.V.); (F.I.)
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (A.M.I.); (A.D.I.); (V.C.); (G.D.V.); (L.F.); (A.D.N.); (D.D.V.); (F.I.)
| |
Collapse
|
22
|
Balboni A, Cretella Lombardo E, Balboni G, Gazzani F. Vertical effects of distalization protocol with Clear aligners in Class II patients: a prospective study. Minerva Dent Oral Sci 2023; 72:291-297. [PMID: 37162331 DOI: 10.23736/s2724-6329.23.04783-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND The aim of the present prospective study was to detect the effects on vertical dentoskeletal dimension produced by molar distalization with Clear Aligners in a group of subjects with Class II malocclusion. METHODS The Clear Aligners Group (CAG) comprised 20 patients (13 females, seven males) with a mean age of 17.2±3.2 years. The same standardized protocol of sequential distalization was applied in all subjects. For each patient lateral cephalograms have been analyzed before treatment (T1) and at the end of the therapy (T2). RESULTS At the end of treatment, clear aligners were effective in the correction of Class II dental relationship with the correction of the overjet (-1.3 mm). The treated group showed statistically significant reduction in FMA angle (-1.3°) associated with a counterclockwise rotation of the occlusal plane (POccl^PF -3.1°; SN^POccl -4.2°) and a slight intrusion of maxillary first molars to palatal plane (-0.9 mm). Finally, statistically significant differences were detected in anterior facial height (N-Me) and in the ArGo^GoMe angle (-1.2 mm and -3.4°, respectively). CONCLUSIONS Upper molar distalization with clear aligners represents a valid alternative to non-extraction treatment of Class II malocclusion, reducing the extrusion of maxillary first molars and improving the control of the occlusal plane and of the vertical dimension.
Collapse
Affiliation(s)
- Alessia Balboni
- Department of Systems Medicine, Tor Vergata University, Rome, Italy -
| | | | - Giulia Balboni
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | | |
Collapse
|
23
|
Elfouly D, El-Harouni NM, Ismail HA, El-Bialy T, Ghoneima A. Does maxillary sinus proximity affect molar root resorption during distalization using Invisalign? a CBCT study. BMC Oral Health 2023; 23:905. [PMID: 37990186 PMCID: PMC10664583 DOI: 10.1186/s12903-023-03672-x] [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: 07/04/2023] [Accepted: 11/15/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND This study aimed to assess the correlation between maxillary sinus proximity to root apices of maxillary molars and root resorption during molar distalization using clear aligner therapy (CAT). MATERIALS AND METHODS Thirty-eight cone beam computed tomography scans (CBCTs) obtained pre- (T0) and post-treatment (T1) from 19 adult patients (36.68 ± 13.50 years), who underwent maxillary molar distalization using Invisalign® aligners (Align Technology, Inc., San José, CA, USA) with a minimum of 2 mm distalization, were evaluated in this study At least 22 h of aligner wear per day was a main inclusion criterion. Sinus proximity and changes in root lengths were measured for 61 molars (183 roots). Spearman coefficient analysis was used for assessing correlation between sinus proximity and root resorption. The level of significance was set at p ≤ 0.05. The reproducibility of measurements was assessed by intraclass correlation coefficient (ICC). RESULTS Spearman coefficient revealed no significant correlation between sinus proximity and molar root resorption for mesiobuccal, distobuccal or palatal roots (p = 0.558, p = 0.334, p = 0.931, respectively). CONCLUSION There was no correlation between maxillary sinus proximity to root apices of maxillary molars and root resorption.
Collapse
Affiliation(s)
- Dina Elfouly
- Department of Orthodontics, Faculty of Dentistry, Alexandria University, Champollion St., P.O. Box 21521, Azarita, Alexandria, Egypt.
| | - Nadia M El-Harouni
- Department of Orthodontics, Faculty of Dentistry, Alexandria University, Champollion St., P.O. Box 21521, Azarita, Alexandria, Egypt
| | - Hanan A Ismail
- Department of Orthodontics, Faculty of Dentistry, Alexandria University, Champollion St., P.O. Box 21521, Azarita, Alexandria, Egypt
| | - Tarek El-Bialy
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Ahmed Ghoneima
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
- Adjunct Faculty, Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry, Indianapolis, IN, USA
| |
Collapse
|
24
|
Kang F, Wu Y, Cui Y, Yuan J, Hu Z, Zhu X. The displacement of teeth and stress distribution on periodontal ligament under different upper incisors proclination with clear aligner in cases of extraction: a finite element study. Prog Orthod 2023; 24:38. [PMID: 37981597 PMCID: PMC10657915 DOI: 10.1186/s40510-023-00491-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 09/08/2023] [Indexed: 11/21/2023] Open
Abstract
OBJECTIVES To investigate the displacement of dentition and stress distribution on periodontal ligament (PDL) during retraction and intrusion of anterior teeth under different proclination of incisors using clear aligner (CA) in cases involving extraction of the first premolars. METHODS Models were constructed, consisting of the maxilla, PDLs, CA and maxillary dentition without first premolars. These models were then imported to finite element analysis (FEA) software. The incisor proclination determined the division of the models into three groups: Small torque (ST) with U1-SN = 100°, Middle torque (MT) with U1-SN = 110°, and High torque (HT) with U1-SN = 120°. Following space closure, a 200 g intrusion force was applied at angles of 60°, 70°, 80°, and 90° to the occlusal plane, respectively. RESULTS CA therapy caused lingual tipping and extrusion of incisors, mesial tipping and intrusion of canines, and mesial tipping of posterior teeth in each group. As the proclination of incisors increased, the incisors presented more extrusion and minor retraction, and the teeth from the canine to the second molar displayed an increased tendency of intrusion. The peak Von Mises equivalent stress (VMES) value successively decreased from the central incisor to the canine and from the second premolar to the second molar, and the VMES of the second molar was the lowest among the three groups. When the angle between the intrusion force and occlusal plane got larger, the incisors exhibited greater intrusion but minor retraction. CONCLUSIONS The "roller coaster effect" usually occurred in cases involving premolar extraction with CA, especially in patients with protruded incisors. The force closer to the vertical direction were more effective in achieving incisor intrusion. The stress on PDLs mainly concentrated on the cervix and apex of incisors during the retraction process, indicating a possibility of root resorption.
Collapse
Affiliation(s)
- Fujia Kang
- Department of Orthodontics, Hospital of Stomatology, Jilin University, Jilin University, Changchun, Jilin, China
| | - Yumiao Wu
- Department of Orthodontics, Hospital of Stomatology, Jilin University, Jilin University, Changchun, Jilin, China
| | - Yuchen Cui
- Department of Orthodontics, Hospital of Stomatology, Jilin University, Jilin University, Changchun, Jilin, China
| | - Jiamin Yuan
- Department of Orthodontics, Hospital of Stomatology, Jilin University, Jilin University, Changchun, Jilin, China
| | - Zhiqiang Hu
- Department of Orthodontics, Hospital of Stomatology, Jilin University, Jilin University, Changchun, Jilin, China
| | - Xianchun Zhu
- Department of Orthodontics, Hospital of Stomatology, Jilin University, Jilin University, Changchun, Jilin, China.
| |
Collapse
|
25
|
Padmanabhan A, Khan Y, Lambate V, K U, Naveed N, Singh M, Nagi PK. Efficacy of Clear Aligners in Treating Class III Malocclusion With Mandibular Molar Distalization: A Systematic Review. Cureus 2023; 15:e48134. [PMID: 38046776 PMCID: PMC10692399 DOI: 10.7759/cureus.48134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 11/01/2023] [Indexed: 12/05/2023] Open
Abstract
The primary goal of orthodontic therapy in pseudo-class III is to restore the proper dental connection by rectifying the canine and molar relationship to Class I through lower molar and premolar visualization, as well as providing normal anterior overjet. The purpose of this systematic study was to determine the efficacy of clear aligners in treating class III malocclusion with mandibular molar distalization. A wide range of searches were done on various search engines like Cochrane, Web of Science, Embase, PubMed, Scopus, and Google Scholar to collect relevant articles related to our study. This review's article selection was guided by the PRISMA flowchart. The electronic findings provided numerous articles with nearly 78 articles regarding clear aligners in class III malocclusion with molar distalization. From this, seven full-text papers were evaluated for eligibility criteria, with two articles being rejected with justification and five articles being elaborated in the current systematic review. The current evidence of this review suggested that the clear aligners were effective in correcting class III malocclusion with molar distalization. The amount of molar distalization is about 2 to 3 mm, which helps in achieving molar and canine relationship in class I, with a high compliance level and also improvement of the facial profile.
