Search

Objectives: The purpose of this preliminary study was to determine the differences between planned and actual maxillary molar movements after the completion of treatment with an initial set of clear aligners including sequential maxillary molar distalization. Methods: The data records of 14 non-growing patients who completed orthodontic treatment with sequential maxillary molar distalization using clear aligners were retrospectively evaluated (n= 14, 4 males and 10 females, 33.61 ± 8.57 years). Data on planned tooth movements were obtained from ClinCheck software (ClinCheck Pro version 5.3). The amounts of actual tooth movements were obtained by performing superimposition of lateral cephalograms taken before and after treatment. The amounts of distal translation and tipping between planned and actual maxillary molar movements were compared with the paired Student's t-test. Results: The statistically significant differences between planned and actual translation movements of maxillary first and second molars were shown after completing treatment with the first series of aligners (p < 0.05). The average actual amount of molar distalization on maxillary first molars was less than the planned amount by 1.32 ± 0.42 mm. Similarly, the average actual amount of molar distalization on maxillary second molars was less than the planned amount by 1.57 ± 0.45 mm. The accuracy for molar distalization, namely, the percentage of actual distal translation to planned movement, was 40.11% for maxillary first molars and 35.39% for maxillary second molars. However, the difference between the planned and actual angulation movements was not significant (p > 0.05). Conslusions: In conclusion, the amounts of actual distal translation of maxillary molars through the utilization of clear aligners were significantly lower than planned. However, there were no statistically significant differences between the degrees of actual and planned molar angulation movement. [ABSTRACT FROM AUTHOR]

Background and objectives Different expedited aligner wear protocols are currently in practice. This review was undertaken to systematically appraise the available evidence on the comparative efficacy of orthodontic tooth movement (OTM) across the different wear protocols. Search methods Two assessors conducted comprehensive searches of electronic databases, including MEDLINE (via PubMed), Scopus, Embase, Web of Science, Google Scholar, Directory of Open Access Journals, Cochrane Library, OpenGrey, and Clinical Trial Registry, till 18 February 2024. Titles and abstracts were independently screened. Selection criteria Prospective or retrospective studies comparing expedited wear protocols with the conventional 14-day protocol were included. Data collection and analysis A pre-piloted data extraction form was used. Risk of bias (RoB) assessment employed the Cochrane RoB 2.0 tool for randomized-controlled trials (RCTs) and the Newcastle–Ottawa scale for non-RCTs. The quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation Pro tool. Results Six studies, including 3 RCTs and 3 non-RCTs, were selected from 9076 records. Four studies (two RCTs and two retrospective cohort) found no statistically significant difference (P  > 0.05) in the OTM efficacy between expedited and conventional protocols. Two studies (one RCT and one prospective cohort) found greater efficacy (P  < 0.05) with the 14-day protocol, with the RCT reporting greater efficacy for certain movements, such as maxillary posterior intrusion, maxillary posterior distal tipping and buccal torquing, and mandibular posterior intrusion and extrusion. One RCT reported statistically insignificant difference (P  > 0.05) in pain perception between the 10-day and 14-day protocols. Two studies demonstrated low RoB, two moderate, and two high RoB. The evidence level was very-low for OTM efficacy and high for pain perception. Meta-analysis was precluded due to significant heterogeneity among the studies. Conclusions Within the limitations of the study, the 7-day, 10-day, and 14-day protocols did not show any significant difference in OTM efficacy, except for certain movements that exhibited superior outcomes with the 14-day wear. Hence, a 'hybrid aligner-wear protocol', based on clinical judgement, might serve a better alternative in complex situations. Registration PROSPERO CRD42021288179 [ABSTRACT FROM AUTHOR]

Purpose: There is an overall paucity of data examining the specific details of orthodontic patients' patterns or orthodontic service disruptions possibly influenced by COVID-19 pandemic. Therefore, this study aimed to explore the impact of the COVID-19 pandemic on orthodontic clinic disruption regarding the change in adult patients' characteristics and decisions of orthodontic treatment devices. Patients and Methods: A retrospective sample of 311 patients receiving orthodontic treatment from 2018 to 2022 were collected and divided into two groups: before (n = 167) and during (n = 144) the COVID-19 pandemic. Demographics, dental indices, the index of complexity outcome and need (ICON), and the degree of treatment difficulty were analyzed. Results: There were fewer students among patients during the COVID-19 pandemic than before (24.5% versus 35.9%, P = 0.036). Compared with patients before the pandemic, more patients selected ceramic brackets or Invisalign during the pandemic (P = 0.022). There were higher percentage of class I dental malocclusions among patients during than before the COVID-19 pandemic (P = 0.044). Moreover, the ICON score and the score of the degree of treatment difficulty were both significantly lower for patients during than before the COVID-19 pandemic (63.9± 14.0 versus 58.3± 15.3, P=0.001 and 7.4± 2.6 versus 6.8± 2.6, P=0.049, respectively). Conclusion: The COVID-19 pandemic influenced the characteristics and decisions of orthodontic patients. Those who still came to the orthodontic clinic despite the COVID-19 outbreak may have been those with less malocclusion severity and treatment difficulty. Besides, during the time of covid-19 pandemic, more patients chose ceramic bracket and Invisalign as their orthodontic treatment device rather than conventional or self-ligating metal brackets. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The article informs about a retrospective study evaluating the alignment outcomes of Invisalign aligner treatment by comparing predicted and achieved overjet and overbite measurements. Topics include the methodology involving ClinCheck Pro data, statistical analyses revealing significant differences between predicted and achieved outcomes, and the conclusion that planned changes in overjet and overbite differed significantly from actual results.

