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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.

Introdução: A sobremordida aumentada é muito comum na população em geral e a sua correção é essencial para a manutenção da articulação temporomandibular e da saúde oral. Estudos sugerem que o aparelho Invisalign® oferece maior conforto, facilidade de limpeza, tendo melhor estética que aparelhos convencionais. Porém a sua eficácia na correção de mordida profunda é controversa. Objetivos: Analisar a eficácia do sistema Invisalign® na correção de sobremordida profunda em pacientes adultos. Material e métodos: Realizou-se pesquisas bibliográficas nas bases de dados PubMed e ScienceDirect. Um total de 12 artigos foram selecionados, sendo estes estudos clínicos prospetivos e retrospetivos, redigidos em língua inglesa, publicados entre 2012 e 2022, tratamentos realizados em pacientes adultos. Resultados: A mordida profunda pode ser tratada com inclinação e/ou intrusão real de dentes anteriores, extrusão dos dentes posteriores ou combinação entre todas, nivelando a curva de Spee quando se apresenta acentuada. É importante considerar no planeamento, os fatores etiológicos e estéticos do paciente. Foram avaliados os resultados associados à previsibilidade e eficácia nos movimentos de intrusão de dentes anteriores, inclinação bucolingual, extrusão de dentes posteriores, ou correção de sobremordida aumentada e controlo da dimensão vertical com sistema Invisalign. Conclusões: Verificou-se que o sistema Invisalign é um tratamento relativamente eficaz para correção da maioria dos casos de mordida profunda leve e moderada em pacientes adultos. A eficácia no tratamento de casos severos depende da etiologia da mal oclusão e de um planeamento adequado ao caso. Serão necessários mais estudos para demonstrar efetivamente a eficácia deste sistema de alinhadores no tratamento de pacientes adultos com mordida profunda.

The movement of teeth by orthodontic treatment with the Invisalign (IN) system and fixed orthodontic appliances (FOA) is characterized by the reconstruction of periodontal ligaments, alveolar bone, and gingiva. A reflection of these phenomena can be found in the composition of gingival crevicular fluid (GCF). A total of 90 samples from 45 participants (45 whole saliva and 45 GCF), including 15 patients with FOA, 15 patients with IN, and 15 patients with oral health, were subjected to matrix-assisted laser desorption/ionization mass spectrometry (MALDI-TOF/MS) analysis. Mass fingerprints were generated for each sample. Three models were tested: a quick classifier (QC), a genetic algorithm (GA), and a supervised neural network (SNN). For both groups of samples (saliva and GCF), the GA model showed the highest recognition abilities of 88.89% (saliva) and 95.56% (GCF). Differences between the treated (FOA and IN) groups and the control group in saliva and GCF samples were determined using cluster analysis. In addition, we monitored the effect of long-term orthodontic treatment (after 6 months) in the lag phase of orthodontic tooth movement. The results show increased levels of inflammatory markers (α-defensins), which may indicate an ongoing inflammatory process even after 21 days from force application.

Backgrond: Until now, there have been many studies on the postoperative stability of orthognathic patients treated with traditional fixed orthodontic appliances. Recently, the use of clear aligners as orthodontic appliances has increased in orthodontic treatment for aesthetic and patient convenience. The aim of this preliminary study was to investigate the stability and characteristics of patients undergoing orthognathic surgery using clear aligners. Patients and Methods: This study was performed on patients who underwent orthognathic surgery by one surgeon at Pusan National University Dental Hospital from April 2017 to August 2021. A comparative study was conducted on five patients treated with clear aligners during orthodontic treatment and ten patients treated with traditional fixed appliances as a control group. Postoperative skeletal changes and recurrence were evaluated by cone beam computed tomography and lateral cephalometric radiographs taken two days postoperatively and six months postoperatively. Several measurement variables were used to confirm the presence or absence of recurrence, preoperative and postoperative orthodontic treatment period, and the number of extracted teeth. Results: Postoperative stability for six months after surgery was not significantly different between the clear aligner group and the traditional fixed appliance group. The preoperative orthodontic treatment period was also shorter in the clear aligner group, and the number of extracted premolar teeth and impacted teeth were also fewer in the clear aligner group, but there was no significant difference. Conclusions: Orthodontic treatment using clear aligners continues to develop, and it is believed that there is no limit to what can be accomplished during orthodontic surgery accompanied by clear aligners.

Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz Desde a introdução do posicionador dentário em 1944, aparelhos removíveis análogos aos alinhadores transparentes têm sido empregues para realizar movimentos ortodônticos leves a moderados. A terapia com alinhadores faz parte da prática ortodôntica há décadas, mas principalmente desde a introdução do sistema Invisalign em 1998, tornou-se numa opção cada vez mais comum ao arsenal ortodôntico. Esta revisão bibliográfica tem como objetivo avaliar e descrever os princípios biomecânicos que estão subjacentes aos alinhadores transparentes Assim, o presente trabalho destacará a crescente popularidade dos aparelhos transparentes de alinhamento, examinará em detalhe os princípios da biomecânica deste tipo de aparelhos, bem como as indicações clínicas e as limitações da terapia com alinhadores em geral. Os alinhadores transparentes podem fornecer um melhor controlo do movimento dentário em comparação com os aparelhos ortodônticos removíveis tradicionais. Além disso, quando o planeamento do tratamento é bem elaborado, o movimento dentário difícil, incluindo o movimento em corpo, pode ser alcançado. No entanto, até o momento, o nível de qualidade dos estudos publicados não é suficiente para tirar quaisquer conclusões sobre a previsibilidade de tratamentos realizados com alinhadores transparentes. Since the introduction of the dental positioner in 1944, removable appliances analogous to clear aligners have been employed to perform mild to moderate orthodontic movements. Aligner therapy has been part of orthodontic practice for decades, but especially since the introduction of the Invisalign system in 1998, it has become an increasingly common option to the orthodontic arsenal. This literature review aims to evaluate and describe the biomechanical principles that underlie transparent aligners. Thus, this paper will highlight the growing popularity of clear aligners, examine in detail the principles of biomechanics of these types of appliances, as well as the clinical indications and limitations of aligner therapy in general. Transparent aligners can provide better control of dentary movement compared to traditional removable orthodontic appliances. Furthermore, when treatment planning is well designed, difficult tooth movement, including in-body movement, can be achieved. However, to date, the quality level of published studies is not sufficient to draw any conclusions about the predictability of treatments performed with clear aligners.

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OBJETIVO: Analizar a lo largo de esta revisión sistemática la eficacia y predictibilidad de los movimientos dentales en la expansión transversal de la arcada, beneficios de los alineadores como terapia ortodóncica y la disponibilidad o ausencia de evidencia sobre la estabilidad de la arcada una vez finalizado el tratamiento. MATERIAL Y MÉTODO: Se realiza una búsqueda electrónica en las bases de datos PubMed, Cochrane, Medline, Web of Sciencey Scopus. La evaluación de la calidad de los estudios observacionales se realizó utilizando la herramienta ROBINS-I. La clasificación OCEM se utilizó para evaluar el nivel de evidencia de cada resultado identificado. RESULTADOS: Diez artículos (dos ensayos clínicos prospectivos y ocho retrospectivos) fueron incluidos en nuestra revisión sistemática. Nuestros estudios tuvieron un riesgo de sesgo moderado. CONCLUSIONES: Los alineadores demostraron ser una alternativa positiva para el movimiento de expansión, que ofrece un alto grado de predictibilidad y que favorece a la higiene oral del paciente. Es fundamental realizar pruebas CBCT y se hace evidente la necesidad de realizar un protocolo consensuado sobre las referencias anatómicas para que las mediciones sean objetivas y homogéneas en los futuros estudios. Se necesitan estudios a largo plazo sobre la expansión transversal con alineadores para valorar el éxito y la estabilidad de este tipo de tratamiento. OBJETIVE: To analyze throughout this systematic review the efficacy and predictability of dental movements in the transverse expansion of the arch, the aligners’ benefitsas orthodontic therapyand the availability or absence of evidence on the stability of the arch after treatment. MATERIAL AND METHODS: An electronic researchwas made using PubMed, Cochrane, Medline, Web of Scienceand Scopus databases. Quality assessment of observational studies was done by using the ROBINS-Itool and. The OCEM classification was used to assessevidence level for each identified outcome. RESULTS: Ten articles (two prospective and eight retrospective clinical trials) were included in our systematic review. Ourstudies had a moderate risk of bias.CONCLUSIONS: The aligners proved to be a positive alternative to the expansion movement, offering a high degree of predictability and enhancing the oral hygiene of the patient. It is essential to carry out CBCT tests and it is evident the need to developan agreed protocol on anatomical references so that the measurements would beobjective and homogeneous in future studies.Long-term studies about transverse expansion with aligners are needed to assess the success andstability of this type of treatment. Máster en odontología infantil

