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Abu Arqub S, Al-Moghrabi D, Allareddy V, Upadhyay M, Vaid N, Yadav S. Content analysis of AI-generated (ChatGPT) responses concerning orthodontic clear aligners. Angle Orthod 2024; 94:263-272. [PMID: 38195060 PMCID: PMC11050467 DOI: 10.2319/071123-484.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 11/01/2023] [Indexed: 01/11/2024] Open
Abstract
OBJECTIVES To assess the accuracy of ChatGPT answers concerning orthodontic clear aligners. MATERIALS AND METHODS A cross-sectional content analysis of ChatGPT generated responses to queries related to clear aligner treatment (CAT) was undertaken. A total of 111 questions were generated by three orthodontists based on a set of predefined domains and subdomains. The artificial intelligence (AI)-generated (ChatGPT) answers were extracted and their accuracy was determined independently by five orthodontists. The accuracy of answers was assessed using a prepiloted four-point scale scoring rubric. Descriptive statistics were performed. RESULTS The total mean accuracy score for the entire set was 2.6 ± 1.1. It was noted that 58% of the AI-generated answers were scored as objectively true, 18% were selected facts, 9% were minimal facts, and 15% were false. False claims included the ability of CAT to reduce the need for orthognathic surgery (4.0 ± 0.0), improve airway function (3.8 ± 0.5), achieve root parallelism (3.6 ± 0.5), alleviate sleep apnea (3.8 ± 0.5), and produce more stable results compared to fixed appliances (3.8 ± 0.5). CONCLUSIONS The overall level of accuracy of ChatGPT responses to questions concerning CAT was suboptimal and lacked citations to relevant literature. Ability of the software to offer current and precise information was limited. Therefore, clinicians and patients must be mindful of false claims and relevant facts omitted in the answers generated by ChatGPT.
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Fan Y, Zhang X. In vitro study examines posterior torque impact on 3D mechanics of anterior teeth in clear aligner treatment. BMC Oral Health 2024; 24:486. [PMID: 38654276 DOI: 10.1186/s12903-024-04240-7] [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: 01/18/2024] [Accepted: 04/09/2024] [Indexed: 04/25/2024] Open
Abstract
INTRODUCTION This study utilizes investigate the impact of posterior torques on the three-dimensional force exerted on the lower anterior teeth during the retraction in orthodontic clear aligners treatment. METHODS Four groups of mandibular dental arch light-cured resin models will be created, including: mandibular posterior teeth with standard torque, mandibular posterior teeth with labial torque, and mandibular posterior teeth with lingual torque. Each group will consist of 12 sets of clear aligners. The aligners will be worn, and measurements will be taken using the six-axis measurement platform to evaluate the three-dimensional force exerted on the lower anterior teeth under various initial torques applied to the mandibular posterior teeth. SPSS 26.0 used for ANOVA analysis, α = 0.05 significance level. RESULTS Comparing mandibular posterior teeth with standard torque to those with labial torque, no statistically significant changes were observed in buccolingual force. In the mesiodistal direction, mandibular incisors exhibited a significant decrease in distal force, while canines showed a significant increase. Both findings had a significance level of P < 0.05; Lingual torque on mandibular posterior teeth, compared to standard torque, led to a significant increase in lingual force for incisors and a significant increase in labial force for canines in the buccolingual direction (P < 0.05). Additionally, mandibular incisors exhibited a significant decrease in distal force in the mesiodistal direction (P < 0.05). CONCLUSION Varying initial torques on mandibular posterior teeth significantly impact force on lower anterior teeth. Labial torque reduces lingual force on incisors and increases distal force on canines. Lingual torque increases lingual force on incisors and labial force on canines.
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Affiliation(s)
- Yongjie Fan
- Department of Orthodontics, The Fourth Affiliated Hospital of Inner Mongolia Medical University, Baotou, 014030, China.
| | - Xin Zhang
- Department of Orthodontics, The Fourth Affiliated Hospital of Inner Mongolia Medical University, Baotou, 014030, China
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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Cesur E, Tuncer K, Sevgi D, Balaban BC, Arslan C. Evaluation of the Quality and Reliability of YouTube TM Videos Created by Orthodontists as an Information Source for Clear Aligners. Turk J Orthod 2024; 37:44-49. [PMID: 38556952 PMCID: PMC10986454 DOI: 10.4274/turkjorthod.2023.2022.127] [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] [Received: 08/25/2022] [Accepted: 03/19/2023] [Indexed: 04/02/2024]
Abstract
Objective This study aimed to evaluate the quality, reliability, and content usefulness of videos created by orthodontists on clear orthodontic aligners. Methods Videos were screened using YouTubeTM by conducting a search for "Invisalign". After a preliminary evaluation of the first 250 results, 61 videos that met the selection criteria were scored and their length, days since upload, and numbers of views, likes, dislikes, and comments were recorded. These data were used to calculate the interaction index and viewing rate. Video reliability was assessed using a five-item modified DISCERN index, and video quality was assessed using the Video Information and Quality Index. A 10-item content usefulness index was created to determine the usefulness of the video content. Descriptive statistics of the parameters were calculated, and correlation coefficients were calculated to evaluate the relationships between the parameters. Results The mean reliability score was 2.75±1.02 (out of 5), and the total quality score was 11.80±3.38 (out of 20). The total content usefulness index was quite low, with a mean score of 2.52±2.14 (out of 10). Interaction index and viewing rate were positively correlated with reliability score (r=0.463, p<0.01; r=0.295, p<0.05) and total quality score (r=0.365, p<0.01; r=0.295, p<0.01, respectively). The reliability score was positively correlated with the total quality score (r=0.842, p<0.01) and total content usefulness index (r=0.346, p<0.01). Conclusion Videos about orthodontic aligner treatment have average reliability and quality but largely insufficient content.
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Affiliation(s)
| | - Koray Tuncer
- Antalya Bilim University Faculty of Dentistry, Department of Orthodontics, Antalya, Turkey
| | - Duygu Sevgi
- İstanbul Medipol University Faculty of Dentistry, Department of Orthodontics, İstanbul, Turkey
| | - Barkın Cem Balaban
- İstanbul Medipol University Faculty of Dentistry, Department of Orthodontics, İstanbul, Turkey
| | - Can Arslan
- Yeditepe University Faculty of Dentistry, Department of Orthodontics, İstanbul, Turkey
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Kang J, Jeon HH, Shahabuddin N. Does aligner refinement have the same efficiency in deep bite correction?: A retrospective study. BMC Oral Health 2024; 24:338. [PMID: 38491450 PMCID: PMC10943900 DOI: 10.1186/s12903-024-04099-8] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/04/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Refinements are very common in clear aligner treatments. The aim of this study is to assess whether the predictability of deep overbite correction is similar over several refinements using clear aligners (Invisalign, Align Technology, San Jose, Calif) and examine the accuracy of vertical movement and inclination change of individual teeth. METHODS This retrospective study included 20 deep bite patients (7M and 13F; 32.63 ± 11.88 years old; an initial overbite of 5.09 ± 0.98 mm), consecutively treated from September 2016 and March 2023, who completed at least two sets of aligners, including refinements. The initial, predicted, and achieved models were exported from ClinCheck or OrthoCAD (Cadent Inc, Carlstadt, NJ) and superimposed via best-fit surface-based registration using SlicerCMF (version 4.9.0; cmf.slicer.org). We also examined 15 out of 20 patients who completed treatments. The overbite correction and changes in vertical movement and inclination for individual teeth were measured. Descriptive statistics and a paired t-test or Wilcoxon signed-rank test were performed. P < 0.05 was considered statistically significant. RESULTS The mean accuracy of overbite correction was 37.63% after 1st set, followed by 11.19%, 6.32%, and 13.80% (2nd-4th sets), respectively. There were statistically significant differences between the predicted and achieved vertical movements and inclination changes for all teeth for the 1st and 2nd sets. For the completed cases, the mean overbite correction was 38.54% compared to the initially planned overbite correction, which is similar to one of the 1st set. Still, the vertical movements and inclination changes of all teeth present statistically significant differences between the initially planned and finally achieved movements except for maxillary lateral incisor torque. CONCLUSIONS The most overbite correction occurs during the 1st set of aligners, and refinement treatment does not significantly improve the deep bite correction.
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Affiliation(s)
- Jessica Kang
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, 240 South 40th Street, Philadelphia, PA, 19104-6030, USA
| | - Hyeran Helen Jeon
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, 240 South 40th Street, Philadelphia, PA, 19104-6030, USA.
| | - Nishat Shahabuddin
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, 240 South 40th Street, Philadelphia, PA, 19104-6030, USA
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Nicita F, Calapaj M, Alibrandi S, Donato L, Aquilio E, D'Angelo R, Sidoti A. Efficacy of an experimental gaseous ozone-based sterilization method for clear aligners. Angle Orthod 2024; 94:194-199. [PMID: 38381802 PMCID: PMC10893927 DOI: 10.2319/061623-421.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 11/01/2023] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVES To assess effectiveness of an experimental sterilization method based on the exposure of an O3/O2 gas mixture directly inside the packaging for clear aligners. MATERIALS AND METHODS Fifty samples consisting of pieces of polyethylene terephthalate glycol (PET-G) aligners were contaminated by manual handling and subsequently divided into different groups (n = 30 for exposure to O3/O2 gas at different times, n = 10 for positive control with 2% chlorhexidine digluconate, n = 10 for negative control). The measurement of optical densities (OD) of the initial and final microbial cultures was recorded for all groups. Kruskal-Wallis test was used for differences between groups while Wilcoxon test was used to compare initial and final OD values within groups. Statistical significance was set at P < .05. RESULTS Comparison within the groups showed statistically significant differences for exposure to the gaseous mixture (72 hours), for positive and negative controls. Other significant differences were found in the multiple comparisons between the application of gaseous ozone (48 hours and 72 hours) and the negative control. CONCLUSIONS The direct exposure of gaseous ozone on the aligners inside their packaging showed microbicidal capacity at 72 hours, which was equivalent to the positive control with immersion in chlorhexidine digluconate. This innovative sterilization procedure could be considered in the final manufacturing processes of clear aligners to eliminate the potentially pathogenic microorganisms that are deposited on surfaces of these orthodontic devices.
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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] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [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.
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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.
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Geramy A, Safari F. Effect of clear aligner type on maxillary full-arch intrusion: 3D analysis using finite element method. BMC Oral Health 2024; 24:231. [PMID: 38350943 PMCID: PMC10865575 DOI: 10.1186/s12903-024-03984-6] [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: 09/26/2023] [Accepted: 02/05/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Vertical maxillary excess (VME) is one of the most common reasons for seeking orthodontic treatment. Total intrusion with aligners is a promising alternative to surgery in some cases. Considering the elastic deformation of aligners, this study aimed to evaluate the possible desirable and undesirable teeth displacements during full maxillary arch intrusion using clear aligners and temporary anchorage devices (TADs). METHODS The maxillary arch and clear aligners were modeled in SolidWorks. Four aligner brands including Leon, Duran, Duran Plus, and Essix Plus were selected based on their material properties. Anterior and posterior intrusion forces of 80 and 300 g were applied from attachments between the canines and first premolars and between the first and second molars, respectively. Vertical and anteroposterior tooth displacements were determined. RESULTS The greatest intrusion was recorded at the buccal of the second molar, followed by the first molar. The lowest value was measured at the palatal of the molars with all aligners except Duran, which indicated minimal intrusion in the central incisor. All teeth were mesially displaced at the incisal/occlusal except incisors that moved distally. All apices showed distal movement. CONCLUSIONS Total intrusion using clear aligners may be accompanied by other tooth movements, including buccal tipping and mesial-in rotation of the molars, retrusion of incisors, and mesial movement of other teeth.