The article informs about a validation study that investigated the consistency between predicted changes in overbite (OB) and overjet (OJ) in Align Technology's digital treatment plan for Invisalign and the actual changes measured with Geomagic Control X software. Topic include the results showed a high level of agreement, indicating that ClinCheck's digital treatment-planning facility provides valid data regarding OB and OJ changes during the prescribed Invisalign treatment.

Introduction: Fixed orthodontic treatment has been the standard method to treat malocclusions for decades; however, the number of adults seeking more inconspicuous ways to enhance their smiles has significantly increased. This trend has led to the rising popularity of clear aligners among the general population, hailed as the 'invisible treatment' for correcting misaligned teeth. Aim: To assess the level of awareness among residents of Maharashtra regarding clear aligners. Materials and Methods: A cross-sectional study was conducted at the Department of Orthodontics and Dentofacial Orthopaedics, School of Dental Sciences, Krishna Vishwa Vidyapeeth (KVV) Karad, Maharashtra, India with a sample size of 423 participants. An online survey on awareness and perceptions of clear aligners among the general population of Maharashtra was carried out for one month through the dissemination of an online questionnaire. The questionnaire was administered using Google Forms and consisted of 12 closed-ended questions. The online data was collected and analysed while assessing its content validity. Results: The mean age of the study participants was 28.4±5.88 years. According to the survey, 203 (47.99%) participants had visited an orthodontist, with 87 (43.03%) receiving clear aligner recommendations as a treatment option. Notably, 266 (62.88%) were already familiar with clear aligners, and 268 (63.36%) considered them to be an effective treatment. Conclusion: The study findings indicated that 62.88% of participants had prior knowledge of clear aligners, while only 47.99% had visited an orthodontist. [ABSTRACT FROM AUTHOR]

Background and Objectives: Evaluation of the levels of cytokine and bone metabolic biomarkers (BMBs) in patients receiving fixed orthodontic therapy (FOT) and Invisalign. Materials and Methods: Sixty participants were enrolled after meeting the predefined inclusion criteria. Patients then underwent either FOT or Invisalign by allocating them randomly to each group (n = 30). The basic periodontal assessment was performed, including the plaque index (PI), gingival index (GI), and bleeding on probing (BoP), at baseline and again after 4 weeks. Gingival crevicular fluid (GCF) samples were taken from each individual at baseline and after 4 weeks. An enzyme-linked immunosorbent assay (ELISA) technique was used to determine the cytokine and BMB levels. An unpaired t-test compared the FOT and Invisalign group's means and SDs. Paired t-tests examined the difference between T0 baseline and T1. Results: Patients treated with either FOT or Invisalign presented no statistically significant difference in terms of periodontal parameters such as PI, GI, and BoP (p > 0.05). The levels of IL-6 were significantly higher in patients treated with FOT as compared to Invisalign at T1 (p < 0.05) The other tested cytokines, IL-10, 13, 17, and GM-CSF, were not significantly different in either the FOT or Invisalign group at baseline and 4 weeks follow-up (p > 0.05). Regarding BMBs, it was detected that NTx and OC levels in both of the investigated groups were not significantly different at baseline and after 4 weeks (p > 0.05). However, NTx levels rose significantly (p < 0.05) and OC levels fell from T0 to T1. Conclusions: FOT and Invisalign displayed comparable outcomes in terms of cytokine and BMB levels. However, only IL-6 and NTx were significantly different at week 4 from baseline. [ABSTRACT FROM AUTHOR]

The article discusses the predictability of the Invisalign appliance in leveling the maxillary curve of Spee, finding a significant difference between predicted and actual outcomes. Topics include the limitations of Invisalign in predicting vertical movements, challenges in managing deep overbites, and discrepancies in planned intrusive and extrusive movements for different teeth.