Collapse
Affiliation(s)
- Aishwarrya Padmanabhan
- Orthodontics and Dentofacial Orthopedics, Sri Ramakrishna Dental College and Hospital, Coimbatore, IND
| | - Yusuf Khan
- Orthodontics and Dentofacial Orthopedics, Diamond Medical Specialists, Taif, SAU
| | - Vikrant Lambate
- Orthodontics and Dentofacial Orthopedics, Mahatma Gandhi Missions (MGM) Dental College and Hospital, Navi Mumbai, IND
| | - Ushanandhini K
- Orthodontics and Dentofacial Orthopedics, Sri Ramakrishna Dental College and Hospital, Coimbatore, IND
| | - Niha Naveed
- Orthodontics and Dentofacial Orthopedics, Saveetha Dental College, Chennai, IND
| | - Mansi Singh
- Orthodontics and Dentofacial Orthopedics, Kalka Dental College and Hospital, Meerut, IND
| | - Puneet Kamal Nagi
- Periodontics, Punjab Government Dental College and Hospital, Amritsar, IND
| |
Collapse
|
26
|
Arslan S, Kilinc H. Evaluation of the effects of different composite materials and surface roughening techniques in bonding attachments of clear aligner on monolithic zirconia. Orthod Craniofac Res 2023; 26:546-551. [PMID: 36840412 DOI: 10.1111/ocr.12643] [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: 09/28/2022] [Revised: 11/07/2022] [Accepted: 02/14/2023] [Indexed: 02/26/2023]
Abstract
OBJECTIVE The aim of this study is to evaluate the bond strengths of two different composite types used in the production of clear aligner attachments on monolithic zirconia with three different surface roughening processes. MATERIALS AND METHODS Packable composite Filtek Z250 was used in one group (PC-G) and flowable composite Filtek Supreme Ultra Flowable was used in the other group (FC-G). PC-G and FC-G groups were also divided into three subgroups as diamond bur+silane (Group 1), 50 μm aluminium oxide (Al2 O3 ) sandblasting+silane (Group 2) and 110 μm Al2 O3 sandblasting+silane (Group 3). Scanning electron microscopy (SEM) analysis was performed. Clear aligner attachments were bonded to the monolithic zirconia specimens. Shear bond strength (SBS) values were measured. Statistical analysis was performed using two-way ANOVA and post-hoc Tukey's tests (P < .05). RESULTS The highest SBS value was found in PC-G sandblasted with 110 μm Al2 O3 (P ≤ .001). The etching method with 110 μm sandblasting showed high SBS values in both composite types. The lowest SBS value gave FC-G in diamond bur roughening (P ≤ .001). CONCLUSIONS For the bonding of clear aligner attachments on monolithic zirconia, roughening with 110 μm particle size sandblasting and the choice of packable composite could be recommended in terms of retention.
Collapse
Affiliation(s)
- Semiha Arslan
- Department of Orthodontics, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Hamiyet Kilinc
- Department of Prosthodontics, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey
| |
Collapse
|
27
|
Bellocchio AM, Portelli M, Ciraolo L, Ciancio E, Militi A, Peditto M, Barbera S, Nucera R. Evaluation of the Clinical Variables Affecting Attachment Reproduction Accuracy during Clear Aligner Therapy. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6811. [PMID: 37895792 PMCID: PMC10607942 DOI: 10.3390/ma16206811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/09/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND The purpose of this study was to evaluate some of the clinical variables that influence the accuracy of reproducing the planned attachment shape. The following clinical variables were considered: the template material, type of composite, and pressure application on the template during attachment curing. METHODS In this study, the evaluated materials for the thermoplastic transfer template construction are Erkolen 0.8 (polyethylene: PE) and Erkodur 0.8 (polyethylene terephthalate glycol-PET-G), and two types of composite resins: Enaflow (light-curing low-viscosity composite resin) and Enamel plus dentina HRI (light-curing high-viscosity composite resin). Two different light-curing lamps were used: Valo cordless color with no pressure and push light pressure (SCS). The 26 models included in the study were imported into the 3 Shape Ortho System 2022 (ver. 85.0.20 3 Shape, Denmark), and attachments were virtually placed on the dental elements of the first premolar and on both sides of the first upper molars. The accuracy of the attachment reproduction was evaluated through linear and angular evaluations against the reference model (MCAD). Three physical models were obtained: model A (MA), which was printed with attachments; model B (MB) with attachments made with a PE template; and model C (MC) with attachments made with a PET-G template. RESULTS The results showed statistically significant differences (p < 0.05) between the PE and PET-G templates with greater precision using the PET-G template. Statistically significant differences (p < 0.05) were found among the high-viscosity composite and low-viscosity composite with pressure curing. CONCLUSIONS In light of the obtained data, using a PET-G template is recommended. The pressure application during composite curing reduces the reproduction accuracy with a low-viscosity composite.
Collapse
Affiliation(s)
- Angela Mirea Bellocchio
- Department of Biomedical Sciences, Dentistry and Morphological and Functional Imaging, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy; (M.P.); (L.C.); (E.C.); (A.M.); (M.P.); (S.B.); (R.N.)
| | | | | | | | | | | | | | | |
Collapse
|
28
|
Liu X, Wu J, Cheng Y, Gao J, Wen Y, Zhang Y, Luo H, Jin Z, Ma Y. Effective contribution ratio of the molar during sequential distalization using clear aligners and micro-implant anchorage: a finite element study. Prog Orthod 2023; 24:35. [PMID: 37806991 PMCID: PMC10560653 DOI: 10.1186/s40510-023-00485-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 08/03/2023] [Indexed: 10/10/2023] Open
Abstract
INTRODUCTION This study aims to investigate the biomechanical effects of anchorage reinforcement using clear aligners (CAs) with microimplants during molar distalization. And also explores potential clinical strategies for enhancing anchorage in the sequential distalization process. METHODS Finite element models were established to simulate the CAs, microimplants, upper dentition, periodontal ligament (PDL), and alveolar bone. In group set I, the 2nd molars underwent a distal movement of 0.25 mm in group set II, the 1st molars were distalized by 0.25 mm after the 2nd molars had been placed to a target position. Each group set consisted of three models: Model A served as the control model, Model B simulated the use of microimplants attached to the aligner through precision cuts, and Model C simulated the use of microimplants attached by buttons. Models B and C were subjected to a series of traction forces. We analyzed the effective contribution ratios of molar distalization, PDL hydrostatic stress, and von Mises stress of alveolar bone. RESULTS The distalization of the 2nd molars accounted for a mere 52.86% of the 0.25-mm step distance without any reinforcement of anchorage. The remaining percentage was attributed to the mesial movement of anchorage teeth and other undesired movements. Models B and C exhibited an increased effective contribution ratio of molar distalization and a decreased loss of anchorage. However, there was a slight increase in the undesired movement of molar tipping and rotation. In group set II, the 2nd molar displayed a phenomenon of mesial relapse due to the reciprocal force produced by the 1st molar distalization. Moreover, the efficacy of molar distalization in terms of contribution ratio was found to be positively correlated with the magnitude of force applied. In cases where stronger anchorage reinforcement is required, precision cuts is the superior method. CONCLUSIONS The utilization of microimplants in conjunction with CAs can facilitate the effective contribution ratio of molar distalization. However, it is important to note that complete elimination of anchorage loss is not achievable. To mitigate undesired movement, careful planning of anchorage preparation and overcorrection is recommended.