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Affiliation(s)
- Allahyar Geramy
- Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Safari
- Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
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Zhu L, Liu L, Wang W, Deng WW. Effects of different patterns of movement for correcting a deep curve of Spee with clear aligners on the anterior teeth: a finite element analysis. BMC Oral Health 2024; 24:217. [PMID: 38341537 PMCID: PMC10859030 DOI: 10.1186/s12903-024-03906-6] [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: 08/08/2023] [Accepted: 01/16/2024] [Indexed: 02/12/2024] Open
Abstract
OBJECTIVE To analyse the anterior teeth effects of clear aligners on five different patterns of mandibular molar movement and to define the most effective configuration to be implemented with clear aligners through finite element analysis. METHODS A three-dimensional mandibular model with a deep overbite in the mandible was constructed using cone beam computerized tomography (CBCT) data. The model included the mandibular dentition, mandibular periodontal ligaments, attachments, and aligners. Five models were created: (1) configuration A: second molar distalization (0.25 mm); (2) configuration B: second molar distalization (0.25 mm), first molar extrusion (0.15 mm); (3) configuration C: second molar distalization (0.25 mmm), first and second premolar extrusion(0.15 mm); (4) configuration D: second molar distalization (0.25 mm), first molar and first/second premolar extrusion(0.15 mm); and (5) configuration E: second molar distalization (0.25 mm), first molar and first/second premolar extrusion (0.15 mm), first molar and first/second premolar expansion (0.15 mm). RESULTS In all configurations, the anterior teeth exhibited labial tipping and the mandibular central incisor of configuration E showed the highest labial tipping. Configuration E demonstrated a relatively minor impact on mandibular molars distalization compared with configuration A. Configuration A showed the highest distal displacement value, and configuration E produced the lowest displacement value. Configuration E caused the highest periodontal ligament (PDL) pressure of the central and lateral incisors. The differences in the canines between configurations C and D,were not significant, and the stress distribution differed among the five groups. CONCLUSIONS All patterns utilizing clear aligners facilitated mandibular molar distalization. Extruding the premolars and second molar distalization at the same time had little impact on second molar distalization; When expansion and extrusion were simultaneously performed during the distalization of mandibular molars, our prime consideration was the alveolar bone on the labial side of the anterior teeth to prevent the occurrence of gingival recession, dehiscence, and fenestration. Due to the lack of consideration for periodontal tissues in this study, clinical protocols should be designed based on the periodontal status of the mandibular anterior teeth.
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Affiliation(s)
- Lin Zhu
- Graduate School of Dalian Medical University, Dalian, China
| | - Lin Liu
- Department of Orthodontics, DaLian Stomatological Hospital, DaLian, China.
| | - Wei Wang
- Urumql DW Innovation InfoTech Co., Ltd., Urumqi, Xinjiang, China
| | - Wen Wen Deng
- Department of Orthodontics, DaLian Stomatological Hospital, DaLian, China
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Atta I, Bourauel C, Alkabani Y, Mohamed N, Kimbe H, Alhotan A, Ghoneima A, Elshazly T. Physiochemical and mechanical characterisation of orthodontic 3D printed aligner material made of shape memory polymers (4D aligner material). J Mech Behav Biomed Mater 2024; 150:106337. [PMID: 38154364 DOI: 10.1016/j.jmbbm.2023.106337] [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: 11/18/2023] [Revised: 12/14/2023] [Accepted: 12/16/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVES To conduct a physiochemical and mechanical material analysis on 3D printed shape-memory aligners in comparison to thermoformed aligners. MATERIALS AND METHODS Four materials were examined, including three thermoformed materials: CA Pro (CP), Zendura A (ZA), Zendura FLX (ZF), and one 3D printed material: Tera Harz (TC-85). Rectangular strips measuring 50 × 10 × 0.5 mm were produced from each material. Five tests were conducted, including differential scanning calorimetry (DSC), dynamic mechanical analysis (DMA), shape recovery tests, three-points bending (3 PB), and Vickers surface microhardness (VH). RESULTS DSC recorded glass transition temperatures (Tg) at 79.9 °C for CP, 92.2 °C for ZA, 107.1 °C for ZF, and 42.3 °C for TC-85. In DMA analysis at 20-45 °C, a prominent decrease in storage modulus was observed, exclusively for TC-85, as the temperature increased. Notably, within the temperature range of 30-45 °C, TC-85 exhibited substantial shape recovery after 10 min, reaching up to 86.1 %, while thermoformed materials showed minimal recovery (1.5-2.9 %). In 3 PB test (at 30, 37, 45 °C), ZA demonstrated the highest force at 2 mm bending, while TC-85 exhibited the lowest. Regarding VH at room temperature, there was a significant decrease for both ZA and ZF after thermoforming. ZA had the highest hardness, followed by ZF and TC-85, with CP showing the lowest values. CONCLUSIONS TC-85 demonstrates exceptional shape memory at oral temperature, improving adaptation, reducing force decay, and enabling, together with its higher flexibility, extensive tooth movement per step. Additionally, it maintains microhardness similar to thermoformed sheets, ensuring the durability and effectiveness of dental aligners. CLINICAL RELEVANCE The 3D printed aligner material with shape memory characteristics (4D aligner) has revolutionized the orthodontic aligner field. It showed mechanical properties more suitable for orthodontic treatment than thermoforming materials. Additionally, it offers enhanced control over aligner design and thickness, while optimizing the overall workflow. It also minimizes material wastage, and reduces production expenses.
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Affiliation(s)
- Islam Atta
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany
| | | | - Yasmine Alkabani
- Restorative and Dental Materials Department, National Research Centre, Giza, Egypt
| | | | - Hoon Kimbe
- Research Institute of Agriculture and Life Sciences, College of Agriculture and Life Sciences, Seoul National University, Seoul, Republic of Korea
| | - Abdulaziz Alhotan
- Department of Dental Health, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed Ghoneima
- Department of Orthodontics and Pediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
| | - Tarek Elshazly
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany; Department of Orthodontics and Pediatric Dentistry, Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates.
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de Almeida MR. Current status of the biomechanics of extra-alveolar miniscrews. J World Fed Orthod 2024; 13:25-37. [PMID: 38155064 DOI: 10.1016/j.ejwf.2023.12.002] [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: 11/11/2023] [Revised: 11/27/2023] [Accepted: 12/04/2023] [Indexed: 12/30/2023]
Abstract
Temporary skeletal anchorage devices such as miniscrews are frequently used nowadays. Compared to miniplates, miniscrews are much less expensive and technically easier to place and remove; they are popular and can be easily placed by an orthodontist. Extra-alveolar miniscrews offer benefits compared to inter-radicular miniscrews, such as reduced risk of root damage and the lack of interference with the mesiodistal tooth movement. They are particularly useful for addressing anchorage loss issues and enabling specific tooth movements such as total arch maxillary and mandibular retraction, posterior distalization, molar protraction, molar intrusion, occlusal plane control, and midline correction. The present paper discusses the current biomechanics principles related to the use of extra-alveolar miniscrews placed in the infrazygomatic and mandibular buccal shelf.
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Affiliation(s)
- Marcio Rodrigues de Almeida
- Department of Orthodontics, University of North Parana, Av José Vicente Aiello, 7-70, Bauru-SP, Londrina, Paraná 17053-082, Brazil.
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Karalikkattil TL, Batra N, Vivek CR, Reddy V, Manimegalan P, Tom A. Effectiveness of Invisalign Treatment on Open Bite Correction. J Pharm Bioallied Sci 2024; 16:S850-S852. [PMID: 38595389 PMCID: PMC11000900 DOI: 10.4103/jpbs.jpbs_1058_23] [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] [Received: 10/15/2023] [Revised: 10/27/2023] [Accepted: 10/28/2023] [Indexed: 04/11/2024] Open
Abstract
Background Open bite is a common orthodontic malocclusion that can have functional and aesthetic implications. Traditional orthodontic treatments have been used to correct open bites, but the effectiveness of Invisalign, a clear aligner therapy, in open bite correction remains a topic of interest. Materials and Methods A retrospective analysis was conducted on a cohort of 50 patients with open bites who underwent Invisalign treatment. Pre-treatment and post-treatment records, including cephalometric radiographs, dental models, and clinical photographs, were assessed. The open bite was defined as a negative overbite greater than 2 mm. Treatment duration, number of aligners used, and patient compliance were also recorded. Statistical analysis, including paired t-tests and subjective patient feedback, was employed to evaluate the treatment outcomes. Results The mean pre-treatment open bite was -3.5 mm (SD = 1.2), and the mean treatment duration was 18 months (SD = 2.5). On average, patients received 24 sets of aligners (SD = 4.1) during the treatment. Post-treatment evaluation showed that the mean overbite improved to + 1.5 mm (SD = 0.8), indicating successful open bite correction. The paired t-test revealed a statistically significant difference between pre-treatment and post-treatment open bite measurements (P < 0.001). Patient satisfaction was high, with 90% of participants reporting improved aesthetics and comfort. Conclusion Invisalign treatment demonstrates effectiveness in correcting open bites, with statistically significant improvements in overbite measurements.
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Affiliation(s)
| | - Namit Batra
- Consultant Orthodontist and Private Practitioner, Uttar Pradesh, India
| | - CR Vivek
- Department of Orthodontics, Maruti College of Dental Sciences and Research Centre, Bengaluru, Karnataka, India
| | - Vivek Reddy
- Department of Orthodontic and Dentofacial Orthopedics, Gulf Orthodontic Center Muscat, Oman
| | - Priya Manimegalan
- Orthodontics and Dentofacial Orthopedics, Kannur Dental College, Anjarakandy, Kerala, India
| | - Athul Tom
- Department of Orthodontics, Kannur Dental College, Anjarakandy, Kerala, India
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Alam* MK, Alruwaili SFH, Alessa MK, Alhamid AA, Albilasi SSM, Alanazi SA. Effects of Orthodontic Mechanics on Root Resorption: A Comparative Study. J Pharm Bioallied Sci 2024; 16:S806-S808. [PMID: 38595390 PMCID: PMC11001105 DOI: 10.4103/jpbs.jpbs_1022_23] [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] [Received: 10/10/2023] [Revised: 10/21/2023] [Accepted: 10/23/2023] [Indexed: 04/11/2024] Open
Abstract
Background Orthodontic treatment is a common dental procedure aimed at correcting malocclusions and improving dental aesthetics. However, one of the potential side effects of orthodontic treatment is root resorption, which can lead to permanent damage to the tooth's root structure. Materials and Methods In this comparative study, 60 orthodontic patients were divided into three groups, each receiving a different orthodontic treatment approach: Group A-conventional fixed orthodontic appliances, Group B-self-ligating orthodontic appliances, and Group C-clear aligners. Digital radiographs were taken before and after treatment to assess root resorption. The extent of root resorption was quantified using a standardized measurement scale. Results The results indicated that Group A exhibited an average root resorption of 0.2 mm, Group B showed an average root resorption of 0.1 mm, and Group C had the lowest average root resorption of 0.05 mm. These findings suggest that clear aligners resulted in significantly less root resorption compared to conventional fixed orthodontic appliances and self-ligating orthodontic appliances (P < 0.05). Conclusion This comparative study highlights the differential effects of various orthodontic mechanics on root resorption. Clear aligners demonstrated the least amount of root resorption when compared to conventional fixed orthodontic appliances and self-ligating orthodontic appliances.
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Affiliation(s)
- Mohammad Khursheed Alam*
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
- Department of Dental Research Cell, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India
- Department of Public Health, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, Bangladesh
| | | | - Mohammed Khalid Alessa
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
| | - Abdullah Anwar Alhamid
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
| | - Saif Saud M Albilasi
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
| | - Samer Abdullah Alanazi
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
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Alfawzan AA. Evaluation of Patient Acceptance and Compliance with Clear Aligners vs. Lingual Braces: A Randomized Trial. J Pharm Bioallied Sci 2024; 16:S546-S548. [PMID: 38595386 PMCID: PMC11001114 DOI: 10.4103/jpbs.jpbs_854_23] [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] [Received: 09/05/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 04/11/2024] Open
Abstract
Background The efficacy of orthodontic treatments is often influenced by patient acceptance and compliance. This study aims to compare patient acceptance and compliance between clear aligners and lingual braces in a randomized clinical trial. Materials and Methods A total of 100 patients requiring orthodontic treatment were randomly allocated into two groups: clear aligners (n = 50) and lingual braces (n = 50). Data on patient acceptance and compliance were collected through self-reported questionnaires and clinical observations over a period of 12 months. Results Patient acceptance was significantly higher in the clear aligner group, with 80% reporting high levels of comfort, compared to 60% in the lingual braces group (P < 0.05). Compliance rates were 92% for clear aligners and 85% for lingual braces (P = 0.1). Conclusion Clear aligners showed a higher level of patient acceptance and a slightly better compliance rate, although the difference was not statistically significant. These findings suggest that clear aligners may be a preferable option for patients prioritizing comfort.