The Invisalign® system (SmartForce® G8) aims to guarantee aesthetics and provide good orthodontic treatment results. Dentoalveolar expansion is possible with clear aligners and can be used to correct dentoalveolar crossbite, resolve crowding or modify the arch shape. Despite the treatment's effectiveness, there is still disagreement among professionals concerning its true clinical potential. This study aimed to analyze the effectiveness and predictability of coronal tooth expansion movement in permanent dentition in patients who had completed the first phase of treatment with Invisalign® orthodontic aligners. Materials and Methods: The tooth movement tables of 75 previously selected cases were analyzed in terms of dental-arch width and expansion efficiency, through the Invisalign® platform, considering the pre-treatment (T0), planned treatment (TP) and post-treatment models (T1) using ClinCheck Pro® 6.0 software. All patients were treated by an orthodontic specialist and Invisalign® Diamond Provider in a private practice (T.P.). Results: Difference between T1 and T0: for each maxillary and mandibular measurement, there was a statistically significant difference between pre- and post-aligner treatment values. The greatest amount of expansion occurred in both the upper and the lower premolars. Difference between TP and T1: for each maxillary measurement, statistically significant differences were verified for the molar and canine. At the mandibular level, statistically significant differences were only verified in the first molar. Conclusions: The Invisalign® clear aligners are effective for simultaneous intra-arch expansion in both jaws. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The advantages of Clear Aligners Therapy (CAT) include the braces being virtually invisible, comfortable to wear, and removable for eating and brushing; that way, CAT can be used to treat a wide range of orthodontic issues. In 1999, the company Align Technology introduced the frst commercial clear aligner system called Invisalign. The Invisalign system was initially only available to orthodontists, but later became available to general dentists as well. The system quickly gained popularity among patients who were looking for a more discreet and comfortable alternative to traditional braces. In 2000, Align Technology received FDA clearance for the Invisalign system, which further increased its popularity. The biomechanics of clear aligners involve the use of custom‑made tooth aligners that are specifcally shaped to guide teeth into desired positions. These aligners are typically made from flexible materials such as polyurethane or ethylene vinyl acetate and are adjusted to apply the necessary forces for tooth movement. Attachment devices, such as power ridges or buttons, are often used to enhance or assist in specifc tooth movements and for retention of the aligner. The use of attachments allows for the exertion of desired force on the teeth, which is crucial for the success of Clear Aligner Therapy. CAT should be used if patients are concerned about the esthetic appearances of their teeth—for example, actors and other individuals that rely on their appearances in public in a professional context—and if the misalignment is not severe, so that clear aligners can still work. One should not use CAT in cases of severe crowding or spacing issues that require extractions. If the patient has complex jaw discrepancies or skeletal issues or if teeth need to be moved extensively in multiple directions, CAT is likely not going to be strong enough. In conclusion, Clear Aligner Therapy is a safe, effective, and convenient orthodontic treatment option that offers patients a virtually invisible way to achieve a straighter, more beautiful smile. With continued advancements in technology and a growing body of research supporting its effectiveness, the future of Clear Aligner Therapy looks bright. [ABSTRACT FROM AUTHOR]

Objective: This study aims to assess the scientific evidence regarding the clinical outcomes of Invisalign therapy in controlling orthodontic tooth movement. Materials and methods: An electronic search was conducted on PubMed, Cochrane Library, Web of Science, Embase, and Scopus from November 2015 to November 2022 to identify relevant articles. Methodological shortcomings were highlighted, and an evaluation of the quality of the included studies was completed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. Results: Fifteen non-randomized controlled trials were included in the analysis. Most non-randomized controlled trials (n=11; 73%) were rated with a moderate risk of bias according to the ROBINS-I tool. There were statistically significant differences between the pretreatment and posttreatment arches. The average expansion was significantly different from that predicted for each type of tooth in both the maxilla and mandible. Furthermore, the efficiency decreased from the anterior area to the posterior area in the upper arch. Conclusion: Despite the fact that arch expansion with Invisalign® is not entirely predictable, clear aligner treatment is a viable option for addressing dentition crowding. The efficacy of expansion is greatest in the premolar area. More research focusing on treatment outcomes with different materials of aligners should be conducted in the future. Overcorrection should be considered when planning arch expansion with Invisalign. In the maxilla, the expansion rate decreases from the anterior to the posterior, and presetting sufficient buccal root torque of posterior teeth may result in improved efficiency of expansion. [ABSTRACT FROM AUTHOR]

Copyright of Clinical Orthodontics is the property of Dental Press International and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Coronal torque is one of the key factors in orthodontic treatment. An adequate torque value has an impact on aesthetics and soft tissue profile. The aim of this quantitative, comparative and observational longitudinal cohort study was to analyze the efficacy of the maxillary central incisor coronal torque in the Invisalign® system and evaluate the relation between coronal torque movement and patient's facial biotype. In total, 27 patients were selected. The planned movements (TP) were obtained from the Invisalign Doctor Site® using mathematical formulas that consider the T0 measurements. Pre-treatment (T0) and after full use of the first set of aligners (T1) scanners were evaluated using Geomagic® Control X TM by superimposing T0 and T1 models using a transverse plane and the long axis of the tooth crown. IBM® SPSS® software was used for statistical purposes. We found statistically significant differences between T0 and T1 in pro-inclination and retro-inclination, as well as between achieved and planned values in pro-inclination (p = 0.011). We verified that hyperdivergent clinical cases presented higher mean values of coronal torque, and hypodivergent cases presented lower values. In pro-inclination, the differences between the planned and achieved values were greater in hypodivergent cases and smaller in hyperdivergent cases. In retro-inclination, the differences between the planned and achieved values were greater in normodivergent cases and smaller in hypodivergent cases. This study highlights that inefficacy is more accentuated in pro-inclination. Aligners are an effective tool for producing coronal repercussions of torque movement, being more effective in retro-inclination. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Orofacial Orthopedics/Fortschritte der Kieferorthopadie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Skeletal malocclusion patients have facial malformations and occlusal dysfunctions that require orthodontic-orthognathic joint treatment, while the combination treatment takes time and requires close communication between surgeons and orthodontists. Thus, improving the efficiency and effectiveness of the combination treatment is necessary, and it is still a challenge. Now, digital technology provides us with an excellent alternative. Despite the widespread use of digital technology in orthognathic surgery simulation and clear aligner orthodontic therapy, it has not been fully integrated into the combined orthognathic and orthodontic treatment process, and the components remain independent. Methods: A fully digital approach to seamlessly integrating various parts of the combined treatment through digital technology was investigated in this study in order to achieve an efficient transition. Five patients with skeletal Class III malocclusion were enrolled, and all made fully digital treatment plans at the beginning of actual implementation, which included the design of pre-surgical orthodontic, orthognathic surgery, and post-surgical orthodontic. Then, every aspect of the clinical operation was carried out in accordance with the fully digital routine. After the entire treatment process was completed, the skeleton and dentition discrepancy between virtual planning and the actual result was evaluated. Results: All participants completed the fully digital treatment process, and no complication was observed. The linear deviation of the skeletal anatomy was less than 1 mm, and the angular deviation was less than 1 degree. Except in one case in the lower dentition, the deviation of the virtual dental design from the real alignment was less than 2 mm. Furthermore, with one exception of maxillary anterior-posterior dimension, the linear deviations of the skeleton were not statistically significant. Therefore, the simulation accuracy of the fully digital approach was clinically acceptable. Conclusions: The digital treatment approach is clinically feasible and has achieved satisfactory results. The discrepancy between virtual design of the entire digital process and actual post-treatment situation was acceptable in clinic. A fully digital approach was proved effective in the treatment of skeletal Class III malocclusion, with which the efficient transition of treatment procedures was realized. [ABSTRACT FROM AUTHOR]