Background: The COVID-19 pandemic outbreak may have a large impact on orthodontic treatment. Regular orthodontic visits were strongly and widely interrupted by the unprecedented epidemiological threat. Methods: The data regarding orthodontic queries were investigated in a real-time surveillance using Google Trends. Search terms “braces”, “invisalign”, “get braces”, “get braces off”, “braces pain” and the phrase “social distancing” were analyzed regarding the year preceding the pandemic outbreak and the time of the pandemic. Moreover, the five-year trend for queries “braces” vs. “invisalign”, as an example of different types of orthodontic appliances, was compared. Results: There was a significant decrease in orthodontics phrase queries in the spring of 2020, connected with the worldwide restrictions and lockdowns announced all over the world. There was a lower interest in the “braces pain” query during the first lockdown in 2020. The number of searches for “invisalign” increased steadily over time, while the number of searches for “braces” was relatively stable across the investigated time period. Conclusions: The course of the COVID-19 pandemic has had a large impact on the orthodontic-related search queries. Orthodontists must be better-prepared for any sudden changes in the possible future in the epidemiological situation that may change accessibility to dental offices.

Invisalign has improved periodontal health in comparison to traditional metal wire braces. Due to a growing interest in attaining better teeth esthetics, there are more adults seeking Invisalign treatment. Ten percent carbamide peroxide (CP) breaks down to 6.5% urea and 3.5% hydrogen peroxide, which elevates oral pH, removes stains, and diminishes caries by inhibiting plaque formation. The aim of this study is to investigate whether 10% CP use during Invisalign treatment can enhance tooth shade esthetics while decreasing plaque levels and improving gingival health indices. Twenty-eight patients at Western University dental center undergoing Invisalign were assigned to two groups where the experimental group applied daily bleaching material (10% CP, Ultradent Inc., South Jordan, UT, USA), while the control group did not for 4 weeks. Tooth shade, plaque index (PI), and gingival index (GI) were assessed at baseline and in 2-week intervals for 6 weeks. Results showed that 10% CP had significant change in tooth shade over the 2- and 4-weeks periods (p &lt, 0.05) and significantly reduced plaque and gingival indices (p &lt, 0.05), with minimal to no relapse after 2 weeks post-op. Thus, applying CP at 10% may be a useful application during Invisalign treatment in improving teeth shade and overall gingival health.

Background The aim of the study was to compare the amount of interproximal enamel reduction (IPR) provided on ClinCheck software with the amount of IPR carried out by the orthodontist during treatment with clear aligners. Methods 30 subjects (14 males, 16 females; mean age of 24.53 ± 13.41 years) randomly recruited from the Invisalign account of the Department of Orthodontics at the University of Rome “Tor Vergata” from November 2018 to October 2019, were collected according to the following inclusion criteria: mild to moderate dento-alveolar discrepancy (1.5–6.5 mm); Class I canine and molar relationship; full permanent dentition (excluding third molars); both arches treated only using Comprehensive Package by Invisalign system; treatment plan including IPR. Pre- (T0) and post-treatment (T1) digital models (.stl files), created from an iTero scan, were collected from all selected patients. The OrthoCAD digital software was used to measure tooth mesiodistal width in upper and lower arches before (T0) and at the end of treatment (T1) before any refinement. The widest mesio-distal diameter was measured for each tooth excluding molars by “Diagnostic” OrthoCAD tool. The total amount of IPR performed during treatment was obtained comparing the sum of mesio-distal widths of all measured teeth at T0 and T1. Significant T1–T0 differences were tested with dependent sample t-test (P Results In the upper arch, IPR was digitally planned on average for 0.62 mm while in the lower arch was on average for 1.92 mm. As for the amount of enamel actually removed after IPR performing, it was on average 0.62 mm in the maxillary arch. In the mandibular arch, the mean of IPR carried out was 1.93 mm. The difference between planned IPR and performed IPR is described: this difference was on average 0.00 mm in the upper arch and 0.01 in the lower arch. Conclusions The amount of enamel removed in vivo corresponded with the amount of IPR planned by the Orthodontist using ClinCheck software.

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.