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Affiliation(s)
- Ahmed A. Alfawzan
- Department of Preventive Dentistry, College of Dentistry in Ar Rass, Qassim University, Ar Rass, Kingdom of Saudi Arabia
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Domenico C, Carlotta F, Carmela S, Alessandra C, Mauro L, Donatella F, Marta M, Rosa E, Michele T. Curve of Spee modification in different vertical skeletal patterns after clear aligner therapy: a 3D set-up retrospective study. Prog Orthod 2024; 25:5. [PMID: 38246933 PMCID: PMC10800316 DOI: 10.1186/s40510-023-00503-1] [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: 10/11/2023] [Accepted: 11/20/2023] [Indexed: 01/23/2024] Open
Abstract
OBJECTIVE The purpose of the present study was to evaluate: (1) changes in the curve of Spee (COS) after clear aligner therapy and (2) whether such changes correlated with the patient's skeletal patterns. MATERIALS AND METHODS Three-dimensional mandibular models of 106 patients (47 males and 59 females; mean age 22.3 SD ± 3.4 years) treated with clear aligners were retrospectively analysed. The perpendicular distance between the occlusal reference plane and the buccal cusp tip of each lateral tooth was measured. Five angular cephalometric measurements (PP-MP, PP-OP, OP-MP, AFH, and PFH) were performed and correlated with the T1-T0 difference in linear distances. The patients were divided into three groups according to facial divergence. Variance analysis with Tukey post hoc correction was performed to evaluate the differences among groups. RESULTS The one-way ANOVA test showed a statistically significant difference for all analysed variables, except for the change in the distance of the second molar from the occlusal reference plane. Tukey's HSD test showed the following differences: In normodivergents, the T1-T0 difference in the distance of the first molar from the occlusal plane was 1 mm greater than that observed in the hyperdivergent group (p < 0.05); in the normodivergent group, the T1-T0 difference in the distance of the second premolar from the occlusal plane was 1.23 mm greater than that observed in the hyperdivergent group (p < 0.05), while in the hypodivergent group, it was 1.08 mm greater than in the hyperdivergent group (p < 0.05); finally, in normodivergents, the T1-T0 difference in the distance of the first premolar from the occlusal plane was 0.97 mm greater than that observed in the hyperdivergent group (p < 0.05). CONCLUSION Treatment with aligners did not lead to a clinically significant change in COS depth. However, when dividing the sample into groups based on craniofacial divergence, COS depth change differed significantly between the three groups.
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Affiliation(s)
- Ciavarella Domenico
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Via Rovelli, 50, 71122, Foggia, Italy
| | - Fanelli Carlotta
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Via Rovelli, 50, 71122, Foggia, Italy.
| | - Suriano Carmela
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Via Rovelli, 50, 71122, Foggia, Italy
| | - Campobasso Alessandra
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Via Rovelli, 50, 71122, Foggia, Italy
| | - Lorusso Mauro
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Via Rovelli, 50, 71122, Foggia, Italy
| | - Ferrara Donatella
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Via Rovelli, 50, 71122, Foggia, Italy
| | - Maci Marta
- Department of Clinical and Experimental Medicine, Dental School of Foggia, University of Foggia, Via Rovelli, 50, 71122, Foggia, Italy
| | - Esposito Rosa
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Lorenzo Natali, 67100, Coppito, L'Aquila, Italy
| | - Tepedino Michele
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Lorenzo Natali, 67100, Coppito, L'Aquila, Italy
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Gao Y, Wang R, Liu Q, Zhou B, Qiao H. Effect of acetaminophen on relieving orthodontic pain with clear aligner based on GAD-7: A retrospective research. Heliyon 2024; 10:e23292. [PMID: 38163203 PMCID: PMC10756994 DOI: 10.1016/j.heliyon.2023.e23292] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
Objectives Patients may have uncomfortable feelings during orthodontic treatment, which can directly lead to dissatisfaction. So in order to improve the patient's sense of pleasure during the treatment, it would be of great benefit if orthodontic pain can be relieved. Materials and methods We included 150 patients wearing clear aligners from 18 to 30 years old during 2018-2020. Then designed following groups to determine the effectiveness of both verbal behavior modification and combination therapy with acetaminophen in reducing treatment pain: Group A, generalized anxiety disorder 7 (GAD-7) scored 0-4; Group B, GAD-7 scored 5-9; Group C, GAD-7 scored 10-14; and Group D, GAD-7 scored 15-21. Results There was a difference in the visual analog scale (VAS) between verbal behavior modification with and without a 300-mg acetaminophen tablet oral QD in Group A (received the intervention at 8 h and 1 d), Group B at 8 h and 1 d, Group C at 8 h, 1 d, 2 d, and 3 d, and Group D at 8 h, 1 d, 2 d, 3 d, and 4 d. After 8 h, 1 d, 2 d, 3 d, and 4 d in patients with verbal behavior modification, VAS was markedly increased in Group D compared with Group A, B and C. Furthermore, after 8 h and 1 d in patients with verbal behavior modification and 300-mg acetaminophen tablet oral QD, VAS was strongly enhanced in Group D. Conclusions Dental anxiety is strongly associated with pain in orthodontic patients receiving clear aligners. Acetaminophen administration may be a benefit in orthodontic pain that results from clear aligners, especially in the group with more GAD-7.
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Affiliation(s)
- Yunan Gao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Rui Wang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Qiong Liu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Bo Zhou
- Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Hu Qiao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
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17
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Zhang Y, Zheng J, Wu Q, Jiang T, Xiao H, Du Y, Qi Y, Jin Z, Li F. Three-dimensional spatial analysis of temporomandibular joint in adolescent Class II division 1 malocclusion patients: comparison of Twin-Block and clear functional aligner. Head Face Med 2024; 20:4. [PMID: 38184631 PMCID: PMC10770962 DOI: 10.1186/s13005-023-00404-y] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/18/2023] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND Our study aimed to use three-dimensional (3D) spatial morphological measurement methods to compare the influence of Twin-Block and clear functional aligners on the temporomandibular joint (TMJ) of adolescent Class II division 1 malocclusion mandibular retraction patients. We also aimed to explore the similarities and differences in the effects on the TMJ upon using Twin-Block and clear functional aligner. METHODS Cone-beam computed tomography (CBCT) data of 49 patients with Class II division 1 malocclusion (Twin-Block group: 24; clear functional aligner group: 25) were collected before and after functional orthodontic treatment, and a 3D model of the TMJ was reconstructed using MIMICS 21.0 software. Eighteen measurement parameters, including the anterior, superior, and posterior joint spaces, were measured and compared using the 3D model. RESULTS After the two groups underwent functional appliance treatment, the height, volume, and surface area of the condyle, length of the mandibular ramus and mandibular length increased; The retro-displaced condyle moved to the middle position of the articular fossa, while the rest of the condylar position did not change significantly. Remodeling of the articular fossa after treatment was not evident. The superior joint space of the clear functional aligner group increased, but there was no significant change after Twin-Block appliances treatment. CONCLUSIONS Both appliances promote condylar growth and sagittal and vertical development of the mandible in adolescent Class II division 1 malocclusion mandibular retraction patients. The length of the mandibular ramus showed a more significant increase following treatment with the Twin-Block appliances than with clear function aligners.
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Affiliation(s)
- Yueying 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, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Jiajing Zheng
- 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, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Qiuyue Wu
- 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, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Tianlu Jiang
- 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, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Hua Xiao
- 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, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Yusen Du
- 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, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Yizhe Qi
- 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, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of 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, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China.
| | - Feifei Li
- 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, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China.
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18
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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.
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Jaber ST, Hajeer MY, Burhan AS, Alam MK, Al-Ibrahim HM. Treatment effectiveness of young adults using clear aligners versus buccal fixed appliances in class I malocclusion with first premolar extraction using the ABO-Objective Grading System: A randomized controlled clinical trial. Int Orthod 2023; 21:100817. [PMID: 37837842 DOI: 10.1016/j.ortho.2023.100817] [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: 07/30/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 10/16/2023]
Abstract
OBJECTIVE To compare the effectiveness of the clear aligners with the traditional fixed appliances in the treatment of premolars extraction complex cases using the American Board of Orthodontics Objective Grading System (ABO-OGS). MATERIAL AND METHODS A single-centre, 2-parallel groups RCT with two arms. Forty severe crowding patients (14 males, 26 females; mean age: 21.40±2.42) who required four first premolars extraction were included and randomly allocated into two treatment groups: clear aligners therapy group (CAT), and fixed appliances therapy group (FAT). Cases complexities were measured on pre-treatment records using the Discrepancy index (DI). Post-treatment records were evaluated using the American Board of Orthodontics Objective Grading System (ABO-OGS). Two sample t-tests and Fisher's Exact tests were used to test for significant differences between the two groups. The statistical significance was set at P < 0.006 using Bonferroni's correction. RESULTS For the DI, the mean scores were 32.25 (± 4.33) in the CAT group and 33 (± 7.92) in the FAT group. In the CAT group, the total OGS score ranged between 6-33 points with an average of 17.50(± 7.41), whereas the total score in the FAT group went between 4-30 points with an average of 12.89 (± 6.31) with no significant differences between the two groups (P=0.05). When comparison of the successful cases between the two groups was made, 11 cases received passing scores, and 9 cases received failing scores in the CAT group. Whereas in the FAT group, 17 cases received passing scores, and 3 received a failing score. No statistically significant differences were found in the passing rates between of the CAT and FAT groups (P = 0.421). CONCLUSIONS According to the ABO-OGS total scores, there was no significant difference between the clear aligners and fixed appliances in the treatment of class I severe crowding cases with first premolars extraction in young adults. There were no differences between the two techniques in the OGS components scores except for the occlusal contacts, which were significantly better with the fixed appliances. When comparing the number of successful and failed cases between the two groups, no significant differences were noted, with the fixed appliances having a 30% higher success rate than the clear aligners, which must be considered clinically when choosing between these two techniques in the complex orthodontic cases treatment.
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Affiliation(s)
- Samer T Jaber
- Department of Orthodontics, Faculty of Dentistry, Al-Wataniya Private University, Hama, Syria
| | - Mohammad Y Hajeer
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, Syria.
| | - Ahmad S Burhan
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, Syria
| | - Mohammad Khursheed Alam
- Orthodontic Division, Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
| | - Heba M Al-Ibrahim
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, Syria
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Huang W, Dong L, Yu S, Zheng Y, Wu H, Li C, Zhang Y, Zhang Q, Yan X, Lv T, Yuan X. Stress distribution of the modified clear twin-block aligner on the temporomandibular joint, alveolar bone and teeth: A finite element analysis. Int Orthod 2023; 21:100815. [PMID: 37839391 DOI: 10.1016/j.ortho.2023.100815] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/10/2023] [Accepted: 09/18/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE The modified clear twin-block aligner (CTBA) was developed to provide a mandibular advancement appliance for the treatment of mandibular retrognathia. The objective of this study was to analyse the stress distribution changes of CTBA with 45°, 60° and 70° bite blocks. MATERIAL AND METHODS A three-dimensional model of the craniomaxillofacial bones and teeth was generated from a spiral computed tomography (CT) scan. The models of the articular disc, capsule, periodontal ligament and CTBA were constructed mathematically. After assigning the appropriate material properties and the boundary condition using ABAQUS software, we simulated the CTBA with different bite blocks to analyse the mechanical effects. RESULTS In the temporomandibular joint (TMJ) region, the posterior aspect of the condyle and glenoid fossa experienced tensile stress that was approximately about 22 times greater at 70° than at 45°. The Von Mises stress distribution on the articular disc tended to be uniform. The strain direction of the condyle was backward. In the maxillary bone, the stress on the labial alveolar bone was about 5.83MPa at 70° and greater than that on the lingual side. The resulting displacement of the dentition revealed a tendency for the upper teeth to shift backward and the lower teeth to move forward by 0.46 to 0.49mm. The foregoing stress and displacement rose as the angle of the bite blocks increased. CONCLUSIONS CTBA with 70° bite blocks constituted an advantageous biomechanical setting for the treatment of mandibular retrognathia in teenagers and provided a superior therapeutic effect.