To identify predictors regarding the type and severity of malocclusion that affect total Invisalign treatment duration based on an intraoral digital scan. The subjects of this retrospective clinical cohort were 116 patients treated with Invisalign. A deep learning method was used for automated tooth segmentation and landmark identification of the initial and final digital models. The changes in the six degrees of freedom (DOF), representing types of malalignment, were measured. Linear regression was performed to find the contributing factors associated with treatment time. In addition, the Peer Assessment Rating (PAR) score and a composite score combining 6 DOF were correlated separately to the treatment time. The number of trays differed between sexes (P =.0015). The absolute maximum torque was marginally associated with the total number of trays (P =.0518), while the rest of the orthodontic tooth movement showed no correlation. The composite score showed a higher correlation with the total number of trays (P =.0045) than did individual tooth movement. Pretreatment upper and lower anterior segment PAR scores were positively associated with the treatment time (P <.001). There is not enough evidence to conclude that certain types of tooth movement affect the total aligner treatment time. A composite score seems to be a better predictor for total treatment time than do individual malalignment factors in aligner treatment. Upper and lower anterior malalignment factors have a significant effect on the treatment duration. [ABSTRACT FROM AUTHOR]

To describe an esthetic orthodontic treatment using aligners in an adult patient with dental class II malocclusion associated with crowding. A 25‐year‐old female patient with skeletal class I, bilateral class II relation, increased overjet and overbite and crowding in both arches presented for orthodontic treatment. The patient refused conventional fixed multibracket treatment in favor of aligners. Pre‐ and post‐treatment records are presented. Treatment objectives were achieved in 10 months, and the patient was satisfied with the functional and esthetic outcomes. Combining aligners with appropriate attachment location and geometry is an efficacious means of resolving orthodontic issues such as class II malocclusion in a time frame comparable to that of conventional fixed orthodontics. Staging in distalization increases the predictability of movement. Furthermore, this system is associated with optimal oral hygiene and excellent esthetics. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this retrospective study was to determine the efficacy of Invisalign in a large sample of patients compared to fixed appliances. Method and Materials: The test group consisted of 100 patients treated with Invisalign compared with a control group treated with conventional fixed appliances matched for sex, age, and initial severity of malocclusion based on the amount of anterior dental crowding (Little Index) and the Peer Assessment Rating (PAR Index) scores. The retainer used was a 0.0175-inch multistranded stainless-steel wire bonded from canine-to-canine in the mandibular arch and from lateral inisor-to-lateral incisor in the maxillary arch. A paired t test was used to compare both initial and final PAR scores. Results: There was an overall 80.9% improvement, and 63 subjects did not need any refinement. The mean number of aligners used was 14 (+ 15 for the refinements) in the maxillary arch and 29 (+ 14 for the refinements) in the mandibular arch. The mean duration of treatment was 14 months (+ 7 months for the refinements). Significant statistical differences were found in the posttreatment scores, within both the Invisalign group and the control group. No differences were found in the follow-up scores. Additionally, the duration of treatment was 4 months longer in the control group. Conclusion: More than 90% of the subjects treated with Invisalign achieved a significant improvement, as shown by the PAR scores. A need for additional aligners was reported for 37% of the patients. Fixed bonded retainers seem to be a good option in preventing tooth relapse after Invisalign and fixed conventional treatments. [ABSTRACT FROM AUTHOR]

The objective of this article was to systematically review the literature to determine how effective tooth whitening procedures are when carried out in tandem with orthodontic clear aligners. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Online searches of PubMed, Medline via Ovid, Science Direct, the Cochrane database of systematic reviews via Ovid, Scopus, and Google Scholar as well as manual searches of the references of the selected articles were conducted. Clinical studies which assessed the efficacy of dental bleaching using orthodontic clear aligners were included in the present study. Data from the included studies were extracted and assessed for risk of bias using the Cochrane risk of bias tool. Three studies met the inclusion and exclusion criteria and were included in this study. One study compared the efficiency of tooth bleaching between clear aligners and conventional bleaching trays. One study evaluated the effectiveness of dental bleaching using clear aligners by comparing the tooth shade of those patients to a control group of patients who did not receive dental bleaching during orthodontic clear aligner treatment. One study evaluated the effectiveness of different concentrations of different bleaching agents using clear aligners. All the included studies showed an improved tooth shade when using clear aligners as bleaching trays. [ABSTRACT FROM AUTHOR]