Introdução: A fotobiomodulação e vibração são duas técnicas de aceleração do movimento dentário ortodôntico, não invasivas, que têm demonstrado na literatura, benefícios na analgesia, o que pode permitir algum conforto ao paciente durante o período de tratamento ortodôntico com alinhadores. Objetivo: Avaliar de que forma a fotobiomodulação e vibração atuam na prevenção e redução da dor em pacientes com alinhadores ortodônticos. Material e Métodos: Segundo a estratégica PICOS e como orientação o PRISMA, uma pesquisa bibliográfica foi realizado na base de dados: PubMed, ScienceDirect e Reasearchgate, utilizando combinações das palavras-chave e Mesh Terms, abrangendo artigos entre 2011 e 2021, de idioma Inglês, Portugues e Francês. Resultados: Foi demonstrada a eficácia da fotobiomodulação e vibração na redução e prevenção da dor, melhorando a adaptação ortodôntica sem comprometimento da estética. Os níveis de desconforto e pressão exercida pelos alinhadores nos primeros três dias de tratamento foram considerados reduzidos, sem efeitos adversos. Conclusão: A associação da fotobiomodulação e vibração com alinhadores ortodônticos pode ajudar a melhorar a motivação e satisfação do paciente. O facto de reduzir o tempo de tratamento aliado ao uso de alinhadores, terá um efeito positivo no bem-estar diário do paciente e por isso também na sua percepção de dor. Mais estudos devem ser realizados, uma vez que o mecanismo de ação da PBM e da vibração no alívio da dor ainda não é totalmente compreendido. Introduction : Photobiomodulation and vibration are two non-invasive techniques for accelerating orthodontic tooth movement that have shown benefits in the literature for analgesia, which may allow some comfort to the patient during the period of orthodontic treatment with aligners. Objective : Evaluate how photobiomodulation and vibration act to prevent and reduce pain in patients with orthodontic aligners. Material e Methods : According to the PICOS strategy and PRISMA as a guideline, a bibliographic search was carried out in the following databases: PubMed, ScienceDirect and Reasearchgate, using combinations of keywords and Mesh Terms, covering articles between 2011 and 2021, in English, Portuguese and French. Results : The effectiveness of Photobiomodulation and vibration have been demonstrated in reducing and preventing pain by improving orthodontic adaptation without compromising aesthetics. The levels of discomfort and pressure exerted by the aligners in the first three days of treatment were considered reduced, with no adverse effects. Conclusion : The association of photobiomodulation and vibration with orthodontic aligners can help improving patient’s motivation and satisfaction. The fact of reducing the treatment time combined with the use of aligners, will have a positive effect on the patient's daily well-being and therefore also on his perception of pain.Further studies should be carried out, since the mechanism of action of PBM in pain relief is not yet fully understood.

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.

Aim: to evaluate the internet searches for Invisalign® in Brazil and worldwide between 2018 and 2021, using the Google Trends tool. Methods: An infodemiological study was carried out. The relative search volume (RSV) for the term “invisalign” in Google platform was retrieved for each year of study, both in Brazil and worldwide, using a standard procedure. Results and Conclusion: Both in Brazil and worldwide, there was a statistically significant increase in RSV between 2018 and 2021 (all p

Invisalign aligners have been widely used to correct malocclusions, but their effect on oral cells is poorly known. Previous research evaluated the impact of aligners&rsquo, eluates on various cells, but the cell behavior in direct contact with aligners is not yet studied. In the present study, we seeded oral epithelial cells (cell line Ca9-22) directly on Invisalign SmartTrack material. This material is composed of polyurethane and co-polyester and exhibit better mechanical characteristics compared to the predecessor. Cell morphology and behavior were investigated by scanning electron microscopy and an optical cell moves analyzer. The effect of aligners on cell proliferation/viability was assessed by cell-counting kit (CCK)-8 and 3,4,5-dimethylthiazol-2-yl-2,5-diphenyl tetrazolium bromide (MTT) assay and live/dead staining. The expression of inflammatory markers and proteins involved in epithelial barrier function was measured by qPCR. Cells formed cluster-like structures on aligners. The proliferation/viability of cells growing on aligners was significantly lower (p &lt, 0.05) compared to those growing on tissue culture plastic (TCP). Live/dead staining revealed a rare occurrence of dead cells on aligners. The gene expression level of all inflammatory markers in cells grown on aligners&rsquo, surfaces was significantly increased (p &lt, 0.05) compared to cells grown on TCP after two days. Gene expression levels of the proteins involved in barrier function significantly increased (p &lt, 0.05) on aligners&rsquo, surfaces after two and seven days of culture. Aligners&rsquo, material exhibits no cytotoxic effect on oral epithelial cells, but alters their behavior and the expression of proteins involved in the inflammatory response, and barrier function. The clinical relevance of these effects has still to be established.