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Affiliation(s)
- Wenli Huang
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, 266003 Qingdao, China; School of Stomatology, Qingdao University, 266023 Qingdao, China
| | - Lirong Dong
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, 266003 Qingdao, China; School of Stomatology, Qingdao University, 266023 Qingdao, China
| | - Shaoyang Yu
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, 266003 Qingdao, China; School of Stomatology, Qingdao University, 266023 Qingdao, China
| | - Yao Zheng
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, 266003 Qingdao, China; School of Stomatology, Qingdao University, 266023 Qingdao, China
| | - Haoting Wu
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, 266003 Qingdao, China; School of Stomatology, Qingdao University, 266023 Qingdao, China
| | - Chenzhi Li
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, 266003 Qingdao, China; School of Stomatology, Qingdao University, 266023 Qingdao, China
| | - Yingyue Zhang
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, 266003 Qingdao, China; School of Stomatology, Qingdao University, 266023 Qingdao, China
| | - Qiang Zhang
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, 266003 Qingdao, China; School of Stomatology, Qingdao University, 266023 Qingdao, China
| | - Xiao Yan
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, 266003 Qingdao, China; School of Stomatology, Qingdao University, 266023 Qingdao, China
| | - Tao Lv
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, 250000 Jinan, China.
| | - Xiao Yuan
- Department of Orthodontics, The Affiliated Hospital of Qingdao University, 266003 Qingdao, China; School of Stomatology, Qingdao University, 266023 Qingdao, China.
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Li Q, Du Y, Yang K. Comparison of pain intensity and impacts on oral health-related quality of life between orthodontic patients treated with clear aligners and fixed appliances: a systematic review and meta-analysis. BMC Oral Health 2023; 23:920. [PMID: 38001455 PMCID: PMC10675971 DOI: 10.1186/s12903-023-03681-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 11/20/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVE This study aimed to compare the pain intensity and impacts on oral health-related quality of life (OHRQoL) between orthodontic patients treated with clear aligners (CAs) and fixed appliances (FAs). METHODS A systematic search was conducted up to December 2022 using PubMed, Web of Science, Cochrane Central Register of Controlled Trials, and Embase. Randomized controlled trials (RCTs) and prospective non-randomized controlled trials (non-RCTs) comparing pain intensity or OHRQoL between patients treated with CAs and FAs were included. The risk of bias (RoB) of individual studies was evaluated using the Cochrane RoB tool 2.0 and ROBINS-I tool for RCTs and non-RCTs, respectively. Further, meta-analyses were separately conducted for each included study using the total oral health impact profile (OHIP)-14 and visual analog scale (VAS) scores to evaluate OHRQoL and pain intensity, respectively. RESULTS Overall, 12 studies (5 RCTs and 7 non-RCTs) were included in the study. Subgroup analyses conducted according to the total OHIP-14 scores revealed that patients treated with CAs had higher OHRQoL at 1 week, 1 month, and 6 months of the treatment. Meanwhile, subgroup analyses conducted according to the VAS scores revealed that pain levels were lower in the CA group only at 3 and 4 days of the treatment. CONCLUSIONS Patients treated with clear aligners had higher OHRQoL than those treated with fixed appliances during orthodontic treatment. However, OHRQoL appeared to be similar between the two groups at the end of the treatment. Moreover, patients treated with clear aligners experienced lesser pain than those treated with fixed appliances on the third and fourth day after the initial treatment. The difference in pain intensity between the two treatment modalities was not noted at other time points.
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Affiliation(s)
- Qiuying Li
- Department of Orthodontics, School of Stomatology, Capital Medical University, No.4, Tiantanxili, Beijing, China
| | - Yugui Du
- Department of Orthodontics, School of Stomatology, Capital Medical University, No.4, Tiantanxili, Beijing, China
| | - Kai Yang
- Department of Orthodontics, School of Stomatology, Capital Medical University, No.4, Tiantanxili, Beijing, China.
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Mu C, Sun B, Gong Z, Wei Y, Chen L, Zhang W, Wu H, Zhao B. The tooth movement efficiency of different orthodontic thermoplastics for clear aligners: study protocol for a randomized controlled clinical trial. Trials 2023; 24:684. [PMID: 37872599 PMCID: PMC10594683 DOI: 10.1186/s13063-023-07736-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/16/2023] [Indexed: 10/25/2023] Open
Abstract
INTRODUCTION With regard to the esthetics and comfort of orthodontic treatment, the requirement for removable clear aligners (CAs) is increasing. Unlike conventional fixed orthodontic appliances, CAs were made of thermoplastic film by thermoforming on the personalized dental models. The construction of orthodontic thermoplastic is a critical factor for orthodontic tooth movement (OTM). Polyethylene terephthalate glycol-modified (PETG) and thermoplastic polyurethane (TPU) are the most commonly orthodontic thermoplastics; however, the evidence of the differences between different orthodontic thermoplastic are limited to vitro environment and the evidence in vivo environment is not available. Therefore, this trial aims to provide reliable evidence for orthodontists' personalized treatment plans whether the two most commonly used orthodontic thermoplastics of PETG and TPU have differences in the efficiency of OTM. METHODS AND ANALYSIS This randomized controlled clinical study will recruit 44 orthodontic patients for orthodontic treatment. All the subjects will be randomized into two groups (PETG and TPU, n = 22 for each group). In the first stage (M0 to M1), clear aligners will be made of two orthodontic thermoplastics and move the maxillary first or second premolars 2 mm. In the second stage, patients will take the standard orthodontic treatments. The primary outcome will be the efficiency of clear aligners made of different materials on the digital models. The secondary outcome will be the efficiency of clear aligners made of different materials on the cone-beam computed tomography (CBCT). The efficiency will be calculated through the superimposition of the digital models and CBCT. DISCUSSION The results from this trial will serve as evidence for orthodontists and manufacturers and clarify whether the difference in orthodontic thermoplastics significantly impacts the efficiency of OTM. TRIAL REGISTRATION NUMBER ChiCTR2300070980. Registered on 27 April 2023. https://www.chictr.org.cn/showproj.html?proj=186253.
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Affiliation(s)
- Chuangchuang Mu
- Department of Orthodontics, Shanghai Stomatological Hospital, Fudan University, No.356 Beijing East Road, Shanghai, China
| | - Bingjing Sun
- Department of Orthodontics, Shanghai Stomatological Hospital, Fudan University, No.356 Beijing East Road, Shanghai, China
| | - Zhicheng Gong
- Department of Dental Technology, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
| | - Yuanyuan Wei
- Department of Orthodontics, Shanghai Stomatological Hospital, Fudan University, No.356 Beijing East Road, Shanghai, China
| | - Li Chen
- Department of Orthodontics, Shanghai Stomatological Hospital, Fudan University, No.356 Beijing East Road, Shanghai, China
| | - Wei Zhang
- Department of Orthodontics, Shanghai Stomatological Hospital, Fudan University, No.356 Beijing East Road, Shanghai, China
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Haimiao Wu
- Department of Orthodontics, Shanghai Stomatological Hospital, Fudan University, No.356 Beijing East Road, Shanghai, China
| | - Bingjiao Zhao
- Department of Orthodontics, Shanghai Stomatological Hospital, Fudan University, No.356 Beijing East Road, Shanghai, China.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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.
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Wang S, Huang Y, Fan D, Liu H, Yuan C, Yang L, Wang P. Effects of overtreatment with different attachment positions on maxillary anchorage enhancement with clear aligners: a finite element analysis study. BMC Oral Health 2023; 23:693. [PMID: 37749548 PMCID: PMC10521390 DOI: 10.1186/s12903-023-03340-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/22/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND The effect of attachment positions on anchorage has not been fully explored. The aim of the present study is to analyze the effect of overtreatment with different anchorage positions on maxillary anchorage enhancement with clear aligners in extraction cases. METHODS Models of the maxilla and maxillary dentition were constructed and imported into SOLIDWORKS software to create periodontal ligament (PDL), clear aligners, and attachments. Attachment positions on second premolars included: without attachment (WOA), buccal attachment (BA), and bucco-palatal attachment (BPA). Overtreatment degrees were divided into five groups (0°, 1°, 2°, 3°, 4°) and added on the second premolars. The calculation and analysis of the displacement trends and stress were performed using ANSYS software. RESULTS Distal tipping and extrusion of the canines, and mesial tipping and intrusion of the posterior teeth occurred during retraction. A strong anchorage was achieved in cases of overtreatment of 2.8° with BA and 2.4° with BPA. Moreover, the BPA showed the best in achieving bodily control of the second premolars. When the overtreatment was performed, the canines and first molars also showed reduced tipping trends with second premolars attachments. And the stress on the PDL and the alveolar bone was significantly relieved and more evenly distributed in the BPA group. CONCLUSIONS Overtreatment is an effective means for anchorage enhancement. However, the biomechanical effect of overtreatment differs across attachment positions. The BPA design performs at its best for stronger overtreatment effects with fewer adverse effects.
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Affiliation(s)
- Shiyu Wang
- School of stomatology, Xuzhou Medical University, 221000, Xuzhou, China
| | - Yangyang Huang
- School of stomatology, Xuzhou Medical University, 221000, Xuzhou, China
| | - Dian Fan
- School of stomatology, Xuzhou Medical University, 221000, Xuzhou, China
| | - Hao Liu
- Department of Orthodontics, Affiliated Stomatological Hospital of Xuzhou Medical University, 221000, Xuzhou, China
| | - Changyong Yuan
- School of stomatology, Xuzhou Medical University, 221000, Xuzhou, China
- Department of Implantology, Affiliated Stomatological Hospital of Xuzhou Medical University, 221000, Xuzhou, China
| | - Li Yang
- Department of Orthodontics, Affiliated Stomatological Hospital of Xuzhou Medical University, 221000, Xuzhou, China
| | - Penglai Wang
- School of stomatology, Xuzhou Medical University, 221000, Xuzhou, China.
- Department of Implantology, Affiliated Stomatological Hospital of Xuzhou Medical University, 221000, Xuzhou, China.
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ElNaghy R, El-Aassar YM, Hasanin M. ACTIVATION OF FIXED LABIAL APPLIANCES, BRIEFLY AT INITIATION, MAY REDUCE MASTICATORY PERFORMANCE AND BITE FORCE. J Evid Based Dent Pract 2023; 23:101885. [PMID: 37689452 DOI: 10.1016/j.jebdp.2023.101885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2023]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Duarte L, Bezerra AP, Flores-Mir C, De Luca Canto G, Pereira LJ, Vega Gonçalves TMS. Activation and installation of orthodontic appliances temporarily impairs mastication. Angle Orthod. 2022 Mar 1;92(2):275-286. doi: 10.2319/061,221-469.1. PMID: 34,878,525; PMCID: PMC8887415. SOURCE OF FUNDING Not reported. TYPE OF STUDY/DESIGN Systematic review with meta-analysis of data.
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Raghavan S, Abu Alhaija ES, Duggal MS, Narasimhan S, Al-Maweri SA. White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared to fixed orthodontic treatment. A systematic review and meta- analysis. BMC Oral Health 2023; 23:599. [PMID: 37635207 PMCID: PMC10463770 DOI: 10.1186/s12903-023-03257-8] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/27/2023] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVE To analyse the available evidence regarding the incidence and severity of white spot lesions (WSLs), plaque accumulation and salivary caries-associated bacteria(SCB) in clear aligners (CA) verses conventional fixed (CF) orthodontic appliances. METHODS Electronic searches of MEDLINE, Scopus, Embase, Google Scholar, Clinical trial registry, OpenGrey and ProQuest were done for all relevant studies. Eligibility criteria were; Randomized Controlled Trials and Non-Randomized Studies that compared the incidence and severity of WSLs, plaque accumulation and SCB between CA and CF appliances in patients undergoing orthodontic treatment. The risk of bias(ROB) and certainty of evidence was assessed independently by two reviewers using Cochrane's ROB and GRADEpro, respectively. Standardized mean difference (SMD) was used to estimate the effect size using STATA 17 software. RESULTS A total of 14 studies met the eligibility criteria, and eight were suitable for meta-analysis. The qualitative results showed lower incidence and severity of WSLs, plaque accumulation, and SCB in CA group compared to CF appliances. The pooled results showed significantly lower plaque accumulation(SMD - 1.58;95%CI:-2.57,0.58;p = 0.002) in CA compared to CF appliances. CONCLUSIONS A moderate-quality evidence reveals less plaque accumulation and less SCB in CA, which might be related to the reduced incidence and severity of WSLs associated with CA when compared with CF appliances. However, the results of the present study should be interpreted with caution given the high ROB among some of the included studies as well as the marked heterogeneity across the studies. CLINICAL RELEVANCE For patients who can be treated with either CA or CF appliances, CA may be a better choice concerning oral health. REGISTRATION Open Science Framework (DOI: https://doi.org/10.17605/osf.io/kcpvb ).