The growing popularity of Invisalign is attributed to the fact that patients find it more aesthetically pleasing than the traditional fixed appliance to have their teeth straightened using the Invisalign system. Invisalign was initially intended for use in less severe conditions of orthodontic malalignment. Invisalign has been an effective and aesthetically acceptable alternative to conventional labial fixed appliances since its launch in 1997. CAD/CAM (Computer-aided design/computer-sided machine) stereolithography and a single silicone or digital impression can be used to make a set of custom aligners. Each aligner is set to gradually shift teeth by 0.25 mm to 0.33 mm over two weeks. More individuals are now receiving orthodontic treatment due to this novel tooth mobility approach. Over 300,000 patients have been treated with Invisalign in the previous decade, with the average patient age being 19.5. In most cases, the Invisalign device can stabilize these patients' anterior, posterior and vertical dimensions. Although many dentists and orthodontists believe that Invisalign appliances cause deep bites, this research disproves this theory. This literature review will determine the level of efficacy Invisalign can offer when it comes to the treatment of deep bites. It was concluded that Invisalign is effective in treating mild to moderate overbite cases and is an effective replacement for metallic braces, and provides a good option for esthetic-conscious patients. [ABSTRACT FROM AUTHOR]

The article describes the orthodontically treated case of a 25-year-old patient with skeletal and dental class III malocclusion, anterior crossbite, which caused functional and aesthetic problems, occlusal trauma, and incisor wear. Treatment with transparent aligners was proposed to meet the patient's needs, using the sequential distalization protocol. While sequential distalization is well documented for class II malocclusion treatment in maxillary arch teeth, further investigations are necessary for class III malocclusions. In fact, lower teeth movements are more complex due to mandibular bone density and the presence of the third molars, which are often extracted to perform distalization. In addition, the use of intermaxillary elastics helps control the proclination of the anterior teeth as a reaction to distalizing forces. At the end of the treatment, the patient reached molar and canine class I and positive overjet and overbite. The inclination of lower incisors and the interincisal angle have improved, resulting in aesthetic and functional enhancement. [ABSTRACT FROM AUTHOR]

Background: Since their introduction in orthodontics, clear aligners have been appreciated by patients, including adults, for their comfort and low aesthetic impact. Despite the enormous mobilization of financial resources all over the world aimed at producing new product lines, few clinical studies or high-quality evidence have been produced regarding the real effectiveness of such treatment. Given the few limited kinds of research on the subject, this study aims to produce and critically evaluate other data, to establish the concrete reliability of clear aligners in orthodontic therapy. Results: Significant sample sizes were obtained for intrusion, vestibulo/lingual (V/L) crown tipping, and rotation. The overall accuracy for rotation resulted in 86%, ranging from 96% for maxillary central incisors to 70.4% for mandibular first premolars. The intrusion was registered only for anterior teeth; mean predictability was 92%, with the worst result being 86.7% for mandibular canines and the best being 98% for mandibular central incisors. V/L tipping was the most accurate movement: 93.1% of the prescribed movement was completed. Maxillary central incisors showed the lowest accuracy (80.7%), while mandibular central incisors were the highest (97.5%). Conclusions: The present study provided reassuring data in support of the accuracy of the Invisalign® system. Vestibulo/lingual tipping was the most predictable movement, while rotation of canines, premolars, and lateral incisors were the least predictable. Intrusion resulted highly predictable up to 2 mm. When careful treatment planning follows a correct diagnosis, together with the use of auxiliary features and refinements, the planned results can be achieved in a clinically successful way. Authors believe that there is a major need for greater samples to overcome bias related to variables if we want to answer the unsolved questions, such as the predictability of severe malocclusions treatment. [ABSTRACT FROM AUTHOR]

To assess speech performance of adult patients undergoing orthodontic treatment with Invisalign. Twenty-four adult patients with Invisalign (Invisalign group: 6 men, 18 women; average age; 34.88 years) and 20 adult patients with fixed labial appliances (fixed group: 5 men, 15 women; average age; 38.85 years) were evaluated. Speech was recorded immediately before delivery of the first set of clear aligners or bonding of labial appliances (T0), immediately after delivery or bonding (T1), and 2 months after delivery or bonding (T2). Speech was evaluated via a combination of three auditory analyses: (1) objective acoustic analysis through digital sonography, (2) semiobjective assessment by six speech and language pathologists, and (3) subjective assessment patient questionnaire. The objective acoustic analysis showed a statistically significant difference over time from T0 to T1, T1 to T2, and T0 to T2 for Invisalign patients. The semiobjective analysis revealed a significant speech alteration from T0 to T1 and T1 to T2 for both groups, and from T0 to T2 in the Invisalign group. The subjective analysis showed a significant difference between means of Invisalign and fixed group patient perception at both T1 and T2. Invisalign treatment significantly affected speech, and although patients experience some level of adaptation, speech does not return to normal after 2 months of treatment. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study is to compare the orthodontic patient's experiences with removable and fixed orthodontic appliances on daily activities, food consumption, and oral symptoms in Riyadh city, Saudi Arabia. Methods: This was a cross-sectional observational study carried out among orthodontic patients. A total of 150 adult patients, including 118 in the fixed orthodontic appliance group and 32 in the removable (Invisalign) orthodontic group, who met the inclusion criteria completed a validated and self-administered questionnaire. In addition, the study participants reported their experience in terms of daily routine, food consumption, and oral symptoms one week after appliance activation. Data were analyzed using the chi-square test and Fisher's exact tests for the categorical variables. In addition, Mann–Whitney U, Kruskal–Wallis, and Spearman's tests were also applied to the data. Results: The fixed orthodontic patients compared to the removable orthodontic cases showed significantly higher difficulty in sleeping (1.28± 1.10 vs 0.94± 0.88, p=0.024), sores on the tongue (0.97± 1.00 vs 0.56± 0.76, p=0.042) and cheeks (1.20± 1.11 vs 0.72± 0.81, p=0.027), and the presence of food debris under the appliance (1.53± 1.16 vs.1.00± 0.95, p=0.021). Moreover, the oral health impact score showed a significant positive correlation with the duration of the orthodontic treatment (r=0.339, p< 0.001) and pain intensity (r=0.309, p< 0.001). Conclusion: The fixed orthodontic treatment compared to removable orthodontic treatment resulted in more severe pain, sleeping difficulty, sores on the tongue and cheeks, and food impaction after one week of appliance activation. [ABSTRACT FROM AUTHOR]