Collapse
Affiliation(s)
- Xulin Liu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, China
| | - Junjie Wu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, China
| | - Yuxun Cheng
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, China
| | - Jie Gao
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, China
| | - Yi Wen
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, China
| | - Yubohan Zhang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, China
| | - Houzhuo Luo
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, China
| | - Zuolin Jin
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, China.
| | - Yanning Ma
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, China.
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China.
| |
Collapse
|
29
|
Liu X, Wang W, Gao J, Qin W, Wen Y, Luo H, Ma Y, Jin Z. Actual contribution ratio of maxillary and mandibular molars for total molar relationship correction during maxillary molar sequential distalization using clear aligners with Class II elastics: A finite element analysis. Am J Orthod Dentofacial Orthop 2023; 164:e106-e120. [PMID: 37610384 DOI: 10.1016/j.ajodo.2023.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 07/01/2023] [Accepted: 07/01/2023] [Indexed: 08/24/2023]
Abstract
INTRODUCTION Class II elastics, in combination with clear aligners (CA), are efficient for molar distalization. However, the effects of this combination on intermaxillary molar relationship correction have yet to be investigated. This study aimed to investigate the actual contribution ratio of the maxillary and mandibular molars for total molar relationship correction during maxillary molar distalization using Class II elastics with CA and further explore therapeutic recommendations for clinical practice. METHODS Finite element models (FEMs) were established, including the distalization of the second molars (Set I), followed by the distalization of the first molars (Set II). Model A simulated elastics attached by precision cutting, whereas Model B simulated elastics attached to buttons. Force magnitudes of 100 g, 150 g, and 200 g of force were applied. We recorded the contribution ratio of the maxillary and mandibular molars for total molar relationship correction, effective distalizing distance in 0.25 mm step distance, tipping and rotation angles, and the hydrostatic stress in the periodontal ligament. RESULTS During maxillary molar distalization, mesialization of the mandibular molar had a notable contribution ratio for molar relationship correction. The mandibular first molar was mesialized with mesiolingual rotation tendency. Approximately half of the 0.25 mm step distance was occupied by maxillary molar distalization; the remainder was occupied by anchorage teeth mesialization and tipping or rotation. When traction forces increased, the total molar relationship correction and effective distalization increased; the mandibular molars mesialization contribution ratio also increased, as did rotation and inclination tendency. Precision cutting had a higher total molar relationship correction and more effective distalization than a button but also had a larger contribution ratio of mandibular molar mesialization and inclination or rotation. CONCLUSIONS Mandibular molar mesialization should be considered when correcting the molar relationship using CA with intermaxillary elastics during maxillary molar distalization. It is also important to consider the anchorage teeth mesialization and undesired tipping or rotation.
Collapse
Affiliation(s)
- Xulin Liu
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, China
| | - Wei Wang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
| | - Jie Gao
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, China
| | - Wen Qin
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, China
| | - Yi Wen
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, China
| | - Houzhuo Luo
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, China
| | - Yanning Ma
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, China; Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China.
| | - Zuolin Jin
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, China.
| |
Collapse
|
30
|
Putrino A, Marinelli E, Zaami S. The Power of Customized Clear Aligners in Closing Molar Edentulous Spaces: Clinical and Medico-Legal Considerations in a Scoping Review and Case Report. J Pers Med 2023; 13:1389. [PMID: 37763156 PMCID: PMC10532605 DOI: 10.3390/jpm13091389] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/12/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
Successful closure of edentulous spaces with clear aligners (CAs) is influenced by many factors. CAs are tailored orthodontic devices whose predictability may have relevant medico-legal implications. This study presents a scoping review about missing molar space closure (MMSC) with CAs and a clinical case. This study aims to highlight the feasibility of molar space closure by mesialization with CAs without hybrid supports. Following PRISMA Sc-review guidelines, English-written randomized/non-randomized/observational clinical studies on PubMed, Scopus, Cochrane and Lilacs were searched. An 18-year-old patient, with upper and lower edentulous spaces due to the loss of two first molars, was rehabilitated with CAs (Sorridi®, Sorridi srl, Latina, Italy) without hybrid supports and attachments. The therapy was carried out over 10 months. Currently, there are no studies documenting MMSC by mesialization with only CAs. Existing articles document the closure of premolar or incisor spaces. The upper and lower left second molars replaced the missing first molars, and erupting third molars replaced adjacent teeth. The biomechanical effects in space closure with CAs related to extraction cases appear as priorities of clinical/medico-legal interest. Our case turns attention to this movement of CAs without attachments/hybrid supports, indicating that even such a complex treatment can be comfortable for patients and safely predictable for specialists.
Collapse
Affiliation(s)
- Alessandra Putrino
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy;
| | - Enrico Marinelli
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy;
| | - Simona Zaami
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, 00161 Rome, Italy;
| |
Collapse
|
31
|
Bocchino T, Martina S, Sangiuolo C, Galdi M, Valletta A, D’Antò V. Maxillary Impacted Canine and Upper Lateral Incisor Agenesis Treatment with "Canine First Technique" and Clear Aligners: A Case Report. Healthcare (Basel) 2023; 11:2345. [PMID: 37628542 PMCID: PMC10454623 DOI: 10.3390/healthcare11162345] [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: 07/21/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
The aim of this study was to show a case of an impacted canine in an adult patient with agenesis of the maxillary lateral incisor treated with clear aligners (CA). A 19-year-old male with a persistence of 5.3 and absence of 1.2 came to our department of the School of Orthodontics at the University of Federico II in Naples and asked for an aesthetic treatment. The Canine First approach was used to surgically expose the canine and pull it into the dental arch. In order to ensure long-term aesthetic, periodontal, and occlusal results, a treatment with CAs to close the space through the mesial placement of the canine and the enameloplasty of the tooth crown was performed. At the end of the treatment, the occlusal objectives were achieved.
Collapse
Affiliation(s)
- Tecla Bocchino
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy; (T.B.); (C.S.); (M.G.); (A.V.); (V.D.)
| | - Stefano Martina
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Allende, 84081 Baronissi, Italy
| | - Carolina Sangiuolo
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy; (T.B.); (C.S.); (M.G.); (A.V.); (V.D.)
| | - Marzio Galdi
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy; (T.B.); (C.S.); (M.G.); (A.V.); (V.D.)
| | - Alessandra Valletta
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy; (T.B.); (C.S.); (M.G.); (A.V.); (V.D.)
| | - Vincenzo D’Antò
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy; (T.B.); (C.S.); (M.G.); (A.V.); (V.D.)
| |
Collapse
|
32
|
Farret MM. Orthodontic biomechanics with intermaxillary elastics. Dental Press J Orthod 2023; 28:e23spe3. [PMID: 37493850 PMCID: PMC10365070 DOI: 10.1590/2177-6709.28.3.e23spe3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 05/29/2023] [Indexed: 07/27/2023] Open
Abstract
INTRODUCTION Intermaxillary elastics are orthodontic resources widely used in various malocclusions. Their main advantages are low cost, easy insertion and removal by patients, and application versatility. As main disadvantages, we can highlight the need for cooperation from patients and the side effects normally present in treatments with this resource. Knowledge of the biomechanics involved in the use of intermaxillary elastics is essential to take full advantage of the desired effects and avoid unwanted effects in their use. OBJECTIVE Therefore, the objective of this article is to describe the anchorage preparation, connection methods, time and force of use, and side effects involved in the use of intermaxillary elastics for the treatment of anteroposterior, vertical and transverse problems. For that, clinical cases and biomechanics schemes will be presented, in which all these details will be described.
