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In invisible orthodontics, the role of composite attachments in facilitating complex tooth movements is crucial. This study, which evaluates the efficacy of a novel clinical attachment procedure, holds significant implications for the field. The technique used two templates (one pre-drilled and the other pre-loaded with high-viscosity composites) and was compared with the standard procedure. Fifty attachments were planned for four dental arch prototypes. Dental impressions were taken using digital scans for virtual planning and after tested techniques. The stereolithographic files (STL) obtained were aligned with those of the virtual planning, and a colorimetric map was used to evaluate the composite resin's maximum excess and defect deviation. The enamel–resin interfaces were observed by scanning electron microscopy (SEM). The Fisher test for the distribution of detachments and morphological defects and the Mann–Whitney test for the maximum values of excess and defect were used. No significant results were found between groups for morphological defects and detachments, and the maximum values of defect and excess were reported. SEM images for the experimental technique showed integrated adhesion. This innovative procedure, which has proven reliable and operationally straightforward, holds promise, instilling confidence in its practicality and potential to advance the field of orthodontics. [ABSTRACT FROM AUTHOR]

In this study, the effectiveness of an experimental clinical technique for the reproduction of attachments during an orthodontic treatment with clear aligners was evaluated using a new index (CorAl) for quality assessment that exploits the differential entropy of point clouds. The procedure involves the use of a pre-drilled template and a second pre-loaded template with a high-viscosity composite and is compared with the standard technique. Attachment planning was conducted on four prototypes of dental arches with extracted teeth which were divided into two groups according to the proposed operating procedures. Digital scans were utilized to capture dental impressions for both the purposes of virtual planning and to reproduce the clinical outcomes post-procedure. The point clouds obtained after the reproduction of the attachments were aligned with those from the virtual planning, and the deviation analysis was conducted using the quality index of the CorAl method. Though no significant discrepancies were found among the groups regarding morphological flaws, detachments, or maximum defect values, the differential entropy analysis revealed that the experimental technique offers good alignment in attachment placement. The outcome supports that the innovative procedure of the clinical reproduction of attachments proved to be reliable and operationally simple, with additional benefits derived from using the CorAl index. The advantages of CorAl include the use of a single comparison index, no problem of comparison commutativity, noise immunity, low influence from the presence of holes, and point cloud densities. This allows for the drawing of quality maps that show areas with the highest deviation. [ABSTRACT FROM AUTHOR]

Purpose: The conservative treatment of white spot lesions (WSLs) is essential to prevent enamel demineralization and cavity formation. An ultraconservative approach involves lesion infiltration with low-viscosity light-curing resins with a refractive index similar to the enamel. Resin penetration into the thickness of the lesion inhibits demineralization progression and masks the opaque white aspect of the WSLs. The objective of this clinical study was to evaluate the esthetic improvements and the stability of this conservative method over time. Materials and Methods: Eleven noncavitated, unrestored idiopathic or post-orthodontic WSLs were treated with the resin infiltration technique (Icon, DMG). Observations were made before and after treatment (T0,T1) and after 6 (T2) and 12 months (T2). The color and lightness of both the WSLs and the sound adjacent enamel (SAE) were assessed at three different points with a spectrophotometer (SpectroShade) using the CIE L*a*b*system. A photographic control was also performed. In our study, only the L*value was used, since this parameter can be related to the demineralization degree and is appropriate for evaluating the camouflage effect. The t-test was used to compare the measurements. Results: The mean L value decreased significantly from T0 (80.42 ± 4.15) to T1 (73.28 ± 2.26) in all the treated lesions (p < 0.01). After therapy, every tooth analyzed showed a similar L value in both WSLs and the SAE. The statistical analysis revealed no significant difference (p > 0.05). The WSL color modifications recorded between T1 and T2 (72.83 ± 2.34) or T2 and T3 (71.97 ± 2.56) showed no significant differences (p > 0.05). Conclusion: The results show an immediate camouflage effect on the dichromatism with a significant decrease of the L value. Similar values were recorded between treated WSLs and surrounding sound enamel. The stability of results is shown by the lack of cavities and the absence of significant lightness differences recorded at different observation times. [ABSTRACT FROM AUTHOR]

This case report describes and analyses a tooth fragment reattachment technique used to resolve crown fractures of the anterior teeth. This treatment allows a conservative approach to traumatic coronal lesions offering a better possibility of maintaining aesthetics and function. The authors have illustrated here a clinical case of a fractured incisor. This case is characterized by several traumas on the same tooth that required different therapeutic solutions. We used an easy and ultra-conservative technique without any tooth preparation in the first and third traumatic injuries. In the second trauma, a direct restoration of the fractured tooth was performed. The adhesive reattachment is a simple system to achieve good aesthetic and functional results. Our clinical experiences demonstrated that, when tooth and fragment margins are intact, the reattachment technique without any tooth preparation is a simple and predictable procedure. Quality of adhesion is shown by the retention of the reattached fragment in the second trauma that caused only partial enamel fractures. [ABSTRACT FROM AUTHOR]