To evaluate all available evidence on the prediction of rotational tooth movements with aligners. Seven databases of published and unpublished literature were searched up to 4 August 2020 for eligible studies. Studies were deemed eligible if they included evaluation of rotational tooth movement with any type of aligner, through the comparison of software-based and actually achieved data after patient treatment. Data extraction was done independently and in duplicate and risk of bias assessment was performed with the use of the QUADAS-2 tool. Random effects meta-analyses with effect sizes and their 95% confidence intervals (CIs) were performed and the quality of the evidence was assessed through GRADE. Seven articles were included in the qualitative synthesis, of which three contributed to meta-analyses. Overall results revealed a non-accurate prediction of the outcome for the software-based data, irrespective of the use of attachments or interproximal enamel reduction (IPR). Maxillary canines demonstrated the lowest percentage accuracy for rotational tooth movement (three studies: effect size = 47.9%; 95% CI = 27.2–69.5; P < 0.001), although high levels of heterogeneity were identified (I2: 86.9%; P < 0.001). Contrary, mandibular incisors presented the highest percentage accuracy for predicted rotational movement (two studies: effect size = 70.7%; 95% CI = 58.9–82.5; P < 0.001; I2: 0.0%; P = 0.48). Risk of bias was unclear to low overall, while quality of the evidence ranged from low to moderate. Allowing for all identified caveats, prediction of rotational tooth movements with aligner treatment does not appear accurate, especially for canines. Careful selection of patients and malocclusions for aligner treatment decisions remain challenging. [ABSTRACT FROM AUTHOR]

Aesthetics is a major factor in Orthodontic treatment and it is a primary concern among patients seeking orthodontic treatment. To meet the growing aesthetic desire for an alternative to traditional braces, researchers have created a variety of alternatives, including ceramic or composite braces, lingual orthodontics, and transparent aligners. Clear aligner therapy is a treatment that consists of a set of clear dental appliances that are custom-made to fit the contour of a patient’s teeth. Clear Aligners are an alternative to traditional braces that are used to guide teeth into appropriate alignment. Clear aligners, like braces, utilise a progressive force to regulate tooth movement, but without the need of metal wires or brackets. [ABSTRACT FROM AUTHOR]

For years, patients with dental malocclusions have been treated with multibracket fixed appliances. In recent years there has been a huge boom in clear aligners. This treatment has had many advantages when treating patients, either because the movements you want to perform can be programmed, because being removable, it provides facilities when cleaning the mouth or because it performs continuous outflows. and light for the periodontium of the patient, especially in those cases in which it is compromised. The objective is to analyze whether oral hygiene is better in patients who are treated with clear aligners in the studies already documented in the literature and therefore the negative effects on periodontal health are less than with fixed multibrackets appliances. A bibliographic search was carried out including articles from April 2004 to April 2020, in Pubmed, Scopus, Cochrane, those articles that included studies on animals were discarded, those studies that only registered data from microbes that did not analyze periodontal indices, pilot studies or those written in a language other than Spanish, English or French. The search strategy included the keywords: "Periodontal diseases", "periodontal index", "invisalign" and "fixed orthodontic Treatment". 32 articles were located and after applying the selection criteria 28 were selected. It was observed that with the aligner treatment the best periodontal indices were obtained, and even oral hygiene improved as the months of treatment progressed. Lingual orthodontic treatment was the one with the worst periodontal indices. Visiting the hygienist regularly improves oral hygiene even in patients with multibracket appliances. Clear aligners allow optimal oral hygiene, followed by buccal brackets. Worst results in periodontal indexes are found in lingual brackets patients. [ABSTRACT FROM AUTHOR]

The article describes the orthodontically treated case of a 25-year-old patient with skeletal and dental class III malocclusion, anterior crossbite, which caused functional and aesthetic problems, occlusal trauma, and incisor wear. Treatment with transparent aligners was proposed to meet the patient’s needs, using the sequential distalization protocol. While sequential distalization is well documented for class II malocclusion treatment in maxillary arch teeth, further investigations are necessary for class III malocclusions. In fact, lower teeth movements are more complex due to mandibular bone density and the presence of the third molars, which are often extracted to perform distalization. In addition, the use of intermaxillary elastics helps control the proclination of the anterior teeth as a reaction to distalizing forces. At the end of the treatment, the patient reached molar and canine class I and positive overjet and overbite. The inclination of lower incisors and the interincisal angle have improved, resulting in aesthetic and functional enhancement.