Collapse
Affiliation(s)
- Marcel Marchiori Farret
- Centro de Estudos Odontológicos Meridional (CEOM), Especialização em Ortodontia (Passo Fundo/RS, Brazil)
- Private practice (Santa Maria/RS, Brazil)
| |
Collapse
|
33
|
Al-Tayar B, Al-Somairi MAA, ALshoaibi LH, Wang X, Wang J, Liu J, Al-Tayar B, An X, Si Q. Impact of molar teeth distalization by clear aligners on temporomandibular joint: a three-dimensional study. Prog Orthod 2023; 24:25. [PMID: 37455279 DOI: 10.1186/s40510-023-00474-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 05/15/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Maxillary molar distalization is a common technique used in the non-extraction treatment of Angle Class II malocclusion that can effectively correct the molar relationship and create spaces for anterior teeth alignment. However, this approach may also impact the temporomandibular joint (TMJ) due to predictable changes in the posterior vertical dimension. Despite its widespread use, Class II malocclusions correction by molar distalization with clear aligners has not been investigated for their effects on the TMJ. Therefore, this study aimed to analyze the impact of sequential molar distalization using clear aligners on the TMJ. METHODS Three-dimensional CBCT scans of 23 non-growing patients (7 males, 16 females; mean age 29.8 ± 4.6 years) with skeletal class I or II malocclusion and a bilateral molar class II relationship treated by sequential upper molars distalization with orthodontic clear aligners (Invisalign, Align Technology, San Josè, Ca, USA). A total of 46 joints were examined before and after molar distalization using Anatomage InvivoDental 6.0.3. Linear and angular measurements of the mandibular joint were measured, including joint parameters, inclination, position, and the dimension of the condyle and articular fossa. In addition, 3D volumetric spaces of the joint were analyzed. All data were statistically analyzed by paired T test to determine the differences between the pre-and post-orthodontic procedures. RESULTS No statistically significant differences were found in all primary effects resulting from maxillary molars distalization by clear aligners on TMJ components measurements and joint spaces between T0 and T1. Meanwhile, statistically significant differences were observed in the linear position of the upper molars and the molar relationship parameter with at least P ≤ 0.05. CONCLUSION Treatment by sequential upper molars distalization with clear aligners does not lead to significant TMJ parameters changes in condyle and fossa spaces, dimensions, and positions.
Collapse
Affiliation(s)
- Barakat Al-Tayar
- Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou, 730000, China
- Orthodontics Division, Faculty of Medicine and Health Sciences, Taiz University, Taiz, Yemen
| | - Majedh A A Al-Somairi
- Orthodontics Department, School of Stomatology, China Medical University, Shenyang, 110000, China
| | - Lina H ALshoaibi
- Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou, 730000, China
| | - Xiaoli Wang
- Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou, 730000, China
| | - Junbin Wang
- Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou, 730000, China
| | - Jiajie Liu
- Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou, 730000, China
| | - Baher Al-Tayar
- Graduate Student of Dental Health Science, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Dentistry, Faculty of Medical Sciences, Aljanad University for Science and Technology, Taiz, Yemen
| | - Xiaoli An
- Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou, 730000, China.
| | - Qingzong Si
- Department of Oral Medicine, School of Stomatology, Lanzhou University, Lanzhou, 730000, China
| |
Collapse
|
34
|
Miao Z, Zhang H, Han Y, Wang L, Wang S. Orthodontic care in orthodontic patients during the COVID-2019 pandemic: emergency, emergency response and orthodontic treatment preference. BMC Oral Health 2023; 23:364. [PMID: 37277764 DOI: 10.1186/s12903-023-03066-z] [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: 01/07/2023] [Accepted: 05/20/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND The objective of this study was to investigate the characteristics of emergencies and the requirement for emergency treatment after the suspension of orthodontic appointments. The attitude towards orthodontic treatment preference was evaluated as well, including receiving orthodontic treatment and the preference for orthodontic appliances. SUBJECTS AND METHODS An electronic questionnaire was distributed to the patients, including 4 sections: Section 1 - demographic and basic information; Section 2 - the characteristics of emergencies and emergency treatment requirements; Section 3 - the NRS-11 for pain and Manchester Orofacial Pain Disability Scale used to evaluate the intensity of orofacial pain and disability; and Section 4 - attitudes towards receiving orthodontic treatment and appliance preference. Descriptive statistics, Pearson's chi-square test, Wilcoxon's rank-sum test and stepwise generalized linear model (GLM) were performed with significance set at P < 0.05. RESULT Most participants' (91.61%) follow-up appointments were suspended. The emergency rate and emergency treatment requirements were not different between the fixed appliance (FA) and clear aligner (CA) groups. Patients who reported emergencies (P < 0.01) in the FA group (P < 0.05) and some emergencies in the FA (P < 0.05) suffered worse pain and disability. More FA participants preferred alternative appliances (P < 0.05) due to pain and disability (P < 0.05). CONCLUSION FA patients' emergencies caused worse pain and disability when orthodontic appointments were suspended. Pain and disability were not the causes of emergency treatment requirements. The CA group seemed to show a tendency towards orthodontic appliance preference, which was an ideal modality to weather the epidemic, combined with telemedicine.
Collapse
Affiliation(s)
- Zeyao Miao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Haijuan Zhang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yandong Han
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Lirong Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.
| | - Shuang Wang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
- Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
- Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
| |
Collapse
|
35
|
Yao S, Jiang W, Wang C, He Y, Wang C, Huang L. Improvements of tooth movement efficiency and torque control in expanding the arch with clear aligners: a finite element analysis. Front Bioeng Biotechnol 2023; 11:1120535. [PMID: 37324442 PMCID: PMC10267454 DOI: 10.3389/fbioe.2023.1120535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 05/25/2023] [Indexed: 06/17/2023] Open
Abstract
Objectives: The purpose of this study was to analyze the effect of different movement strategies, embossment structures, and torque compensation of the aligner on tooth movement during arch expansion using clear aligners by finite element analysis. Methods: Models comprising the maxilla, dentition, periodontal ligament, and aligners were created and imported into a finite element analysis software. The tests were performed using the following: three orders of tooth movement (including alternating movement with the first premolar and first molar, whole movement with second premolar and first molar or premolars and first molar), four different shapes of embossment structures (ball, double ball, cuboid, cylinder, with 0.05, 0.1, 0.15-mm interference) and torque compensation (0°, 1°, 2°, 3°, 4°, and 5°). Results: The expansion of clear aligners caused the target tooth to move obliquely. Alternating movement resulted in higher movement efficiency with lower anchorage loss as compared with whole movement. Embossment increased the efficiency of crown movement but did not contribute positively to torque control. As the angle of compensation increased, the tendency of oblique tooth movement was gradually controlled; however, the movement efficiency decreased concurrently, and stress distribution on the periodontal ligament became more even. For each 1° increase in compensation, the torque per millimeter of the first premolar would decrease by 0.26°/mm, and the crown movement efficiency eliminate decreased by 4.32%. Conclusion: Alternating movement increases the efficiency of the arch expansion by the aligner and reduces anchorage loss. Torque compensation should be designed to enhance torque control in arch expansion using an aligner.
