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D'Antò V, Rongo R, Casaburo SD, Martina S, Petrucci P, Keraj K, Valletta R. Predictability of tooth rotations in patients treated with clear aligners. Sci Rep 2024; 14:11348. [PMID: 38762583 PMCID: PMC11102536 DOI: 10.1038/s41598-024-61594-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 05/07/2024] [Indexed: 05/20/2024] Open
Abstract
Clear aligners are employed daily for the treatment of several malocclusions. Previous clinical studies indicated low accuracy for the correction of tooth rotations. The aim of this study was to evaluate the predictability of tooth rotations with clear aligners. The sample comprised 390 teeth (190 mandibular; 200 maxillary), measured from the virtual models of 45 participants (21 men, 24 women; mean age: 29.2 ± 6.6 years old). For each patient, pre-treatment (T0) digital dental models (STL files), virtual plan (T1) and post-treatment digital dental models (T2) of both the mandibular and maxillary arches were imported onto Geomagic Control X, a 3D metrology software which allows angular measurements. Rotations were calculated by defining reproducible vectors for all teeth in each STL file and superimposing both T0 with T1 to determine the prescribed rotation, and T0 with T2 to determine the achieved rotation. Prescribed and achieved rotations were compared to assess movement's accuracy. The Wilcoxon signed-rank test and paired t-test were used to assess differences between the prescribed and achieved movements (P < 0.05). The overall predictability of rotational movement was 78.6% for the mandibular arch and 75.0% for the maxillary arch. Second molar accuracy was the lowest in both arches. Clear aligners were not able to achieve 100% of the planned movements.
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Affiliation(s)
- Vincenzo D'Antò
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, School of Orthodontics, University of Naples Federico II, Via Pansini, 5, 80131, Naples, Italy.
| | - Roberto Rongo
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, School of Orthodontics, University of Naples Federico II, Via Pansini, 5, 80131, Naples, Italy
| | - Sossio Dario Casaburo
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, School of Orthodontics, University of Naples Federico II, Via Pansini, 5, 80131, Naples, Italy
| | - Stefano Martina
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Via Al-Lende, 84081, Baronissi, Italy
| | - Paolo Petrucci
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, School of Orthodontics, University of Naples Federico II, Via Pansini, 5, 80131, Naples, Italy
| | - Kreshnik Keraj
- Department of Prosthodontic, Faculty of Dental Medicine, University of Medicine, Rruga e "Dibrës", AL1005, Tirana, Albania
| | - Rosa Valletta
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, School of Orthodontics, University of Naples Federico II, Via Pansini, 5, 80131, Naples, Italy
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Barashi MA, Habis RM, Alhazmi HA. Predictability of Orthodontic Space Closure Using Invisalign Clear Aligners: A Retrospective Study. Cureus 2024; 16:e56706. [PMID: 38646261 PMCID: PMC11032648 DOI: 10.7759/cureus.56706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2024] [Indexed: 04/23/2024] Open
Abstract
Introduction Clear aligners have demonstrated success in achieving complex tooth movements. However, orthodontists have faced challenges related to the predictability of clear aligners. This retrospective study aimed to assess the predictability of ClinCheck® accuracy in space closure before and after Invisalign® treatment and to identify factors associated with the need for refinement. Methods Patient records from one private clinic in Makkah, Saudi Arabia, were analyzed, and a sample of 55 adult patients who had spacing and underwent Invisalign treatment were included. Data on demographic and orthodontic variables were collected, and a chi-square test was conducted to examine the association between the requirement for refinement and demographic as well as clinical/orthodontic factors. Furthermore, the initial and final space measurements were compared using paired t-tests across various demographic and clinical/orthodontic variables. Results After completing the treatment, 70.9% (N=39) of the cases did not require any orthodontic refinement. The mean final space measurement was higher for males compared to females (0.7 mm and 0.4 mm, respectively), individuals who received treatment in the upper compared to lower arch (0.5 and 0.4 mm, respectively), those with moderate compared to mild spacing (0.5 and 0.1 mm, respectively), and those with class III compared to class I Angle classification (0.9 and 0.3 mm, respectively). Additionally, patients with severe spacing had a significantly higher probability of requiring refinement compared to patients with mild spacing (adjusted odds ratio = 20.9; p < 0.05). Conclusion The study emphasizes the significance of careful patient selection and treatment planning, suggesting that orthodontists should consider overcorrecting in space closure when using clear aligners, especially in cases with more significant spacing.
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Mendes Ribeiro SM, Aragón MLSDC, Espinosa DDSG, Shibasaki WMM, Normando D. Orthodontic aligners: between passion and science. Dental Press J Orthod 2024; 28:e23spe6. [PMID: 38198351 PMCID: PMC10768648 DOI: 10.1590/2177-6709.28.6.e23spe6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/10/2023] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION The benefits and safety of using orthodontic aligners have been reported more by clinical experience and expert opinion than by scientific evidence. Another important aspect is that aligners are constantly evolving. It is important to obtain evidence that allows for new updates in manufacturing technology, in the development of new movement planning protocols, in the incorporation and design of attachments, and in the aid of skeletal anchorage. METHODS Evidence retrieved from six electronic databases (CINAHL, MEDLINE, EMBASE, Psych Info, the Cochrane Library and the Joanna Briggs Library) is presented by means of questions and answers. CONCLUSIONS There is evidence that the aligners presented different levels of difficulty in performing each type of movement, with rotational and vertical movements being the most difficult to perform. Regarding perception of pain due to tooth movement, it seems to have less impact at the beginning of treatment; but dealing with more phonoarticulatory changes seems to require more treatment time in more complex cases. Aligners do not prevent the occurrence of root resorption, although the incidence and severity of resorption may be reduced, making oral hygiene easier and accepting the risk of white spots, caries and periodontal disease. Given the conflicting evidence, the release of bisphenol-A from the aligner cannot be denied. Solutions must be found to reduce the environmental impact of aligners disposal. There is an urgent need for well-designed randomized controlled trials.