To compare the efficacy of orthodontic tooth movement with three aligner wear protocols: 7 day, 10 day, and 14 day. Eighty patients were randomly allocated into three groups: group A (7-day changes), group B (10-day changes), and group C (14-day changes). The posttreatment scans were compared with the final virtual treatment simulations through digital superimposition. The differences between predicted and actual achieved treatment outcomes were computed in six angular and six linear dimensions. Differences >0.5 mm for linear measurements and >2° for angular measurements were considered clinically relevant. Within groups, and irrespective of wear protocol, all linear discrepancies in both jaws were deemed clinically insignificant (<0.5 mm) while nearly all angular discrepancies were considered clinically significant (>2.0°). When the three groups were compared, group C (14-day changes) showed significantly greater accuracy in the posterior segment for maxillary intrusion, distal-crown tip and buccal-crown torque, and mandibular intrusion and extrusion. The mean treatment duration in the 7-day aligner change group was nearly half that of the 14-day aligner change group (5 months vs 9 months). Fourteen-day changes were statistically significantly more accurate in some posterior movements. However, this difference in accuracy did not exceed the threshold for clinical significance (>0.5 mm/>2.0°). Achieving a clinically similar accuracy between the 7-day protocol and 14-day protocol in half the treatment time suggests a 7-day protocol as an acceptable treatment protocol. Clinicians may consider slowing down to a 14-day protocol if challenging posterior movements are desired. [ABSTRACT FROM AUTHOR]

Distalization is one of the most useful movements in orthodontic treatments. The aim of this systematic review is to analyze the effectiveness of lower molar distalization using clear aligner therapy (CAT). An electronic search was made from January 2012 to October 2022 using PubMed, Scopus, and LILACS databases without language limitations. This systematic review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses checklist. The search strategy resulted in 151 studies. A screening was performed to remove duplicates, and all the studies that did not respond to our questions for the title or abstract. Three studies underwent full text analysis. From the evaluation of the studies included in this review, it is possible to state that lower molar distalization is a clinical solution, but it is not a full bodily movement. CAT can provide more specifically a distal tipping movement. This is confirmed analyzing the discrepancy between expected movement and obtained movement. CAT can be considered a valid therapeutic option in patients with dental class III malocclusion, but it is obtained as a tipping movement instead of a body movement. Over-correction should be considered during the planning of the therapy. [ABSTRACT FROM AUTHOR]

Copyright of Acta Odontologica Latinoamericana: AOL is the property of Acta Odontologica Latinoamericana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To evaluate the accuracy of Invisalign technology in achieving predicted tooth positions with respect to tooth type and direction of tooth movement. Materials and Methods: The posttreatment models of 30 patients who had nonextraction Invisalign treatment were digitally superimposed on their corresponding virtual treatment plan models using best-fit surface-based registration. The differences between actual treatment outcome and predicted outcome were computed and tested for statistical significance for each tooth type in mesial-distal, facial-lingual, and occlusal-gingival directions, as well as for tip, torque, and rotation. Differences larger than 0.5 mm for linear measurements and 28 for angular measurements were considered clinically relevant. Results: Statistically significant differences (P , .05) between predicted and achieved tooth positions were found for all teeth except maxillary lateral incisors, canines, and first premolars. In general, anterior teeth were positioned more occlusally than predicted, rotation of rounded teeth was incomplete, and movement of posterior teeth in all dimensions was not fully achieved. However, except for excess posttreatment facial crown torque of maxillary second molars, these differences were not large enough to be clinically relevant. Conclusions: Although Invisalign is generally able to achieve predicted tooth positions with high accuracy in nonextraction cases, some of the actual outcomes may differ from the predicted outcomes. Knowledge of dimensions in which the final tooth position is less consistent with the predicted position enables clinicians to build necessary compensations into the virtual treatment plan. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the expression of receptor activator of nuclear factor-kappa ligand (RANKL), osteoprotegerin (OPG), osteopontin (OPN), interleukin 1β (IL-1β), and transforming growth factor ß1 (TGF-ß1) in the gingival crevicular fluid (GCF) of teeth subjected to orthodontic forces released by aligners. Materials and Methods: A total of 10 healthy, adult patients were selected to participate in this split-mouth study. The treatment plan was designed to obtain only one movement with the first aligner: distalization of a second molar. GCF samples were obtained from pressure and tension sites of the test tooth and from the mesiobuccal and distobuccal sites of the control tooth. The GCF sample volumes were measured using a Periotron 8000. Levels of TGF-β, IL-1β, RANKL, OPG, and OPN were measured by enzyme-linked immunosorbent assay. Results: IL-1β showed a significant increase at the pressure sites after 1 week and 3 weeks with respect to baseline ( P < .05) compared with control sites. The kinetics of TGF-1β and OPN were characterized by a significant increase at the tension sites of the test teeth ( P < .05) after 3 weeks from the application of orthodontic force. The RANKL level was significantly increased at pressure and tension sites after 1 hour and after 1 week from the application of the orthodontic forces ( P = .023 and P = .043, respectively). Conclusions: An increased concentration of bone modeling and remodeling mediators at the pressure sites (IL-1β, RANKL) and tension sites (TGF-1β, OPN) was observed. These scenarios are compatible with previous in vivo and in vitro studies investigating the biological effects of orthodontic tooth movement. [ABSTRACT FROM AUTHOR]