Collapse
Affiliation(s)
- Song Yao
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Wei Jiang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Chunjuan Wang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yao He
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Chao Wang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Key Laboratory of Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, Beijing, China
| | - Lan Huang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| |
Collapse
|
36
|
Ji L, Li B, Wu X. Evaluation of biomechanics using different traction devices in distalization of maxillary molar with clear aligners: a finite element study. Comput Methods Biomech Biomed Engin 2023; 26:559-567. [PMID: 35543236 DOI: 10.1080/10255842.2022.2073789] [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: 11/03/2022]
Abstract
The study aimed to mechanically evaluate the tooth displacement of molar distalization by clear aligners combined with micro-implant through different traction devices using finite element analysis. A three-dimensional finite element model of complete maxillary dentition was constructed. Simultaneously move the maxillary first and second molars 0.2 mm distally at the height of 4 mm and 6 mm of micro-implant, and 150 g force was applied to button, precision cut and angelbutton respectively. Initial tooth movement in six different conditions of anterior tooth and molars was analyzed and calculated with ANSYS software. All the upper anterior tooth exhibited uncontrolled labial tipping and intrusion upon the six conditions, and the central incisor showed the largest tendency of crown labial inclination. Among the absolute values of crown-root displacement difference of the anterior tooth in sagittal direction, the angelbutton was the smallest, which means the torque control ability was superior to others. However, button played a more accurate role in the sagittal and vertical control of canine. With the increase of micro-implant height, the torque control ability of anterior tooth was decreased, but the intrusion trend increased. The controlled distal inclination with extrusion of the first molar and uncontrolled distal inclination with intrusion of the second molar were observed, and the angelbutton had more effective horizontal and vertical control on molars, which was close to bodily movement than others. As a new type of traction device, angelbutton has excellent anchorage control effect in clear aligners therapy of molar distalization, which further realizes the accurate expression of orthodontic force.
Collapse
Affiliation(s)
- Lili Ji
- Dental Hospital of Shanxi Medical University, Taiyuan, P. R. China
| | - Bing Li
- Dental Hospital of Shanxi Medical University, Taiyuan, P. R. China
| | - Xiuping Wu
- Dental Hospital of Shanxi Medical University, Taiyuan, P. R. China
| |
Collapse
|
37
|
Huang Y, Chen Y, Yang D, Tang Y, Yang Y, Xu J, Luo J, Zheng L. Three-dimensional analysis of the relationship between mandibular retromolar space and positional traits of third molars in non-hyperdivergent adults. BMC Oral Health 2023; 23:138. [PMID: 36894923 PMCID: PMC9999568 DOI: 10.1186/s12903-023-02843-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 02/27/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND The anatomical position of the mandibular third molars (M3s) is located in the distal-most portions of the molar area. In some previous literature, researchers evaluated the relationship between retromolar space (RS) and different classifications of M3 in three‑dimensional (3D) cone-beam computed tomography (CBCT). METHODS Two hundred six M3s from 103 patients were included. M3s were grouped according to four classification criteria: PG-A/B/C, PG-I/II/III, mesiodistal angle and buccolingual angle. 3D hard tissue models were reconstructed by CBCT digital imaging. RS was measured respectively by utilizing the fitting WALA ridge plane (WP) which was fitted by the least square method and the occlusal plane (OP) as reference planes. SPSS (version 26) was used to analyze the data. RESULTS In all criteria evaluated, RS decreased steadily from the crown to the root (P < 0.05), the minimum was at the root tip. From PG-A classification, PG-B classification to PG-C classification and from PG-I classification, PG-II classification to PG-III classification, RS both appeared a diminishing tendency (P < 0.05). As the degree of mesial tilt decreased, RS appeared an increasing trend (P < 0.05). RS in classification criteria of buccolingual angle had no statistical difference (P > 0.05). CONCLUSIONS RS was associated with positional classifications of the M3. In the clinic, RS can be evaluated by watching the Pell&Gregory classification and mesial angle of M3.
Collapse
Affiliation(s)
- Yumei Huang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yunjia Chen
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Dan Yang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yingying Tang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Ya Yang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jingfeng Xu
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jun Luo
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.
| | - Leilei Zheng
- Stomatological Hospital of Chongqing Medical University, Chongqing, China. .,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China. .,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
| |
Collapse
|
38
|
Li L, Guo R, Zhang L, Huang Y, Jia Y, Li W. Maxillary molar distalization with a 2-week clear aligner protocol in patients with Class II malocclusion: A retrospective study. Am J Orthod Dentofacial Orthop 2023:S0889-5406(23)00071-9. [PMID: 36872177 DOI: 10.1016/j.ajodo.2022.11.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 03/06/2023]
Abstract
INTRODUCTION This study aimed to investigate the efficacy of molar distalization with or without anterior teeth retraction. METHODS Forty-three patients who received maxillary molar distalization with clear aligners were retrospectively enrolled and further divided into 2 groups: a retraction group (with maxillary incisor retraction ≥2 mm in ClinCheck) and a nonretraction group (without anteroposterior movement or with the labial movement of the maxillary incisor in ClinCheck). Pretreatment and posttreatment models were collected and laser-scanned to obtain the virtual models. Three-dimensional digital assessments of molar movement, anterior retraction and arch width were analyzed in the reverse engineering software Rapidform 2006. To calculate the efficacy of tooth movement, the achieved tooth movement assessed on the virtual model was compared with the predicted tooth movement in ClinCheck. RESULTS The achieved efficacy rates of molar distalization for the maxillary first and second molars were 36.48% and 41.94%, respectively. There was a significant difference in molar distalization efficacy between the retraction group (31.50% at the first molar and 35.63% at the second molar) and the nonretraction group (48.14% at the first molar and 52.51% at the second molar). In the retraction group, the efficacy of incisor retraction was 56.10%. The efficacy of dental arch expansion was more than 100% at the first molar levels in the retraction group and at the second premolar and first molar levels in the nonretraction group. CONCLUSIONS There is a discrepancy between the outcome and the predicted maxillary molar distalization with clear aligners. The efficacy of molar distalization with clear aligners was significantly affected by anterior teeth retraction, and the arch width significantly increased at the premolar and molar levels.
Collapse
Affiliation(s)
- Linwei Li
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Runzhi Guo
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Liwen Zhang
- Department of Dental Medical Center, China-Japan Friendship Hospital, Beijing, China
| | - Yiping Huang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yilin Jia
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China.
| | - Weiran Li
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China.
| |
Collapse
|
39
|
D’Antò V, Valletta R, Ferretti R, Bucci R, Kirlis R, Rongo R. Predictability of Maxillary Molar Distalization and Derotation with Clear Aligners: A Prospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2941. [PMID: 36833638 PMCID: PMC9957205 DOI: 10.3390/ijerph20042941] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
Clear aligners are employed daily for the treatment of Class II malocclusions, when a valid option involves distalization and derotation of the upper first and second molars. Evidence regarding the predictability of these movements is slight, and the treatment outcome that clinicians plan may not be achieved. Therefore, the purpose of this study is to assess the accuracy of distalization and derotation with clear aligners. Geomagic Control X, a 3D quality control software, was used to superimpose digital models of the pre-treatment, post-treatment, and virtual plan (ideal post-treatment) measurements of 16 patients (4 M, 12 F; mean age 25.7 ± 8.8 years). Linear and angular measurement tools were used to calculate the amount of tooth movement prescribed and achieved. Distal displacement of the buccal cusps had an overall accuracy of 69% for the first molar and 75% for the second molar. The accuracy of molar derotation was higher for the first molar (77.5%) than for the second molar (62.7%). The aligners were not able to achieve 100% of the ideal post-treatment result; thus, planning of refinements is often needed. However, clear aligners can be regarded as a valuable option for the distalization of first and second molars.