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Affiliation(s)
- Shailaja Raghavan
- College of Dental Medicine, QU Health, Qatar University, Doha, P.O. Box: 2713, Qatar.
| | - Elham S Abu Alhaija
- College of Dental Medicine, QU Health, Qatar University, Doha, P.O. Box: 2713, Qatar
| | - Mandeep Singh Duggal
- College of Dental Medicine, QU Health, Qatar University, Doha, P.O. Box: 2713, Qatar
| | | | - Sadeq Ali Al-Maweri
- College of Dental Medicine, QU Health, Qatar University, Doha, P.O. Box: 2713, Qatar
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Rajput AS, Patil A, Das M, Kapil S. Post processing of low cost Aligners fabricated by additive manufacturing process to enhance the surface quality and functionality. J Mech Behav Biomed Mater 2023; 144:106003. [PMID: 37406482 DOI: 10.1016/j.jmbbm.2023.106003] [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: 05/24/2023] [Revised: 06/28/2023] [Accepted: 06/28/2023] [Indexed: 07/07/2023]
Abstract
Additive Manufacturing (AM) processes have ample advantages compared to traditional manufacturing processes, including mass customization, material efficiency, bioprinting, and fabrication of complex geometries with reduced lead time. Despite such benefits, it suffers most from staircase effects that deteriorate the fabricated part's surface quality. Nowadays, additively manufactured aligners are suitable for treating malocclusion and temporomandibular defects of teeth. Fused Deposition Modelling (FDM) is one of the best substitutes for clear aligners production to reduce per-unit cost. Glycol-modified Polyethylene Terephthalate (PETG) is opted as the material to fabricate the clear aligners due to its biocompatibility and non-toxicity. However, the poor surface quality of the additively manufactured is a major challenge in developing clear aligners with the FDM. A novel experimental setup is designed and developed to enable Chemical Vapor Smoothing (CVS) to enhance the surface quality of the clear aligners. Furthermore, based on the Surface roughness, the comparison is made between the surface quality polished with various chemicals (namely methylethylketone (also known as 2-butanone), toluene and, cyclohexanone). Moreover, Response Surface Methodology (RSM) is used to analyze the impact of different process parameters (i.e., the chemical volume, exposure time, and workpiece orientation) on the surface quality of the clear aligners. Moreover, RSM shows that the impact of the clear aligners orientation on %ΔRa during the CVS is higher than other process parameters. Results demonstrate that cyclohexanone produces more uniform surface quality with a 92.73% reduction in surface roughness compared to methylethylketone and toluene on PETG, i.e., 89.66% and 88.63%, respectively. The developed surface finishing method is capable of producing uniform, smooth surfaces over the FDM-fabricated PETG clear aligners.
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Affiliation(s)
- Atul Singh Rajput
- Department of Mechanical Engineering, Indian Institute of Technology Guwahati, India
| | - Abhishek Patil
- Department of Mechanical Engineering, Indian Institute of Technology Guwahati, India
| | - Manas Das
- Department of Mechanical Engineering, Indian Institute of Technology Guwahati, India
| | - Sajan Kapil
- Department of Mechanical Engineering, Indian Institute of Technology Guwahati, India.
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Figueiredo MAD, Romano FL, Feres MFN, Stuani MBS, Ferreira JTL, Nahás ACR, Matsumoto MAN. Maxillary alveolar bone evaluation following dentoalveolar expansion with clear aligners in adults: A cone-beam computed tomography study. Korean J Orthod 2023; 53:263-275. [PMID: 37497583 PMCID: PMC10387425 DOI: 10.4041/kjod22.243] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 06/04/2023] [Accepted: 06/21/2023] [Indexed: 07/28/2023] Open
Abstract
Objective To investigate the effects of maxillary orthodontic expansion on the alveolar bone tissue in adult patients treated with aligners by using cone-beam computed tomography. Methods Thirty patients (22 females and 8 males; mean age: 36.3 years) were treated with Invisalign® aligners. Cone-beam computed tomography and digital models were obtained before (T0) and after (T1) upper arch expansion. The bone thicknesses in the cervical, middle, and apical areas of the incisors, canines, premolar, and first molars were buccally and palatally measured, totaling 96 areas and 2,880 measurements. The buccolingual inclinations and transverse measurements of the teeth were obtained from digital models to correlate them with the bone changes. The statistical tests used were Student's t-test, analysis of variance, and Pearson's correlation tests (p < 0.05). Results From the 96 areas evaluated, 84 revealed an increase or stability in the alveolar bone thickness and twelve displayed significant bone loss. Bone changes did not correlate with the tooth inclination and transverse measurements. Conclusions Within the limitation of the present study, mild levels of upper arch expansion obtained with Invisalign® aligners in adult patients did not result in any clinically significant loss of alveolar bone thickness.
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Affiliation(s)
- Marcio Antonio de Figueiredo
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Fábio Lourenço Romano
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | | | - Maria Bernadete Sasso Stuani
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - José Tarcísio Lima Ferreira
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | | | - Mírian Aiko Nakane Matsumoto
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
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McKay A, McCray J, Bankhead B, Lee MM, Miranda G, Adel SM, Kim KB. Forces and moments generated during extrusion of a maxillary central incisor with clear aligners: an in vitro study. BMC Oral Health 2023; 23:495. [PMID: 37461004 DOI: 10.1186/s12903-023-03136-2] [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: 04/14/2023] [Accepted: 06/14/2023] [Indexed: 07/20/2023] Open
Abstract
OBJECTIVE To assess the possibility of extrusion of a maxillary central incisor with the use of buccal and lingual pressure columns in the absence of attachments, and to evaluate the forces and moments experienced by the teeth using both thermoformed and 3D-printed clear aligners. MATERIALS AND METHODS A three-axis force and moment sensor (Aidin Robotics, Anyang, South Korea) was used to measure the forces and moments during extrusion of an upper left central incisor (UL1) and any forces experienced by the upper right central incisor (UR1) using thermoformed aligners and 3D-printed aligners. For the thermoformed aligners, the materials used were ATMOS® (American Orthodontics, Sheboygan, WI) and Zendura FLX® (Bay Materials LLC, Fremont, CA). 3D-printed aligners were fabricated using TC-85 clear photocurable resin (Graphy Inc., Seoul, South Korea). For each material type, three conditions were tested: Group 1: No attachment or pressure columns (control); Group 2: Attachment only; and Group 3: Pressure columns only. Each group was planned for 0.5 mm of extrusion on the UL1. RESULTS All force readings collected demonstrated statistically significant differences when compared by materials and when compared by groups, with a P value of < 0.001. In the absence of attachment or pressure columns (Group 1), ATMOS® and TC-85 groups exerted extrusive force on the UL1. However, significantly lower forces and moments were exerted by the TC-85 group in comparison to the ATMOS® and Zendura FLX® groups. In the presence of attachment (Group 2), all three ATMOS®, Zendura FLX® and TC-85 groups exerted extrusive force on the UL1, with the TA group showing different directions of faciolingual force, mesiodistal force and faciolingual inclination on the UR1 when compared to the other two thermoformed groups. Whereas in the presence of pressure columns (Group 3), only the TC-85 3D-printed aligner group exerted extrusive force. Thermoformed aligners generated significantly higher mean forces and moments than 3D-printed aligners. Significant levels of unintended forces and moments were present in all groups. CONCLUSIONS Force levels generated during extrusion with clear aligners are significantly lower with those 3D-printed using TC-85 than with those thermoformed using ATMOS® or Zendura FLX®. Attachments consistently generated extrusive forces, and may be an effective adjunct in achieving extrusion of incisors. Extrusion may be achieved without the use of attachments by utilizing pressure columns in 3D-printed aligners using TC-85. While different strategies can generate extrusive forces, there are significant unintended forces and moments.
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Affiliation(s)
- Abraham McKay
- Department of Orthodontics, Saint Louis University, Saint Louis, MO, USA
| | - Julie McCray
- Department of Orthodontics, Saint Louis University, Saint Louis, MO, USA
| | - Brent Bankhead
- Department of Orthodontics, Saint Louis University, Saint Louis, MO, USA
| | - Michael M Lee
- Department of Orthodontics, Saint Louis University, Saint Louis, MO, USA
| | - Gabriel Miranda
- Department of Orthodontics, Saint Louis University, Saint Louis, MO, USA
| | - Samar M Adel
- Department of Orthodontics, Saint Louis University, Saint Louis, MO, USA.
- Department of Orthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Ki Beom Kim
- Department of Orthodontics, Saint Louis University, Saint Louis, MO, USA
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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Hong YY, Zhou MQ, Cai CY, Han J, Ning N, Kang T, Chen XP. Efficacy of upper-incisor torque control with clear aligners: a retrospective study using cone-beam computed tomography. Clin Oral Investig 2023; 27:3863-3873. [PMID: 37036513 DOI: 10.1007/s00784-023-05006-1] [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: 09/26/2022] [Accepted: 03/28/2023] [Indexed: 04/11/2023]
Abstract
OBJECTIVES The objectives of this retrospective clinical study were to evaluate the efficacy of clear aligners on upper-incisor torque control, with the expectation of providing guidance for clinics. MATERIALS AND METHODS Pretreatment (T0) and posttreatment (T1) cone-beam computed tomography (CBCT) scans of 47 patients with a nonextraction treatment using clear aligners were obtained and 120 upper-incisors with torque ≥5° were selected. Voxel-based superimpositions were performed using Dolphin imaging software and achieved movements were then measured. Difference between achieved and predicted movement (DAPM) and the efficiency for upper-incisor torque were used to evaluate the torque control efficacy. RESULTS The achieved torque movement with clear aligners was lower than predicted significantly, as the mean efficiency was 46.81±33.95%. Additionally, the achieved incisor movement of the crown and root differed significantly from the predicted movement, especially root movement. CONCLUSIONS Clear aligners struggle to control upper-incisor torque, particularly root movement. In that case, overcorrection is necessary to prevent torque loss. CLINICAL RELEVANCE Clear aligners remain a limitation on torque control and overcorrection should be considered.
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Affiliation(s)
- Ya-Ya Hong
- Department of Orthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, No. 166, Qiutao North Road, Hangzhou, 310006, Zhejiang, China
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Meng-Qi Zhou
- Department of Orthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, No. 166, Qiutao North Road, Hangzhou, 310006, Zhejiang, China
| | - Chao-Ying Cai
- Department of Orthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, No. 166, Qiutao North Road, Hangzhou, 310006, Zhejiang, China
- Department of Dentistry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jie Han
- Department of Pediatric Dentistry, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang, China
| | - Nan Ning
- MeiQi Technology, Zhejiang, China
| | - Ting Kang
- Department of Orthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, No. 166, Qiutao North Road, Hangzhou, 310006, Zhejiang, China.
| | - Xue-Peng Chen
- Department of Orthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, No. 166, Qiutao North Road, Hangzhou, 310006, Zhejiang, China.
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Perillo L, d'Apuzzo F, De Gregorio F, Grassia V, Barbetti M, Cugliari G, Nucci L, Castroflorio T. Factors Affecting Patient Compliance during Orthodontic Treatment with Aligners: Motivational Protocol and Psychological Well-Being. Turk J Orthod 2023; 36:87-93. [PMID: 37346005 DOI: 10.4274/turkjorthod.2022.2021.0255] [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] [Indexed: 06/23/2023]
Abstract
Objective Compliance is critical for successful outcomes in orthodontics, and personality traits may play a role in determining patient adherence. This study aimed to monitor compliance during treatment with removable clear aligners (CA) [Align Technology Inc, San José, Calif ], and evaluate the influence of motivational techniques and the patient's profiles assessed through the psychological well-being (PWB) questionnaire on clinical outcomes. Methods Thirty-nine consecutive patients in permanent dentition seeking treatment with CA were recruited from two universities. Casts were obtained before treatment and after 3, 6, and 12 months and the corresponding digital Clincheck©.STL files were used to calculate the discrepancy index to check for differences between virtual and real treatment stages. Patients were divided into two groups: the Case group, which received motivational techniques at each appointment, and the control group which received instructions only at the beginning. Psychological profiles were evaluated before treatment (T0) and after 3 (T1), 6 (T2), and 12 (T3) months. Results There were no differences between the Case and Control groups regarding the use of motivational reminders. The analysis of the PWB showed that almost all values increased, and there was a strong correlation between dental casts and correspondent. STL files at every time point. The PWB showed increased values from T0 to T3 in the sample. Conclusion Motivational techniques did not affect patient compliance, and treatment outcomes were achieved as planned. The PWB of all patients improved throughout the treatment with CA.