Introduction: Due to the search for more aesthetic and comfortable alternatives to perform orthodontic treatments and to the great technological development, orthodontic aligners have assumed great importance. More and more complex treatments have been carried out with these appliances without, however, having all aspects involved in their use being studied in depth. Its biomechanical planning requires different approaches than those used in fixed orthodontics, as the force systems involved in movements, responses and side effects are distinct, and the professional must be prepared when opting for the technique. Objective: The objective of this article is to perform an evaluation of the force systems created on the space closure with aligners, its characteristics, and problems, as well as make some suggestions to overcome the difficulties inherent to its use. Conclusion: Space closure with aligners is possible, but depends on the correct selection of the patient, in addition to requiring the proper planning of the applied forces. The use of auxiliary resources and overcorrections to address the deficiencies of the aligner systems should always be considered. Digital planning should be used as a map of the force systems that will be applied, and not just as a marketing tool, keeping in mind that determining the objectives and the way to achieve them is the responsibility of the orthodontist, and that treatment plans must be individualized for each situation, following appropriate biomechanical precepts. RESUMO Introdução: Devido à busca por alternativas mais estéticas e confortáveis para realizar tratamentos ortodônticos e ao grande desenvolvimento tecnológico, os alinhadores ortodônticos assumiram uma grande importância. Tratamentos cada vez mais complexos vêm sendo realizados com esses dispositivos sem que, no entanto, sejam estudados em profundidade todos os aspectos envolvidos na sua utilização. Seu planejamento biomecânico requer abordagens diferentes da Ortodontia fixa, pois os sistemas de forças envolvidos nas movimentações, respostas e efeitos colaterais são distintos, e o profissional deve estar preparado ao optar por essa técnica. Objetivo: O objetivo deste artigo é fazer uma avaliação dos sistemas de forças envolvidos no fechamento de espaços com alinhadores, suas características e problemas, bem como apresentar algumas sugestões para contornar as dificuldades decorrentes de seu uso. Conclusão: O fechamento de espaços com alinhadores é possível, mas depende da correta seleção do paciente, além de exigir o adequado planejamento das forças aplicadas. O uso de recursos auxiliares e sobrecorreções para suprir as deficiências dos sistemas de alinhadores deve ser sempre considerado. O planejamento digital deve ser usado como um mapa dos sistemas de forças que serão aplicados, e não apenas como ferramenta de marketing, tendo em mente que a determinação dos objetivos e da maneira de atingi-los é de responsabilidade do ortodontista e que os planejamentos devem ser individualizados para cada situação, seguindo preceitos biomecânicos adequados.

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Objectives To assess if there is any difference in pain levels between orthodontic treatment with clear aligners or fixed appliances. Materials and methods An electronic search was completed in PubMed, The Cochrane Database, Web of Science, Scopus, Lilacs, Google Scholar, Clinical Trials, and OpenGrey databases without any restrictions until February 2019. All comparative study types contrasting pain levels between clear aligners and fixed appliances were included. The risk of bias (RoB) was assessed using the Newcastle-Ottawa Scale, ROBINS-I-Tool, or ROB 2.0 according to the study design. The level of evidence was assessed through the GRADE tool. Results After removal of duplicates, exclusion by title and abstract, and reading the full text, only seven articles were included. Five were prospective non-randomized clinical trials (CCT), one was a cross-sectional study, and one was a randomized clinical trial (RCT). Two studies presented a high RoB, three a moderate RoB, and two a low RoB (including the RCT). A meta-analysis was not performed because of clinical, statistical, and methodological heterogeneity. Most of the studies found that pain levels in patients treated with Invisalign were lower than those treated with conventional fixed appliances during the first days of treatment. Differences disappeared thereafter. No evidence was identified for other brands of clear aligners. Conclusions Based on a moderate level of certainty, orthodontic patients treated with Invisalign appear to feel lower levels of pain than those treated with fixed appliances during the first few days of treatment. Thereafter (up to 3 months), differences were not noted. Malocclusion complexity level among included studies was mild. Pain is one of many considerations and predictability and technical outcome are more important, mainly considering that the difference does not seem to occur after the first months of the orthodontic treatment.