Collapse
Affiliation(s)
- Vincenzo D’Antò
- School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Via Pansini, 5, 80131 Naples, Italy
| | - Rosa Valletta
- School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Via Pansini, 5, 80131 Naples, Italy
| | - Roberto Ferretti
- School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Via Pansini, 5, 80131 Naples, Italy
| | - Rosaria Bucci
- School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Via Pansini, 5, 80131 Naples, Italy
| | | | - Roberto Rongo
- School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Via Pansini, 5, 80131 Naples, Italy
| |
Collapse
|
40
|
Kwak KH, Oh S, Choi YK, Kim SH, Kim SS, Park SB, Kim YI. Effects of different distalization directions and methods on maxillary total distalization with clear aligners: a finite element study. Angle Orthod 2023; 93:490510. [PMID: 36719258 PMCID: PMC10117206 DOI: 10.2319/072622-519.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 12/01/2022] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES To analyze the effects of maxillary tooth distalization by clear aligner (CA) treatment with variations in the angular direction of the distalization force, presence of attachments, and force-application method used. MATERIALS AND METHODS A finite element model containing alveolar bone, dentition, and periodontal ligament was constructed. Analytical model groups were as follows: (1) distalization with buttons (without attachments), (2) buttons on canines (with attachments), (3) precision cuts on the canines (without attachments), and (4) precision cuts on the canines (with attachments). A distalization force of 1.5 N was applied to the button or precision cut at -30°, -20°, -10°, 0°, 10°, 20°, and 30° to the occlusal plane. RESULTS As the direction of force approached +30°, the dentition inclined posteriorly. The posterior movement pattern was significantly influenced by the presence of an attachment and the direction of force, rather than the area where the force was applied. Distal inclination was dramatically reduced with attachments. A disengagement or deformation of the CA may reduce the distalization efficiency of the dentition or move the dentition in an inappropriate direction. CONCLUSIONS Attachments for efficient distalization by the CA are necessary. The use of miniscrews in the direction of force parallel to the occlusal plane is more advantageous than the use of Class II elastics. Due to CA deformation, distalization with the button on the canines can be more effective for distal movement of the maxillary dentition.
Collapse
|
41
|
Sabouni W, Muthuswamy Pandian S, Vaid NR, Adel SM. Distalization using efficient attachment protocol in clear aligner therapy-A case report. Clin Case Rep 2023; 11:e6854. [PMID: 36698525 PMCID: PMC9860201 DOI: 10.1002/ccr3.6854] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/01/2023] [Accepted: 01/03/2023] [Indexed: 01/23/2023] Open
Abstract
To describe an esthetic orthodontic treatment using aligners in an adult patient with dental class II malocclusion associated with crowding. A 25-year-old female patient with skeletal class I, bilateral class II relation, increased overjet and overbite and crowding in both arches presented for orthodontic treatment. The patient refused conventional fixed multibracket treatment in favor of aligners. Pre- and post-treatment records are presented. Treatment objectives were achieved in 10 months, and the patient was satisfied with the functional and esthetic outcomes. Combining aligners with appropriate attachment location and geometry is an efficacious means of resolving orthodontic issues such as class II malocclusion in a time frame comparable to that of conventional fixed orthodontics. Staging in distalization increases the predictability of movement. Furthermore, this system is associated with optimal oral hygiene and excellent esthetics.
Collapse
Affiliation(s)
- Waddah Sabouni
- Private Practice, Invisalign CentreDubaiUnited Arab Emirates
| | | | - Nikhilesh R. Vaid
- Department of OrthodonticsSaveetha Dental College, Saveetha Institute of Medical and Technical SciencesChennaiTamil NaduIndia
| | - Samar M. Adel
- Department of OrthodonticsAlexandria UniversityAlexandriaEgypt
| |
Collapse
|
42
|
Treatment of class II malocclusion with Invisalign®: A pilot study using digital model-integrated maxillofacial cone beam computed tomography. J Dent Sci 2023; 18:353-366. [PMID: 36643222 PMCID: PMC9831838 DOI: 10.1016/j.jds.2022.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 08/24/2022] [Indexed: 01/18/2023] Open
Abstract
Background/purpose The treatment effects of Invisalign® are still obscure due to methodological limitations of previous studies. We introduced a method to comprehensively evaluate the dental and skeletal changes of Class II malocclusion treated non-extraction with Invisalign® and compare with the virtual simulation of ClinCheck® using digital models integrated into maxillofacial cone-beam computed tomography (CBCT). Materials and methods The pretreatment (T1) and posttreatment (T2) scanned digital images of actual dentitions were integrated into maxillofacial CBCT images. To evaluate three-dimensional movement of maxillary teeth and change of mandible position, T1 and T2 digital model-integrated maxillofacial CBCT images were superimposed using voxel-based registrations of stable cranial base structures. To evaluate movement of mandibular teeth, model-integrated mandibular CBCT superimposition was registered on mandibular basal bone. To compare achieved and predicted tooth movements, the actual dental images and the virtual digital models created by ClinCheck® were registered on the T1 dentitions. Results For simulated upper first molar (U6) distalization of more than 1 mm, treatment accuracy ranged from 31.1% to 40.1%, which was significantly less than virtual planning and previous reports. In unilateral Class II subjects, the amount of U6 distalization on the Class II side was not significantly different from contralateral side, indicating efficacy of sequential distalization was questionable. Those with favorable overjet correction showed evidence of condylar distraction. Conclusion Digital model-integrated CBCT superimpositions reflected the actual treatment changes in comparison with the virtual simulation, and showed that ideal occlusion was not achieved in mild to moderate Class II adult patients treated non-extraction with Invisalign®.
Collapse
|
43
|
Palone M, Brucculeri L, Cremonini F, Albertini P, Lombardo L. Treatment of severe Class II skeletal malocclusion in a hyperdivergent adult patient via hybrid clear aligner approach: A case report of successful camouflage therapy. J Orthod 2022; 50:205-214. [DOI: 10.1177/14653125221138588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This case report describes the camouflage treatment of an adult patient with hyperdivergent facial pattern presenting with severe Class II skeletal malocclusion, through the use of a hybrid clear aligner approach, that relies on both a partial lingual fixed appliance and the continuous use of Class II elastics throughout therapy. After 11 months of treatment, the goals had been achieved, highlighting that the correct diagnostic framework, proper patient selection and careful digital planning of a compromise treatment can provide satisfactory aesthetic and functional outcomes.
Collapse
Affiliation(s)
- Mario Palone
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - L Brucculeri
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - F Cremonini
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - P Albertini
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - L Lombardo
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| |
Collapse
|
44
|
Class II Malocclusion in Adult Patients: What Are the Effects of the Intermaxillary Elastics with Clear Aligners? A Retrospective Single Center One-Group Longitudinal Study. J Clin Med 2022; 11:jcm11247333. [PMID: 36555949 PMCID: PMC9782913 DOI: 10.3390/jcm11247333] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 12/02/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Abstract
Aim: To evaluate the dental effects of the treatment with clear aligners and intermaxillary elastics in adult patients with Class II malocclusion. Material and methods: A sample of 20 Class II patients treated with Invisalign aligners (5 M and 15 F; mean age of 27.6 ± 6.3 years) was included in this single-center one-group longitudinal study. Dental cast and cephalometric records were analyzed before (T0) and after treatment (T1). Data were analyzed with a t-test for paired data (p < 0.05). Results: There was a significant reduction of the Overjet (OVJ= −1.4 ± 0.2; p ≤0.001) and a retroposition of upper incisors (U1-NPo = −1.3 ± 1.7; p < 0.001). Furthermore, distalization of upper molars with an improvement of molar class (U6-PT Vertical = −0.93 ± 0.97; p < 0.001; Molar Relation = −0.75 ± 0.45; p < 0.001) was observed. A good control of the lower and upper incisor inclination was present, highlighted by the non-significant changes in these values (L1-GoGn = −0.12 ± 5.4; p = 0.923; U1-AnsPns = −1.1 ± 8.1; p = 0.551). In the lower arch, an increase in the intermolar diameter (0.6 ± 1.0; p = 0.01) was present. Finally, there were no statistically significant changes in all the skeletal variables (ANPg = 0.005 ± 0.687; p = 0.974; SN/MP = −0.47 ± 1.9; p = 0.298). Conclusions: Treatment with Invisalign aligners shows a reduction of the Overjet, a retroposition of the upper incisors, good control of the lower incisors, and an improvement of the molar relationship.