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Affiliation(s)
- Letizia Perillo
- Full Professor, Dean of the Faculty of Dentistry, Chairman of the Postgraduate Orthodontic Program, Head of the Orthodontic Division, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Fabrizia d'Apuzzo
- Postdoctoral Research Fellow, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Franca De Gregorio
- Clinical Tutor, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Vincenzo Grassia
- Assistant Professor, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Manuel Barbetti
- Postgraduate Student, Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy
| | - Giovanni Cugliari
- Statistician, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Ludovica Nucci
- Postgraduate and PhD Student, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Tommaso Castroflorio
- Assistant Professor, Department of Surgical Sciences, University of Turin, Turin, Italy
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Grassia V, Ronsivalle V, Isola G, Nucci L, Leonardi R, Lo Giudice A. Accuracy (trueness and precision) of 3D printed orthodontic models finalized to clear aligners production, testing crowded and spaced dentition. BMC Oral Health 2023; 23:352. [PMID: 37268910 DOI: 10.1186/s12903-023-03025-8] [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] [Received: 02/12/2023] [Accepted: 05/09/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND The study's objective was to assess the accuracy (trueness and precision) of orthodontic models obtained from crowded and spaced dentition finalized for the production of clear aligners. Four 3D printers featuring different technologies and market segments were used for this purpose. METHODS Two digital master models were obtained from two patients featuring respectively crowded dentition (CM group) and diastema/edentulous spaces (DEM group). The 3D printers tested were: Form 3B (SLA technology, medium-professional segment), Vector 3SP (SLA technology, industrial segment), Asiga Pro 4K65 (DLP technology, high-professional segment), and Anycubic Photon M3 (LCD technology, entry-level segment). Each 3D printed model was scanned and superimposed onto the reference master model and digital deviation analysis was performed to assess the trueness and precision calculated as root mean square (RMS). All data were statistically examined to obtain intra-group and inter-groups comparisons(p 0.05). RESULTS In both CM and DEM groups, SLA 3D printers (Vector 3SP and Form 3B) showed lower trueness error compared to DLP/LCD technologies (Asiga Pro 4K65, Anycubic Photon M3) (p < 0.001). In general, the entry-level printer (Anycubic Photon M3) showed the greatest trueness error (p < 0.001). Comparing CM and DEM models generated with the same 3D printer, statistically significant differences were found only for Asiga Pro 4k65 and Anycubic Photon M3 printers (p > 0.05). Concerning data of precision, the DLP technology (Asiga Pro 4k65) showed lower error compared to the other 3D printers tested. The trueness and precision errors were within the accepted clinical error for clear aligner manufacturing (< 0.25 mm), with the entry-level 3D printer nearly reaching this value. CONCLUSIONS The accuracy of orthodontic models generated for clear aligners can be affected by different 3D printer technologies and anatomical characteristics of dental arches.
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Affiliation(s)
- Vincenzo Grassia
- Multidisciplinary Department of Medical-Surgical and Dental Specialties School of Medicine and Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Vincenzo Ronsivalle
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Catania, Italy
| | - Gaetano Isola
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Catania, Italy
| | - Ludovica Nucci
- Multidisciplinary Department of Medical-Surgical and Dental Specialties School of Medicine and Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Rosalia Leonardi
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Catania, Italy
| | - Antonino Lo Giudice
- Department of General Surgery and Medical-Surgical Specialties, Section of Orthodontics, University of Catania, Catania, Italy.
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Al-Warafi LA, Al-Worafi NA, Al-Aroomi MA, Alhashimi N, Alsomairi MAA, Al-Rokhami RK, Chen X, Alhammadi MS. Alveolar bone changes following bi-maxillary vertical molars' movements using clear aligners. BMC Oral Health 2023; 23:326. [PMID: 37231473 DOI: 10.1186/s12903-023-03028-5] [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] [Received: 01/31/2023] [Accepted: 05/09/2023] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVE This study aimed to assess the alveolar bone changes following maxillary and mandibular molars' intrusion and extrusion movements using Clear Aligners using Cone-Beam Computed Tomography (CBCT). MATERIALS AND METHODS This is a retrospective clinical study in which 24 adult patients with pre-designed selection criteria and a mean age of 31.1 + 9.9 years were enrolled. The alveolar bone changes around one hundred thirty-three maxillary and mandibular molars intruded or extruded by Clear Aligners therapy were analyzed from CBCT using Invivo 6.0 software. Intra- and inter-examiner reliability analysis was performed using the intra-class correlation coefficient (ICC) and Cronbach's Alpha statistics. The paired t-test was used to analyze significant differences before and after treatment (T0-T1). The significance level was considered at P < 0.05. RESULT The patients were divided into two groups: extrusion (48.9%, n = 65 molars' root) and intrusion (51.1%, n = 68 molars' root) group. There was a significant decrease in the alveolar bone changes in the buccal surface of the mandibular right and left 1st molars in the extrusion group (-1.05 ± 0.97, -0.76 ± 1.12 mm, respectively) and the maxillary left 2nd molars in intrusion group (-0.42 ± 0.77 mm), and the lingual surface of intrusion of the mandibular left 1st molar (-0.64 ± 0.76 mm). Comparing the mean maxillary and mandibular changes (T0-T1) of both studied groups showed that the buccal alveolar bone changes for the left 1st and right 2nd molars showed a significant difference in extrusion and intrusion groups, respectively. CONCLUSIONS The buccal alveolar bone changes is considered the most affected surface following maxillary and mandibular molars' intrusion and extrusion movements using clear aligners, with mandibular molars being more affected than the maxillary ones.
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Affiliation(s)
- Leena Ali Al-Warafi
- Department of Stomatology, The First Affiliated Hospital of Xi'an JiaotongUniversity, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Naseem Ali Al-Worafi
- Department of Orthodontics, School of Stomatology, China Medical University, Shenyang, China
| | - Maged Ali Al-Aroomi
- Department of Oral and maxillofacial surgery, Faculty of dentistry, IBB University, IBB, Yemen
| | - Najah Alhashimi
- College of Dental Medicine, Chief of orthodontics division at Hamad Medical Corporation, Qatar University, Doha, Qatar
| | - Majedh Abdo Ali Alsomairi
- Department of Stomatology, The First Affiliated Hospital of Xi'an JiaotongUniversity, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Remsh Khaled Al-Rokhami
- Department of Orthodontics, School of Stomatology, China Medical University, Shenyang, China
| | - Xi Chen
- Department of Stomatology, The First Affiliated Hospital of Xi'an JiaotongUniversity, Xi'an, 710061, Shaanxi, People's Republic of China.
| | - Maged Sultan Alhammadi
- Division of Orthodontics and Dentofacial Orthopedics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Lyu X, Cao X, Chen L, Liu Y, Li H, Hu C, Tan J. Accumulated biomechanical effects of mandibular molar mesialization using clear aligners with auxiliary devices: an iterative finite element analysis. Prog Orthod 2023; 24:13. [PMID: 37032410 PMCID: PMC10083150 DOI: 10.1186/s40510-023-00462-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/07/2023] [Indexed: 04/11/2023] Open
Abstract
BACKGROUND The biomechanics generated by the clear aligner (CA) material changes continuously during orthodontic tooth movement, but this factor remains unknown during the computer-aid design process and the predictability of molars movement is not as expected. Therefore, the purpose of this study was to propose an iterative finite element method to simulate the long-term biomechanical effects of mandibular molar mesialization (MM) in CA therapy under dual-mechanical systems. METHODS Three groups including CA alone, CA with a button, and CA with a modified lever arm (MLA) were created. Material properties of CA were obtained by in vitro mechanical experiments. MM was conducted by the rebound force exerted by CA material and the mesial elastic force (2N, 30° to the occlusal plane) applied to the auxiliary devices. Stress intensity and distribution on periodontal ligament (PDL), attachment, button and MLA, and displacement of the second molar (M2) during the iterations were recorded. RESULTS There was a significant difference between the initial and cumulative long-term displacement. Specifically, compared to the beginning, the maximum stress of PDL decreased by 90% on average in the intermediate and final steps. The aligner was the main mechanical system at first, and then, the additional system exerted by the button and MLA dominated gradually. The stress of attachments and auxiliary devices is mainly concentrated on their interfaces with the tooth. Additionally, MLA provided a distal tipping and extrusive moment, which was the only group that manifested a total mesial displacement of the root. CONCLUSIONS The innovatively designed MLA was more effective in reducing undesigned mesial tipping and rotation of M2 than the traditional button and CA alone, which provided a therapeutic method for MM. The proposed iterative method simulated tooth movement by considering the mechanical characteristic of CA and its long-term mechanical force changes, which will facilitate better movement prediction and minimize the failure rate.
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Affiliation(s)
- Xinwei Lyu
- Department of Orthodontics, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, 510080, China
- Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Xing Cao
- Department of Orthodontics, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, 510080, China
- Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Luxian Chen
- Department of Orthodontics, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, 510080, China
- Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Yuyao Liu
- Department of Orthodontics, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, 510080, China
- Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Huilin Li
- Department of Orthodontics, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, 510080, China
- Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Cheng Hu
- Department of Orthodontics, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, 510080, China
- Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Jiali Tan
- Department of Orthodontics, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, 510055, China.
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, 510080, China.
- Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, 510080, China.
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Eliliwi M, ElShebiny T, de Menezes LM, Stefanovic N, Palomo JM. Comparing virtual setup software programs for clear aligner treatment. J World Fed Orthod 2023; 12:50-55. [PMID: 36925451 DOI: 10.1016/j.ejwf.2023.02.004] [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] [Received: 08/10/2022] [Revised: 02/27/2023] [Accepted: 02/27/2023] [Indexed: 03/17/2023]
Abstract
BACKGROUND The aim of this study was to compare the outcomes of the same amount of tooth movement among four different virtual setup software programs. METHODS This retrospective study included 32 patients who underwent Invisalign treatment. Patients' initial stereolithography (STL) files were imported to three different software programs (SureSmile Aligner [Dentsply Sirona, Charlotte, NC], Ortho Insight 3D [Motion View software, Chattanooga, TN], and Ortho Analyzer [3Shape, Copenhagen, Denmark]). After virtually moving teeth based on the numbers from ClinCheck Pro (Align Technology, Inc., Santa Clara, CA) tooth movement tables, final STL files were exported from all four software programs. ClinCheck Pro final STL files were used as references, while final STL files from the other software programs were used as targets. Superimpositions were performed between references and target STL files using Geomagic Control X software (3D Systems, Rock Hill, SC), and color-coded maps were obtained to illustrate potential differences. RESULTS Intraclass correlation coefficient showed a high degree of reliability for repeated methodology (0.995-0.997). The differences among absolute averages (Abs Avg.), averages of positive values (+Avg.), and negative values (-Avg.) for both upper and lower models were significant among all software programs (ClinCheck Pro, SureSmile Aligner, Ortho Insight 3D, and Ortho Analyzer), for both upper and lower STL files, the smallest difference was found between ClinCheck Pro and SureSmile Aligner with a median of (0.03, 0.31, -0.19) mm for upper and (0.02, 0.29, -0.17) mm for lower STL files (Abs Avg., +Avg. and -Avg.), respectively. The biggest difference was found to be between ClinCheck Pro and Ortho Analyzer with a median of (0.05, 0.46, -0.45) mm for upper and (0.06, 0.48, -0.40) mm for lower STL files. There were no significant differences in the number of aligners per patient. CONCLUSIONS Final outcomes of the same amount of tooth movement in four different software programs differed significantly. The number of aligners per patient remained unchanged.