Uma atuação ortodôntica preventiva pode trazer múltiplos benefícios para o paciente em crescimento. O presente estudo visa avaliar a previsibilidade e efetividade dos movimentos dentários com Invisalign® First, referente à fase precoce de dentição mista. Selecionaram-se 18 crianças, tratadas ortodonticamente de forma sequencial com Invisalign® First pela Professora Doutora Teresa Pinho na sua clínica privada. Avaliaram-se as fotografias intraorais e os modelos digitais Clincheck® em todas as fases de tratamento, registados com o scanner intraoral iTero®. Os movimentos estudados foram: desrotação molar; expansão da arcada dentária; recuperação de espaço; discrepância da linha média; correção sagital da relação molar; mordida cruzada posterior; mordida aberta e apinhamento. Registou-se o grau de dificuldade associado à sua resolução. Complementou-se o estudo com a aplicação de questionários às crianças e aos seus encarregados de educação. Os casos com recuperação de espaço, mordida aberta e apinhamento foram todos corrigidos. A correção da Classe molar é a que apresenta mais casos por corrigir. Um maior número de refinamentos foi realizado em casos de complexidade superior. O Invisalign® First parece ser efetivo e previsível na obtenção de resultados clínicos comparáveis com os modelos digitais ClinCheck®, contudo mais estudos são necessários. Um grau de dificuldade elevado permite a resolução da patologia, porém influencia a necessidade de refinamentos e logo a duração do tratamento. Destaca-se a necessidade futura de inclusão de mais casos, para suportar os resultados obtidos.

Background Fixed appliances have been the mainstream for orthodontic treatment, while clear aligners, such as Invisalign system, have become increasingly popular. The prevalence of apical root resorption (ARR) in patients with clear aligners is still controversial. The aim of this study was to investigate and compare the prevalence and severity of ARR in patients treated with clear aligners and fixed appliances using cone beam computed tomography (CBCT). Materials and methods A total of 373 roots from 70 subjects, with similar baseline characteristics and the ABO discrepancy index scores (i.e., treatment difficulty), were included into two groups: the clear aligners group (Invisalign, Align Technology, California, USA) and fixed appliances group (Victory Series; 3 M Unitek, California, USA). Root length of each anterior tooth was measured on the CBCT images by two blinded investigators. The ARR on each tooth was calculated as the difference of root length before and after orthodontic treatment. Chi-square test and paired t test was used to compare the ARR between the two groups as well as before and after orthodontic treatments. Results Prevalence of ARR in the clear aligners group (56.30%) was significantly lower than that in the fixed appliances group (82.11%) (P P P Conclusions The prevalence and severity of ARR measured on CBCT in patients with clear aligners were less than those in patients with fixed appliances.

The purpose of this study was to evaluate the arch form changes in class II Caucasian patients treated with Invisalign® (Align Technology, San Jose, CA, USA). A total of 27 class II patients, for whom a maximum of 4 mm arch expansion was planned, were selected. Both maxillary and mandibular digital casts were compared at three different times: pretreatment (T0), accepted set-up (T1), and retention phase (T2). Each digital model was imported into GOM Inspect© software (GOM GmbH, Braunschweig, Germany) to identify teeth crown facial axis (FA) and cusp points to create a coordinate system. In each model the origin of the coordinates was located at the contact point of central incisors and a system of Cartesian axes was constructed. Using the FA points, an average arch form was obtained for each clinical step and then the following comparisons were performed for each class group: T0–T1, T0–T2, and T1–T2. T1 showed wider maxillary and mandibular dental arches compared to T0 with maximum movements observed in the premolar regions (maximum movement 1.94 mm for tooth 15; P

Introduction: The search for more aesthetic and comfortable orthodontic devices has led to an increase in the use of clear aligners. Objective: To increase knowledge on biological mechanisms of orthodontic tooth movement using Invisalign aligners. Methods: This study included 11 patients with a mean age of 23.6 ± 4.8 years. Cases planning included alignment and leveling of lower incisors using Invisalign aligners. Gingival crevicular fluid samples were collected from the lower incisors on the day of delivery of aligner number 1 (T0) and after 1 (T24h), 7 (T7d), and 21 (T21d) days. During the observation period of the study, the patients used only the aligner number 1. Levels of nine cytokines were quantified using Luminex’s multi-analysis technology. Non-parametric tests were used for comparisons between cytokine expression levels over time. Results: Cytokine expression levels remained constant after 21 days of orthodontic activation, except those of MIP-1β, which presented a statistical difference between T24h and T21d with a decrease in the concentration levels. IL-8, GM-CSF, IL-1β, MIP-1β, and TNF-α showed the highest concentrations over time. Conclusions: The different behavior in the levels of the investigated cytokines indicates a role of these biomarkers in the tissue remodeling induced by Invisalign.