Collapse
|
45
|
Greco M, Rossini G, Rombolà A. G-Block: Posterior anchorage device tads-supported after molar distalization with aligners: An adult case report. Int Orthod 2022; 20:100687. [PMID: 36153240 DOI: 10.1016/j.ortho.2022.100687] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/14/2022] [Accepted: 08/15/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Temporary anchorage devices represent a fundamental tool to reliably manage orthodontic anchorage in several conditions. One of the most recent application is represented by the combination of aligners with TADs to simplify specific movements such as posterior intrusion, anterior intrusion, molars distalization. The objective of this case report is to show a novel technique called "G-block" to manage posterior anchorage with a hybrid approach combining aligners and TADs. MATERIALS AND METHODS This case report shows a Class II malocclusions (end to end relationship) with increased overjet and incisors proclination treated with aligners and maxillary distalization approach. To manage the posterior anchorage after second molar distalization and to avoid the use of Class II elastics, TADs (Spider Pin 1.3mm×10mm) were inserted into the interradicular space between the maxillary first and second molars following second molar distalization. The mini screws were used to provide both direct and indirect anchorage. The second molars were connected to the TAD by means of a 0.18 SS wire embedded in the attachment and blocked to the head of the mini-screw for indirect anchorage, while an elastic chain connecting the TADs to the buttons bonded to the first molars and premolars provided direct anchorage during first molar and premolar distalization. RESULTS A solid bilateral Class I occlusion was achieved with a normal overjet and overbite. The dental arches were well aligned and leveled with good intra-arch symmetry and regular arch forms. Final cephalometric analysis showed a significant change in upper incisor proclination (15̊ reduction) while maintaining correct torque control and a significant change in molar relationship. The aesthetic analysis showed an improvement in lip competence and incisor exposure. CONCLUSION The use of TADs for posterior anchorage after maxillary molar distalization with aligners, could represent an effective solution to easily manage the posterior anchorage reducing the need for patient's compliance in using elastics and in particular simplifying the posterior teeth movements by coupling the force expressed from the aligners with the force expressed by the auxiliary system.
Collapse
Affiliation(s)
- Mario Greco
- Department of Paediatric Dentistry, University of L'Aquila, L'Aquila, Italy; Private Practice, Rome, Italy.
| | | | | |
Collapse
|
46
|
Liu X, Cheng Y, Qin W, Fang S, Wang W, Ma Y, Jin Z. Effects of upper-molar distalization using clear aligners in combination with Class II elastics: a three-dimensional finite element analysis. BMC Oral Health 2022; 22:546. [PMID: 36456944 PMCID: PMC9714146 DOI: 10.1186/s12903-022-02526-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/21/2022] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION The effects of upper-molar distalization using clear aligners in combination with Class II elastics for anchorage reinforcement have not been fully investigated yet. The objective of this study is to analyze the movement and stress of the whole dentition and further explore guidelines for the selection of traction methods. METHODS Three-dimensional (3D) finite element models are established to simulate the sequential molar distalization process, including the initial distalization of the 2nd molar (Set I) and the initial distalization of the 1st molar (Set II). Each group set features three models: a control model without Class II elastics (model A), Class II elastics attached to the tooth by buttons (model B), and Class II elastics attached to the aligner by precision cutting (model C). The 3D displacements, proclination angles, periodontal ligament (PDL) hydrostatic stress and alveolar bone von Mises stress in the anterior area are recorded. RESULTS In all of the models, the maxillary anterior teeth are labial and mesial proclined, whereas the distal moving molars exhibit distal buccal inclination with an extrusion tendency. With the combination of Class II elastics, the anchorage was effectively reinforced; model C demonstrates superior anchorage reinforcement with lower stress distribution in comparison with model B. The upper canines in model B present an extrusion tendency. Meanwhile, the mandibular dentition in models B and C experience undesired movement tendencies with little discrepancy from each other. CONCLUSIONS Class II elastics are generally effective for anchorage reinforcement as the upper-molar distalization is performed with clear aligners. Class II elastics attached to an aligner by precision cutting is a superior alternative for maxillary anchorage control in cases that the proclination of upper incisors and extrusion of upper canines are unwanted.
Collapse
Affiliation(s)
- Xulin Liu
- grid.233520.50000 0004 1761 4404Department of Orthodontics, School of Stomatology, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Air Force Medical University, Xi’an, 710032 China
| | - Yuxun Cheng
- grid.233520.50000 0004 1761 4404Department of Orthodontics, School of Stomatology, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Air Force Medical University, Xi’an, 710032 China
| | - Wen Qin
- grid.233520.50000 0004 1761 4404Department of Orthodontics, School of Stomatology, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Air Force Medical University, Xi’an, 710032 China
| | - Shishu Fang
- grid.233520.50000 0004 1761 4404Department of Orthodontics, School of Stomatology, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Air Force Medical University, Xi’an, 710032 China
| | - Wei Wang
- Urumql DW Innovation InfoTech Co.Ltd, Xinjiang, 830000 China
| | - Yanning Ma
- grid.263452.40000 0004 1798 4018Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001 China
| | - Zuolin Jin
- grid.233520.50000 0004 1761 4404Department of Orthodontics, School of Stomatology, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Air Force Medical University, Xi’an, 710032 China
| |
Collapse
|
47
|
Predictability of lower incisor tip using clear aligner therapy. Prog Orthod 2022; 23:37. [PMCID: PMC9637687 DOI: 10.1186/s40510-022-00433-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/03/2022] [Indexed: 11/09/2022] Open
Abstract
Abstract
Background
Uprighting incisors is particularly important with clear aligner therapy as incisor tip determines the mesio-distal space needed in the arch, and consequently the fit of the aligner. The objective of this study was to investigate the accuracy of ClinCheck® software to predict lower incisor tip by comparing digitally prescribed movements with actual clinical outcomes and to determine whether the presence of a vertically orientated rectangular composite attachment influences the efficacy of incisor tip.
Methodology
This retrospective study included 66 lower incisors from 42 non-extraction adult patients treated using the Invisalign® appliance. Twenty-one incisors had vertical attachments, while 45 incisors did not have any attachments. Lower incisor tip was measured at T0 (pre-treatment), T1 (predicted post-treatment) and T2 (achieved post-treatment) on digital models using metrology software. The change in position from T0 to T1 and T0 to T2 was measured from the estimated centre of resistance (CRes) of each tooth. The estimated centre of rotation was plotted relative to the CRes to describe the type of orthodontic tooth movement (OTM) predicted and achieved.
Results
Predicted incisor tip and achieved incisor tip were positively correlated (R2 = 0.55; p < 0.001). For every degree of tip planned 0.4 degrees of tip was achieved. The presence of an attachment resulted in 1.2 degrees greater tip (F = 3.7; p = 0.062) and 0.5 mm greater movement of the predicted apex of the tooth (F = 4.3; p = 0.042) compared with the no attachment group. The type of OTM achieved differed from the type predicted. Sixty-seven percent of incisors investigated were predicted to move by root movement, while 46% achieved this type of movement.
Conclusions
The amount of lower incisor tip achieved was on average substantially less than the ClinCheck® displayed. Vertically orientated rectangular attachments are recommended where large root movement is planned, and their presence slightly improves apex movement.
Collapse
|
48
|
Lione R, Balboni A, Di Fazio V, Pavoni C, Cozza P. Effects of pendulum appliance versus clear aligners in the vertical dimension during Class II malocclusion treatment: a randomized prospective clinical trial. BMC Oral Health 2022; 22:441. [PMID: 36217134 PMCID: PMC9552402 DOI: 10.1186/s12903-022-02483-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/28/2022] [Indexed: 11/11/2022] Open
Abstract
Background The aim of the present study was to compare the effects on vertical dentoskeletal dimension produced by Pendulum appliance and Clear Aligners in patients with Class II malocclusion.