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Affiliation(s)
| | - Tarek ElShebiny
- Assistant Professor, Department of Orthodontics, Case Western Reserve University, Cleveland, Ohio.
| | | | - Neda Stefanovic
- Assistant Professor, Department of Orthodontics, University of Belgrade, Belgrade, Serbia
| | - Juan Martin Palomo
- Professor and Program Director, Department of Orthodontics, Case Western Reserve University, Cleveland, Ohio
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Almagrami I, Almashraqi AA, Almaqrami BS, Mohamed AS, Wafaie K, Al-Balaa M, Qiao Y. A quantitative three-dimensional comparative study of alveolar bone changes and apical root resorption between clear aligners and fixed orthodontic appliances. Prog Orthod 2023; 24:6. [PMID: 36843193 PMCID: PMC9968667 DOI: 10.1186/s40510-023-00458-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 01/30/2023] [Indexed: 02/28/2023] Open
Abstract
BACKGROUND This study aimed to evaluate and compare the alveolar bone changes and to investigate the prevalence and severity of orthodontically induced inflammatory root resorption (OIIRR) of maxillary incisors in patients who received treatment with clear aligners (CA) versus conventional fixed appliances (FA), using cone-beam computed tomography (CBCT). METHODS One hundred sixty maxillary incisors from 40 patients with similar baseline characteristics based on the American Board of Orthodontics discrepancy index scores were divided into the CA and FA groups. The dentoalveolar quantitative changes were analyzed using pre- (T0) and post-treatment (T1) CBCT. The measured parameters included alveolar bone thickness (ABT), alveolar bone height (ABH), root length (OIIRR), and maxillary incisor inclinations. RESULTS Post-treatment, the average palatal and total ABT significantly decreased in central and lateral incisors in the FA group. In contrast, the CA group's average labial ABT of the lateral incisors decreased considerably. Regarding the ABH, both groups showed significant labial and palatal marginal bone resorption. In both groups, root lengths significantly decreased after treatment (p < 0.005). The inter-group comparison revealed that ABT and root length had significantly decreased in the FA group compared to the CA group, while the ABH showed no significant difference between the two groups. The mean absolute reductions of ABT and OIIRR in the CA group were significantly less (- 0.01 ± 0.89 and 0.31 ± 0.42) than those in the FA group (0.20 ± 0.82 and 0.68 ± 0.97), respectively. CONCLUSIONS CA and FA treatments appear to cause a significant ABT reduction and a statistically significant increased OIIRR in the maxillary incisor region, with a greater extent expected with FA treatment. However, the increased OIIRR values in the majority of both groups' cases were not clinically significant. Both treatment modalities resulted in a significant ABH reduction, with the highest found in the labial side of lateral incisors in the CA group.
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Affiliation(s)
- Ibtehal Almagrami
- grid.412633.10000 0004 1799 0733Department of Orthodontics, Faculty of Dentistry, First Affiliated Hospital of Zhengzhou University, No.1 Jianshe East Road Erqi District, Zhengzhou, Henan China ,grid.412413.10000 0001 2299 4112Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Sana’a University, Sanaa, Republic of Yemen
| | - Abeer A. Almashraqi
- grid.412603.20000 0004 0634 1084Department of Pre-Clinical Oral Health Sciences, College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Bushra Sufyan Almaqrami
- grid.49470.3e0000 0001 2331 6153Department of Orthodontics, Hubei-MOST KLOS and KLOBM, School and Hospital of Stomatology, Wuhan University, Wuhan, China ,Ningbo Dental Hospital, Ningbo, Zhejiang China
| | - Amin S. Mohamed
- grid.43169.390000 0001 0599 1243Department of Orthodontics, Xi’an Jiaotong Universit, Xi’an, China
| | - Khaled Wafaie
- grid.412633.10000 0004 1799 0733Department of Orthodontics, Faculty of Dentistry, First Affiliated Hospital of Zhengzhou University, No.1 Jianshe East Road Erqi District, Zhengzhou, Henan China
| | - Maher Al-Balaa
- grid.49470.3e0000 0001 2331 6153Department of Orthodontics, Hubei-MOST KLOS and KLOBM, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yiqiang Qiao
- Department of Orthodontics, Faculty of Dentistry, First Affiliated Hospital of Zhengzhou University, No.1 Jianshe East Road Erqi District, Zhengzhou, Henan, China.
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Wu Y, Yu Q, Xia Y, Wang B, Chen S, Gu K, Zhang B, Zhu M. Does mandibular advancement with clear aligners have the same skeletal and dentoalveolar effects as traditional functional appliances? BMC Oral Health 2023; 23:65. [PMID: 36732724 PMCID: PMC9896678 DOI: 10.1186/s12903-023-02709-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/03/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The study aimed to compare the dentoskeletal effects of Vanbeek Activator, Herbst, Twin-Block and Mandibular Advancement with clear aligners in children with skeletal Class II malocclusions. METHODS A sample with sixty-three patients (37 males, 26 females) was included and divided into untreated control group (C, n = 12), Vanbeek Activator group (V, n = 14), Herbst group (H, n = 11), Twin-Block group (TB, n = 12) and MA group (MA, n = 14). Cephalometric analysis and Johnston Pitchfork analysis were performed to quantify the skeletal and dentoalveolar components in molar relationship and overjet correction. Compare the differences of cephalometric data and Johnston-analysis data. RESULTS The treatment changes showed significant differences in SNB, FH-NP, NA-PA, Co-Go, Co-Pog, ANB, lower facial height ratio, U1-PP, U6-PP, L1-MP and U1-L1. All the appliances improved overjet relationships significantly (Vanbeek, Herbst, Twin-Block and MA were 2.77 mm, 5.53 mm, 4.73 mm and 3.66 mm respectively) with significant retraction of maxillary incisors. The lower incisor displacement of group V and MA was negative, while that of group H and TB was positive and there were significant differences. Molar relationships were also improved by 3.45 mm, 6.85 mm, 3.48 mm and 0.92 mm for Vanbeek, Herbst, Twin-Block and MA. Mandible displacement showed a trend of group H > TB > V > MA. The displacement of maxillary molars in group H was greater than that in group C, TB and MA, and that of mandibular ones was greater than that in group C, V and MA, significantly. Herbst, Twin-Block and MA have more significant dentoalveolar effect than Vanbeek, while Vanbeek has more skeletal effect than the others especially in restraining maxillary growth. CONCLUSIONS Four appliances are all effective in mandibular advancement, modification of class II molar relationship and deep overjet, with unavoidable increase in lower facial ratio. Vanbeek Activator has the most skeletal effects. Vanbeek and MA have a good control of mandibular incisors while more compensatory lower incisors proclination in Herbst and Twin-Block. Herbst has greater maxillary molar distalization. MA allows aligning and leveling meanwhile leading the mandible forward.
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Affiliation(s)
- Yanqi Wu
- grid.16821.3c0000 0004 0368 8293Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200011 China ,grid.412523.30000 0004 0386 9086National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200011 China
| | - Qian Yu
- Department of Pediatric Dentistry, Shanghai Xuhui District Dental Center, Shanghai, 200032 China
| | - Yunhui Xia
- grid.16821.3c0000 0004 0368 8293Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200011 China ,grid.412523.30000 0004 0386 9086National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200011 China
| | - Bo Wang
- grid.16821.3c0000 0004 0368 8293Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200011 China ,grid.412523.30000 0004 0386 9086National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200011 China
| | - Siyue Chen
- grid.16821.3c0000 0004 0368 8293Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200011 China ,grid.412523.30000 0004 0386 9086National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200011 China
| | - Kaijun Gu
- grid.16821.3c0000 0004 0368 8293Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200011 China ,grid.412523.30000 0004 0386 9086National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200011 China
| | - Bojun Zhang
- grid.16821.3c0000 0004 0368 8293Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200011 China ,grid.412523.30000 0004 0386 9086National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, 200011 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200011 China
| | - Min Zhu
- Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China. .,College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200011, China. .,National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, 200011, China. .,Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, 200011, China.
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Castroflorio T, Sedran A, Parrini S, Garino F, Reverdito M, Capuozzo R, Mutinelli S, Grybauskas S, Vaitiekūnas M, Deregibus A. Predictability of orthodontic tooth movement with aligners: effect of treatment design. Prog Orthod 2023; 24:2. [PMID: 36642743 PMCID: PMC9840984 DOI: 10.1186/s40510-022-00453-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 12/17/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUNDS The present study was designed to define: (1) which are the less predictable OTM with Invisalign aligners when the treatment plan is designed by expert operators, (2) if the presence and shape of attachments influence the predictability of OTM and (3) if patients' demographics influence OTM predictability. The sample comprises 79 prospectively recruited patients (mean age 30.8 years; SD 12.0; 23 M, 56 F), treated by expert operators with an average of 27 aligners (SD 15) in the maxillary arch and 25 aligners (SD 11) in the mandibular arch. Post-treatment digital models and final virtual treatment plan models were exported from ClinCheck® software as STL files and subsequently imported into Geomagic Qualify ®software, to compare final teeth positions. The differences were calculated and tested for statistical significance for each tooth in the mesial-distal, vestibular-lingual and occlusal-gingival directions, as well as for angulation, inclination and rotation. In addition, the statistical significance of categorical variables was tested. RESULTS The lack of correction was significant for all movements and in all group of teeth (P < 0.01) except for the rotation of maxillary first molar. The prescribed OTM, the group of teeth and movement, the frequency of aligner change and the use of attachment influence the outcome. The greatest discrepancies in predicted and achieved tooth position were found for angular movements and rotation of teeth characterized by round-shaped crowns, for a ratio of approximately 0.4° per 1° prescribed. Optimized attachments for upper canines and lower premolar rotation seem not working properly. Second molar movements are mostly unexpressed. Furthermore, changing the aligner every 14 days will reduce the lack of correction of the 12% with respect to 7 days aligner change. CONCLUSIONS Predictability of orthodontic movement with aligners still has limitations related to the biomechanics of the system: the shape of some attachments and the characteristics of aligner material need to be redefined. However, the results of this study allow to properly design the virtual treatment plan, revealing how much overcorrection is needed and which attachments are most effective.
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Affiliation(s)
- Tommaso Castroflorio
- Department of Surgical Sciences, Dental School of the University of Torino, Via Nizza 230, 10126, Turin, Italy
| | - Ambra Sedran
- Department of Surgical Sciences, Dental School of the University of Torino, Via Nizza 230, 10126, Turin, Italy.
| | | | | | | | | | - Sabrina Mutinelli
- Department of Neuroscience, School of Dentistry, Section of Pedodontics, University of Padova, Via VII Febbraio 2, 35122, Padua, Italy
| | | | | | - Andrea Deregibus
- Department of Surgical Sciences, Dental School of the University of Torino, Via Nizza 230, 10126, Turin, Italy
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Zhang Y, Wang X, Wang J, Gao J, Liu X, Jin Z, Ma Y. IPR treatment and attachments design in clear aligner therapy and risk of open gingival embrasures in adults. Prog Orthod 2023; 24:1. [PMID: 36617584 PMCID: PMC9826765 DOI: 10.1186/s40510-022-00452-1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/13/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The incidence of open gingival embrasures (OGE) in patients after fixed appliance treatment is relatively high, while there are no detailed reports on patients after clear aligner therapy. Also, no clinical studies with large sample size have investigated whether interproximal enamel reduction (IPR) can actually avoid OGE. The purpose of this study was to determine the prevalence of OGE in adults after clear aligner therapy and to investigate the risk of OGE associated with IPR treatment and attachment design, focusing on the amount and distribution in mandibular anterior teeth. METHODS Pre-treatment and post-treatment intraoral frontal photographs of 225 non-extraction patients were evaluated retrospectively for the occurrence and severity of OGE. The amount of IPR and the number of attachments in the anterior teeth from subjects after screening were recorded according to the first version of clear aligner software (Clincheck, San Jose, USA) and clinical medical documents. Logistic regression analysis was performed to identify the factors contributing to OGE. RESULTS The incidence of OGE in non-extraction patients after clear therapy between maxillary and mandibular central incisors was 25.7% and 40.3%, respectively. IPR was not associated with the occurrence of OGE but was associated with severity (P < 0.05). The number of attachments in the anterior teeth or central incisors was significantly related to the incidence of OGE (P < 0.05) but was not associated with severity. CONCLUSION A high rate of OGE occurs after clear aligner therapy. Clinicians should be aware of the application of IPR and the design of attachments during clear aligner therapy.