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Affiliation(s)
| | | | | | | | - David Normando
- Universidade Federal do Pará (UFPA), Departamento de Ortodontia (Belém/PA, Brazil)
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Dahhas FY, Al-Saif EM, Alqahtani AM, Al Farraj NF, Alshaikh MA, Almadhi BS, Albuolayan N, Alhayaza HH, Asiri NA, Alshaya KH. The Potency of Invisalign® in Class II Malocclusion in Adults: A Narrative Review. Cureus 2023; 15:e49664. [PMID: 38161838 PMCID: PMC10756397 DOI: 10.7759/cureus.49664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 01/03/2024] Open
Abstract
In recent years, a greater number of adult patients are seeking orthodontic treatment, not only for esthetics but for better functioning and hygiene purposes. However, they are more focused on comfortable and invisible treatment alternatives to conventional metal brackets. This abstract is a multifaceted interplay between Invisalign® and different treatments of class II malocclusion, which embarks on the potency of Invisalign® in treating this condition in adult patients. The review delves into analyzing the efficacy of Invisalign® in molar distalization, class II elastics, extraction treatment, class II division 2 patients, their limitations, challenges, and future prospects. This article aspires the orthodontists understand the complex nature of class II malocclusion treatment in adults with Invisalign® and its application in clinical practice with improved patient outcomes.
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Affiliation(s)
| | - Eman M Al-Saif
- Orthodontics, King Fahd University of Petroleum and Minerals, Qatif, SAU
| | | | | | | | | | | | | | - Nada A Asiri
- General Dentistry, Magrabi Dental Center, Jeddah, SAU
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D'Antò V, Valletta R, Di Mauro L, Riccitiello F, Kirlis R, Rongo R. The Predictability of Transverse Changes in Patients Treated with Clear Aligners. Materials (Basel) 2023; 16:1910. [PMID: 36903025 PMCID: PMC10004392 DOI: 10.3390/ma16051910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
Arch expansion might be used to correct buccal corridors, improve smile aesthetics, resolve dental cross bite, and gain space to resolve crowding. In clear aligner treatment, the predictability of the expansion is still unclear. The purpose of this study was to evaluate the predictability of dentoalveolar expansion and molar inclination with clear aligners. In the study, 30 adult patients (27 ± 6.1 years old) treated with clear aligners were selected (treatment time: 8.8 ± 2.2 months). The upper and lower arch transverse diameters were measured for canines, first and second premolars, and first molars on two different sides (gingival margins and cusp tips); moreover, molar inclination was measured. A paired t-test and Wilcoxon test were used to compare prescription (planned movement) and achieved movement. In all cases, except for molar inclination, a statistically significant difference was found between achieved movement and prescription (p < 0.05). Our findings showed a total accuracy of 64% for the lower arch, 67% at the cusp level, and 59% at the gingival level, with a total accuracy of 67% for the upper arch, 71% at the cusp level, and 60% at the gingival level. The mean accuracy for molar inclination was 40%. Average expansion was greater at cusps of canines than for premolars, and it was lowest for molars. The expansion achieved with aligners is mainly due to the tipping of the crown rather than bodily movement of the tooth. The virtual plan overestimates the expansion of the teeth; thus, it is reasonable to plan an overcorrection when the arches are highly contracted.
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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
| | - Luigi Di Mauro
- School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Via Pansini, 5, 80131 Naples, Italy
| | - Francesco Riccitiello
- School of Pediatric Dentistry, 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
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D’Antò V, Valletta R, De Simone V, Pisano M, Martina S. Clear Aligners Treatment of Class III Subdivision with an Extraction of a Lower Bicuspid. Int J Environ Res Public Health 2023; 20:3550. [PMID: 36834244 PMCID: PMC9967822 DOI: 10.3390/ijerph20043550] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 05/27/2023]
Abstract
The aim of this study was to show a case of a Class III subdivision adult patient treated with clear aligners (CA) and the extraction of a lower bicuspid. A 19-year-old male with a class III canine and molar relationship on the right side and a deviation of lower dental midline to the left asked for an aesthetic treatment. He refused orthognathic surgical procedures, so he was offered a camouflage orthodontic treatment with the extraction of lower right first premolar to achieve a canine Class I relationship and to center the lower midline. The treatment was performed with clear aligners and the use of Class III elastics to maintain distal anchorage on the right side during the canine distalization. At the end of the treatment, the occlusal objectives were achieved.
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Affiliation(s)
- Vincenzo D’Antò
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Rosa Valletta
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Vittoria De Simone
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Via Pansini 5, 80131 Naples, Italy
| | - Massimo Pisano
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Allende, 84081 Baronissi, Italy
| | - Stefano Martina
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Allende, 84081 Baronissi, Italy
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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. Int J Environ Res 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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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