Trial design This is a prospective two-arm parallel group randomized clinical trial with 1:1 allocation ratio. Methods The Pendulum Group (PG) consisted of 20 patients (15F, 5 M) with a mean age of 17.2 ± 4.3 years. The Clear Aligners Group (CAG) comprised 20 patients (13F, 7 M) with a mean age of 17.2 ± 3.2 years. Distalization’s protocol in PG involved the activation of TMA wires till the achievement of Class I molar relationship. A protocol of sequential distalization was applied in the CAG. For each subject lateral cephalograms have been analyzed before treatment (T1) and at the end of the therapy (T2). Descriptive statistics and statistical between-group comparisons (PG vs CAG) were calculated for the craniofacial starting forms at T1 and for the T2–T1 changes. Statistical between-group comparisons for the T2–T1 changes were performed with independent samples t-tests (P < 0.05).
Results The PG showed significantly greater increases in SN^GoGn° when compared with CAG (+ 2.1 and − 0.3 degrees, respectively). Clockwise rotation of the occlusal plane with significantly greater increase of SN^POccl angle was observed in PG (+ 2.8 degrees) when compared with CAG (− 4.2 degrees). The PG revealed a significant increase in the N-Me variable with a mean change of + 4.4 mm compared to the CAG with mean values of − 1.2 mm. The PG showed an increase in the ArGo^GoMe angle (+ 0.7° degrees) compared to the CAG (− 3.4° degrees). The PG showed significantly greater increases in both maxillary and mandibular first molar to palatal plane (+ 1.3 and + 2.1 mm, respectively) when compared with CAG (− 0.9 and − 0.2 mm, respectively).
Conclusions Upper molar distalization with clear aligners represents a valid alternative to non-extraction treatment of Class II malocclusion, reducing the extrusion of maxillary first molars and improving the management of the occlusal plane and vertical dimension. Trial registration: ClinicalTrials.gov, NCT05298280. Registered 28 March 2022—Retrospectively registered, https://clinicaltrials.gov.
Collapse
Affiliation(s)
- Roberta Lione
- Department of Systems Medicine, University of Rome 'Tor Vergata', Viale Oxford, 81, 00133, Rome, Italy. .,Department of Dentistry, UNSBC, Tirana, Albania. .,Department of Faculty of Medicine and Surgery, UniCamillus International Medical University, Rome, Italy.
| | - Alessia Balboni
- Department of Systems Medicine, University of Rome 'Tor Vergata', Viale Oxford, 81, 00133, Rome, Italy
| | - Valentina Di Fazio
- Department of Systems Medicine, University of Rome 'Tor Vergata', Viale Oxford, 81, 00133, Rome, Italy
| | - Chiara Pavoni
- Department of Systems Medicine, University of Rome 'Tor Vergata', Viale Oxford, 81, 00133, Rome, Italy.,Department of Dentistry, UNSBC, Tirana, Albania
| | - Paola Cozza
- Department of Dentistry, UNSBC, Tirana, Albania.,Department of Faculty of Medicine and Surgery, UniCamillus International Medical University, Rome, Italy
| |
Collapse
|
49
|
Taffarel IA, Gasparello GG, Mota-Júnior SL, Pithon MM, Taffarel IP, Meira TM, Tanaka OM. Distalization of maxillary molars with Invisalign aligners in nonextraction patients with Class II malocclusion. Am J Orthod Dentofacial Orthop 2022; 162:e176-e182. [PMID: 35965168 DOI: 10.1016/j.ajodo.2022.07.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 07/01/2022] [Accepted: 07/01/2022] [Indexed: 11/01/2022]
Abstract
INTRODUCTION This retrospective study aimed to evaluate whether the treatment of Class II malocclusion with Invisalign aligners with sequential distalization of posterior teeth in adult patients would meet the criteria of American Board of Orthodontics (ABO) standards for the treatment and assess the predictive value of ClinCheck Pro software with the final results comparing the initial time, predictive planning using ClinCheck Pro software, and the final time without any require refinement. METHODS The sample consisted of 32 adult patients with Class II malocclusion (n = 32 [7 men and 25 women]; mean age 35.47 ± 9.61 years). All of them used a set of Invisalign aligners; no refinement set was evaluated. The 7 measurements of the ABO Model Grading System, the millimeter measurements for the anteroposterior ratios of maxillary first molars and the overbite were used in the evaluations and were compared in phases initial time, predictive planning using ClinCheck Pro software, and the final time. For the intraexaminer reliability test, the intraclass correlation coefficient was calculated to analyze the reliability of the measures. The Shapiro-Wilk normality test was used to examine whether the variables were normally distributed. The Wilcoxon nonparametric test for paired samples was applied for variables that did not show normal distribution. The parametric Student t test for paired samples was used for variables that presented normal distribution. The significance level adopted for this study was 0.05. RESULTS In comparison between final ClinCheck and posttreatment results, the ABO index showed a statistically significant difference between the predictions and results for alignment and rotation, buccolingual inclination, overjet, occlusal contact, occlusal relationship, molar relationship, and overbite. The final score of the ABO scores did not meet the standards for Class II correction, contrary to what the ClinCheck Pro software predicted. CONCLUSIONS The null hypothesis that distalization of the posterior teeth occurs in adult patients using Invisalign aligners was rejected. The treatment of Class II malocclusion with Invisalign aligners did not occur as estimated by the virtual planning prepared by ClinCheck according to the standards for evaluating occlusal results established by the ABO at the end of the use of a set of aligners with sequential distalization.
Collapse
Affiliation(s)
- Itamar Antonio Taffarel
- Graduate Dentistry Program, School of Life Sciences, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Gil Guilherme Gasparello
- Graduate Dentistry Program, School of Life Sciences, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Sergio Luiz Mota-Júnior
- Department of Orthodontics, Juiz de Fora Federal University, and Private practice, Juiz de Fora, Minas Gerais, Brazil
| | | | | | - Thiago Martins Meira
- Bahia State University, Guanambi, Bahia, Brazil Graduate Dentistry Program, School of Life Sciences, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Orlando Motohiro Tanaka
- The Center for Advanced Dental Education at Saint Louis University, Saint Louis University, St Louis, Mo Graduate Dentistry Program, School of Life Sciences, Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil.
| |
Collapse
|
50
|
Chi J, Yang L, Liu Y, Yang J, Deng J. Biomechanical Characteristics of Maxillary Molar Distalization Using Different Attachments with Clear Aligners: A 3-Dimensional Finite Element Analysis. J BIOMATER TISS ENG 2022. [DOI: 10.1166/jbt.2022.3094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study aimed to compare the biomechanical characteristics of maxillary teeth in molar distalization with different orthodontic attachments. A 3-dimensional finite model of maxillary molar distalization with clear aligners was generated by computed tomography and contained different
components. Four models—non-attachment (model A), horizontal rectangular attachment (model B), vertical rectangular attachment (model C), and combined attachment (model D)—were set up. The modalities of molar distalization were simulated using a finite element analysis. The results
showed that the minimum displacement (rotation center) of the second molar in models A and B was located at the root furcation. In model C, the minimum displacement was located in the middle third of the palatal root. In model D, the minimum displacement was located at the apical third of
the root. The anchorage teeth in all the four groups tended to have mesial tipping movement. Models B and D had more uniform stress distribution of the periodontal ligament than models A and C. Models with attachment had a larger tooth displacement pattern than that without attachment. Collectively,
if molar distalization is planned before treatment, the appropriate application of attachments can help achieve the desired tooth movements more efficiently.
Collapse
Affiliation(s)
- Jingwen Chi
- School of Stomatology, Qingdao University, Qingdao, 266003, China
| | - Lixia Yang
- School of Stomatology, Qingdao University, Qingdao, 266003, China
| | - Yicong Liu
- School of Stomatology, Qingdao University, Qingdao, 266003, China
| | - Jianjun Yang
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital, Qingdao University, Qingdao, 266001, China
| | - Jing Deng
- School of Stomatology, Qingdao University, Qingdao, 266003, China
| |
Collapse
|