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Affiliation(s)
- Yubohan Zhang
- grid.233520.50000 0004 1761 4404State 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, 710032 China
| | - Xu Wang
- grid.233520.50000 0004 1761 4404State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an, Shaanxi China
| | - Jihong Wang
- The First People’s Hospital of Xianyang, Xianyang City, 712000 China
| | - Jie Gao
- grid.233520.50000 0004 1761 4404State 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, 710032 China
| | - Xulin Liu
- grid.233520.50000 0004 1761 4404State 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, 710032 China
| | - Zuolin Jin
- grid.233520.50000 0004 1761 4404State 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, 710032 China
| | - Yanning Ma
- grid.233520.50000 0004 1761 4404State 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, 710032 China ,grid.263452.40000 0004 1798 4018Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001 China
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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Affiliation(s)
- Mario Greco
- Department of Paediatric Dentistry, University of L'Aquila, L'Aquila, Italy; Private Practice, Rome, Italy.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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Bichu YM, Alwafi A, Liu X, Andrews J, Ludwig B, Bichu AY, Zou B. Advances in orthodontic clear aligner materials. Bioact Mater 2023; 22:384-403. [PMID: 36311049 DOI: 10.1016/j.bioactmat.2022.10.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 11/24/2022] Open
Abstract
Rapid technological improvements in biomaterials, computer-aided design (CAD) and manufacturing (CAM) have endorsed clear aligner therapy (CAT) as a mainstay of orthodontic treatment, and the materials employed for aligner fabrication play an all-important role in determining the clinical performance of clear aligners. This narrative review has attempted to comprehensively encompass the entire gamut of materials currently used for the fabrication of clear aligners and elucidate their characteristics that are crucial in determining their performance in an oral environment. Historical developments and current protocols in aligner fabrication, features of contemporary bioactive materials, and emerging trends related to CAT are discussed. Advances in aligner material chemistry and engineering possess the potential to bring about radical transformations in the therapeutic applications of CAT; in the absence of which, clear aligners would continue to underperform clinically, due to their inherent biomechanical constraints. Finally, while innovations in aligner materials such as shape memory polymers, direct three-dimensional (3D) printed clear aligners and bioactive materials combined with clear aligner materials are essential to further advance the applications of CAT; increased awareness of environmental responsibilities among aligner manufacturers, aligner prescribing clinicians and aligner users is essential for better alignment of our climate change goals towards a sustainable planet.
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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: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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Ertugrul BY, Veli İ. Evaluating the effects of orthodontic treatment with clear aligners and conventional brackets on mandibular condyle bone quality using fractal dimension analysis of panoramic radiographs. J Stomatol Oral Maxillofac Surg 2022; 123:538-545. [PMID: 35688416 DOI: 10.1016/j.jormas.2022.06.001] [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] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/24/2022] [Accepted: 06/04/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Orthodontic treatment carried out with clear aligners has become a method that is preferred by patients. In this study, the effect following orthodontic treatment with clear aligners and with conventional brackets, on the mandibular condyle trabecular bone formation is aimed to be examined. MATERIALS AND METHODS Thirty two individuals (16 females and 16 males) with a mean age of 16.80 ± 3,10 years who received orthodontic treatment with clear aligners and conventional brackets were included in the study. Individuals included in the study from the archive data were divided into two groups according to treatment types. The mandibular condyle bone quality in the panoramic images taken from the patients before orthodontic treatment (T0) and after orthodontic treatment (T1) has been compared retrospectively. This examination is carried out via the fractal analysis method. RESULT The mandibular condyle bone density in individuals that have undergone orthodontic treatment with clear aligners, has been reduced following orthodontic treatment. In individuals that have undergone orthodontic treatment with conventional brackets however the mandibular condyle bone density has increased following treatment (T0) in comparison to before being treated (T1). The mandibular condyle bone density change according to different treatment groups has been found to be statistically different. CONCLUSION Orthodontic treatment with clear aligners provides several advantages to patients. However, besides determining the effectiveness of the treatment, complications must also be examined. Application of clear aligners in orthodontic treatment may cause a decrease in bone density in the mandibular condyle. When evaluating orthodontic treatments carried out with clear aligners, the change of the mandibular condyle head bone should be taken into consideration.
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Affiliation(s)
| | - İlknur Veli
- Izmir Katip Celebi University Faculty of Dentistry, Department of Orthodontics, Izmir, Turkey
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Alhendi A, Khounganian R, Almudhi A. Cytotoxicity assessment of different clear aligner systems: An in vitro study. Angle Orthod 2022; 92:482482. [PMID: 35666210 PMCID: PMC9374349 DOI: 10.2319/121621-919.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/01/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate and compare the cytotoxicity of multiple clear aligner systems (Invisalign, Eon, SureSmile, and Clarity). MATERIALS AND METHODS A cytotoxicity assessment was carried out by immersing three sets of aligners from the included four systems in normal saline for 1 month at 37°C. The solutions were then diluted to three different concentrations (5%, 10%, and 20% volume/volume). Gingival fibroblasts were exposed to the solution after being seeded to 96-well microplates for 48 hours, and the medium was substituted with an MTT solution (MTT: 3-[4,5-dime- thylthiazol-2-yl]-2,5-diphenyltetrazolium bromide). Optical density was then measured to determine cell viability and evaluate cytotoxicity subsequently. RESULTS Cytotoxicity comparison showed no statistically significant difference among the four included systems. However, when cell viability of each system was compared with the control, a significant difference was reported at the 10% and 20% solution concentrations. The Clarity system had the lowest toxicity across all solution concentrations. CONCLUSIONS The thermoplastic materials used by all tested systems (Invisalign, Eon, SureSmile, and Clarity) presented some degree of toxicity (slight to moderate), with statistically significant mean differences compared with the control.
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Takara Y, Haga S, Kimura H, Maki K. Mechanical analysis of factors affecting clear aligner removability. Dent Mater J 2022; 41:534-544. [PMID: 35321972 DOI: 10.4012/dmj.2021-176] [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] [Indexed: 11/23/2022]
Abstract
It is difficult to control corrective forces in orthodontic treatment with clear aligners. The grip of aligners on teeth is important to ensure accurate corrective forces from aligners. This study aimed to measure the gripping force of aligners under various conditions to clarify factors that influence it. We created aligners with different attachment morphologies and placement sites and different margin lengths. We developed a device to measure the mechanics involved in the removal of these aligners. The gripping force was evaluated at five different aligner removal sites on the teeth. We found that the gripping force of the aligner was the weakest on the lingual side of the first molar and strongest on the labial side of the central incisors and that the attachment morphology and placement sites affected the gripping force of aligners.
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Affiliation(s)
- Yurie Takara
- Department of Orthodontics, School of Dentistry, Showa University
| | - Shugo Haga
- Department of Orthodontics, School of Dentistry, Showa University
| | - Hitoshi Kimura
- Department of Engineering Design, Tamagawa University College of Engineering
| | - Koutaro Maki
- Department of Orthodontics, School of Dentistry, Showa University
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Duarte L, Bezerra AP, Flores-Mir C, De Luca Canto G, Pereira LJ, Vega Gonçalves TMS. Activation and installation of orthodontic appliances temporarily impairs mastication. Angle Orthod 2022; 92:275-286. [PMID: 34878525 PMCID: PMC8887415 DOI: 10.2319/061221-469.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 10/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To investigate the masticatory (masticatory performance, bite force, swallowing threshold, muscle activity, and questionnaires) and nutritional (nutrient intake) impacts of the activation and/or installation of different orthodontic appliances (fixed labial, lingual appliances, and clear aligners). MATERIALS AND METHODS Six electronic databases and gray literature were searched (up to May 2021) for relevant studies evaluating mastication and nutrition after activation/installation of orthodontic appliances. This review followed PRISMA guidelines and was registered at PROSPERO (CRD42020199510). The risk of bias (RoB 2 and ROBINS-I) and evidence quality Grading of Recommendations Assessment, Development, and Evaluation were analyzed. RESULTS Of 4226 recorded and screened, 15 studies were finally included. Masticatory performance (standardized mean difference [SMD]: 1.069; 95% coefficient interval [CI]: 0.619 to 1.518) and bite force (SMD: -2.542; 95% CI: -4.867 to -0.217) reduced in the first 24 to 48 hours of fixed labial appliance installation/activation, but they were both normalized after 30 days (P > .05). The swallowing threshold remained constant (P > .05). Nutritional intake was rarely reported but showed copper (P = .002) and manganese (P = .016) reductions, with higher calorie and fat intake (P < .05). Lingual appliances impacted chewing more than labial, and clear aligner wearers reported fewer chewing problems (P < .001). Low to very low levels of evidence were found. CONCLUSIONS Based on low to very low levels of evidence, mastication was reduced during the first 24 to 48 hours of fixed labial appliance activation/installation, but it was transitory (up to 30 days). Due to insufficient data, the nutritional impact of orthodontic appliances was not conclusive.
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Palone M, Baciliero M, Cervinara F, Maino GB, Paoletto E, Cremonini F, Lombardo L. Class II treatment of transverse maxillary deficiency with a single bone-borne appliance and hybrid clear aligner approach in an adult patient: A case report. J World Fed Orthod 2022:S2212-4438(22)00003-0. [PMID: 35120859 DOI: 10.1016/j.ejwf.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/08/2021] [Accepted: 12/31/2021] [Indexed: 11/20/2022]
Abstract
This case report describes the successful orthodontic treatment of a 22-year-old female patient affected by Class II malocclusion, maxillary skeletal transverse deficiency, ectopic maxillary left lateral incisor, and mild mandibular crowding. Due to her adult skeletal age, a bone-borne appliance was applied in order to obtain both purely skeletal rapid maxillary expansion and bilateral molar distalization. After accurate matching between the pretreatment cone-beam computed tomography scan and digital models, 4 self-drilling miniscrews were inserted palatally using a computer-aided design and computer-aided manufacturing (CAD/CAM) surgical template to guide their correct and safe placement, and a bone-borne appliance was fitted. After this first phase, the hybrid clear aligner approach was used to obtain alignment, levelling, and arch coordination, with the use of a partial lingual fixed appliance on the maxillary incisors.
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Pratto I, Busato MCA, Bittencourt PRS. Thermal and mechanical characterization of thermoplastic orthodontic aligners discs after molding process. J Mech Behav Biomed Mater 2021; 126:104991. [PMID: 34864573 DOI: 10.1016/j.jmbbm.2021.104991] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 10/19/2022]
Abstract
Polymeric aesthetic aligners were introduced in orthodontics as an innovative alternative to fixed appliances, however, their compositions and the thermal molding process may influence the biomechanical characteristics of these aligners. In this study four different clear aligner brands were used, ACE 035 Essix, C + Essix, Crystal 0.75 and Crystal 1.0, whose aim was to identify the thermal-processing influence on the mechanical and physicochemical properties of these materials, and to suggest a orthodontic sequence of wear for these appliances to achieve more effective treatment results. For the tensile tests the sample size calculation was based on probability distributions from the F test. The effect size used was 0.3, type 1 error of 0.05. Statistical Yield strength and Young's Modulus results were evaluated using the Shapiro-Wilk test. The groups were compared using the parametric test of analysis of variance, with Tukey post-test. Differences were statistically considered at the p < 0.05. The Infrared spectroscopy analysis showed no changes in the samples' chemical structure after thermal-processing. However, in the polypropylene aligner, differences were verified in the region attributed to the crystalline phase. Differential Scanning Calorimetry analysis for the same sample showed a crystallinity fraction decrease due to relaxation between polymer chains after molding. In the tensile tests evaluated, the tensile strength and 'Young's modulus presented higher values for aligners containing 100% polyethylene terephthalate glycol. Performing an analogy exercise of the properties of orthodontic wires used in conventional fixed appliances and, relating them to orthodontic plastics, aligners composed of different materials and/or thicknesses could be used in increasing sequence in terms of the modulus of elasticity, starting with C+, which has a lower elastic modulus value, using the ACE 035 as an intermediate and finishing with the Crystal 0.75 and 1.0, providing the desired stiffness to the aligners for the final phase.
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Affiliation(s)
- Isabella Pratto
- Universidade Estadual do Oeste do Paraná (UNIOESTE), Departamento de Odontologia, ZIP 85819-110, Cascavel, Paraná, Brazil
| | - Mauro Carlos Agner Busato
- Universidade Estadual do Oeste do Paraná (UNIOESTE), Departamento de Odontologia, ZIP 85819-110, Cascavel, Paraná, Brazil
| | - Paulo Rodrigo Stival Bittencourt
- Universidade Tecnológica Federal do Paraná (UTFPR), Departamento Acadêmico de Química, Bloco I4, ZIP 85884-000, Medianeira, Paraná, Brazil.
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