Clear aligner technology has evolved over the last 15 years, with these appliances continually being modified to increase the range of tooth movements that they can achieve. However, there is very little clinical research available to show how these appliances achieve their results. This article describes the different generations of clear aligners that are available and highlights their use. However, until more clinical research becomes available, aligners cannot be routinely prescribed as an effective alternative to fixed labial appliances. [ABSTRACT FROM AUTHOR]

This case report describes the use of a segmented appliance for space closure prior to using Invisalign. The maxillary right canine was retracted into the extracted first premolar space with a sectional wire from the first molar to the canine with no visible brackets in the incisor region. The advantage of this technique is the ability to achieve better root and rotational control during space closure with a fixed appliance that also has limited visibility. A maxillary fixed appliance was used to refine the esthetics in the maxillary arch due to the limitations of the Invisalign appliance in achieving rotational and vertical movements. [ABSTRACT FROM AUTHOR]

This systematic review aims to highlight the differences between different clear aligner therapies that differ in the presence of attachments or in attachment configuration. Eight electronic databases were searched up to March 2020. Two authors independently proceeded to study selection, data extraction, and risk of bias assessment. The analysis of the results was carried out examining six groups of movements (mesio-distal tipping/bodily movement; anterior bucco-lingual tipping/root torque; posterior bucco-lingual tipping/expansion; intrusion; extrusion; rotation). Five clinical trials were selected and all of them showed a medium risk of bias. Literature showed that attachments mostly increase the effectiveness of orthodontic treatment with clear aligners, improving anterior root torque, rotation, and mesio-distal (M-D) movement; they are also important to increase posterior anchorage. However, some articles showed contradictory or not statistically significant results. Attachments also seem to improve intrusion, but the evidence about this movement, as well as extrusion, is lacking. No studies evaluated posterior bucco-lingual tipping/expansion. Further clinical trials are strongly suggested to clarify the influence of attachments and their number, size, shape, and position on each orthodontic movement. [ABSTRACT FROM AUTHOR]

Objective: To compare the postretention dental changes between patients treated with Invisalign and those treated with conventional fixed appliances. Materials and Methods: This is a comparative cohort study using patient records of one orthodontist in New York City. Two groups of patients were identified that differed only in the method of treatment (Invisalign and Braces group). Dental casts and panoramic radiographs were collected and analyzed using the objective grading system (OGS) of the American Board of Orthodontics (ABO). The cases were evaluated immediately after appliance removal (T1) and at a postretention time (T2), three years after appliance removal. All patients had completed active orthodontic treatment and had undergone at least one year of retention. A Wilcoxon rank sum test was used to evaluate differences in treatment outcomes between the groups for each of the eight categories in the OGS, including four additional subcategories in the alignment category. A Wilcoxon signed rank test was used to determine the significance of changes within each group from T1 to T2. Results: The change in the total alignment score in the Invisalign group was significantly larger than that for the Braces group. There were significant changes in total alignment and mandibular anterior alignment in both groups. There were significant changes in maxillary anterior alignment in the Invisalign group only. Conclusions: In this sample for this period of observation, patients treated with Invisalign relapsed more than those treated with conventional fixed appliances. [ABSTRACT FROM AUTHOR]

Simple Summary: Currently, there are new trends in orthodontics that are increasingly being used in clinical practice, such as aligners. It is important to know the influence of pain perception in orthodontic patients in order to be able to apply less painful and more comfortable techniques for patients. The advancement of different fixed and removable appliances, using precision digital fabrication methods, is increasingly harnessed in the daily life of our society. Negative experiences such as periodontal pain can cause the rejection of orthodontic treatment. Therefore, the study of the location, intensity and type of pain according to the different techniques is beneficial for improving the quality and success of orthodontic treatment. The objective of this prospective clinical study was to analyze the pain (intensity, location and type) that patients presented after the placement of different types of orthodontic appliances: conventional, low friction, lingual and aligners. The sample consisted of 120 patients divided into four groups: conventional (CON), low friction (LF), lingual (LO) and aligners (INV). The participants were given the Short-Form McGill Pain Questionnaire (Ortho-SF-MPQ), where they had to record the pain intensity (no pain, mild, moderate or intense) and the periodontal location at different time points, from the first 4 h to 7 days after the start of treatment. In all the study groups, the most frequent location was both anterior arches, with maximum values between 56.7% (CON group at 24 h) and 30% (LO group at 4 h). The "whole mouth" and "complete lower arch" locations were indicated only by the patients in the lingual group. Regarding pain intensity, the patients reported a higher percentage of mild–moderate pain during the first 3 days of treatment (96.7% in LO at 4 h, 86.7% in CON, 83.3% in LF and 90% in INV at 24 h); later, the reported pain decreased to no pain/mild pain, especially in the lingual group, until reaching values close to zero at 7 days post-treatment. The most frequent type of pain was acute in the low friction and lingual groups (with maxima of 60% and 46.7% at 24 h, respectively). On the contrary, in the conventional (36.7% at 4 h) and Invisalign (40% at 24 h) groups, the sensitive type was the most frequent. There are differences regarding periodontal pain in its intensity, location and type according to the use of different orthodontic techniques. [ABSTRACT FROM AUTHOR]