Method Presentation of a New Integrated Orthodontic-Conservative Approach for Minimally Invasive Full Mouth Rehabilitation: Speed Up Therapy.

The materials available today allow for extensive oral rehabilitations in a non-invasive way, and often an orthodontic preparation is useful and, thanks to the use of clear aligners, is predictable and comfortable. A preliminary study of the wax-up, mock-up, and set-up allow the clinician to plan every aspect of the treatment in detail. Furthermore, the procedure offers the patient an intuitive and understandable view of the expected final result. The new proposed method, called "speed up therapy", allows for the integration of the orthodontic set-up with the mock-up technique, simulating the occlusal and aesthetic components of the planned restoration, in all details. The clinical case presented, demonstrates step by step the predictability and clinical reliability of the proposed procedure. The final clinical result coincides exactly with the initial mock-up and demonstrates that the proposed method is predictable and reliable. The correct execution of the technique is rigorously customized, and its success is operator dependent, both for the clinical aspects and for the dental laboratory. Thus, the visualization of the objectives of the treatment constitutes a decisive support for the clinician and provides the patient with the possibility of benefiting from an immediate improvement by making it easier for them to accept a treatment plan. The visualization also includes an orthodontic phase that potentially lengthens the treatment but makes the realization more conservative and predictable.

The efficacy of orthodontic treatments for anterior crowding with Invisalign compared with fixed appliances using the Peer Assessment Rating Index.

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.

Dentoskeletal effects of the fast-back molar distalizer followed by fixed appliances.

INTRODUCTION: The purpose of this study was to analyze the skeletal and dentoalveolar changes induced by the Fast-Back appliance followed by fixed appliances when compared with untreated Class II controls. MATERIALS AND METHODS: The treated and untreated samples consisted of 27 subjects each (16 girls and 11 boys in the Fast-Back Group, FBG; 15 girls and 12 boys in the control Group, CG) with mean ages at the start of treatment of 13 years 3 months in the FBG and 13 years 2 months in the CG. Subjects of the FBG were treated during either the pubertal or postpubertal periods. Lateral cephalograms were analyzed at 2 observation periods: before distalization (T1) and after comprehensive orthodontic treatment appliance (T2). The T1-T2 changes in the FBG were contrasted with those in the CG by means of Mann-Whitney U test (p<0.05). RESULTS: Treatment induced an average correction of molar relationship of 2.4mm. The significant correction of the overjet (2.1mm) was associated with a significant amount of lower incisor proclination (3.8 degrees). A significant extrusion of lower molars (1.8mm) was recorded in the FBG. The FBG showed also a significant increase in total mandibular length (Co-Gn, 2.6mm), a counterclockwise rotation of the palatal plane (1.4 degrees), an increase in anterior facial height (N-Me, 2.7 mm), and in mandibular ramus height (Co-Go, 2.6mm). CONCLUSIONS: The Fast-Back is an effective appliance for Class II correction during the pubertal or postpubertal periods.

Maxillary molar distalization: Pendulum and Fast-Back, comparison between two approaches for Class II malocclusion.

OBJECTIVES: To compare the dento-alveolar and skeletal effects produced by two different molar intraoral distalization appliances, Pendulum and Fast-Back, both followed by fixed appliances, in the treatment of Class II malocclusion. MATERIALS AND METHODS: 41 patients for Pendulum (18 males and 23 females) and 35 for Fast-Back (14 males and 21 females) were selected, with a mean age at the start of treatment of 12.11 years in the Pendulum group and 13.3 for in the Fast-Back group. The durations of the distalization phase were 8 months in the Pendulum group and 9 months in the Fast-Back group, and the durations of the second phase of treatment with fixed appliances were 19 months in the Pendulum group and 20 months in the Fast-Back group. Lateral cephalograms were analyzed at 3 observation times: before treatment, after distalization and after comprehensive orthodontic treatment. RESULTS: During molar distalization the Pendulum subjects showed greater distal molar movement and less anchorage loss at both the premolars and maxillary incisors than the Fast-Back subjects. Pendulum and Fast-Back produced similar amounts of distal molar movement and overcorrection of molar relationship at the end of distalization though the Fast-Back induced a more bodily movement. Very little change occurred in the inclination of the mandibular plane at the end of the 2-phase treatment in both groups. At the end of treatment the maxillary first molars were on average 1mm more distal in the Pendulum group compared to the Fast-Back group, while the total molar correction was 3.2mm with 3.9° of distal inclination for the Pendulum and 2mm with 1.1° of mesial inclination for the Fast-Back. Both appliance were equally effective in inducing a satisfactory Class I relationship in 97.2% of the cases. CONCLUSION: The Pendulum and the Fast-Back induce similar dentoskeletal effects. The use of the two distalization devices, therefore, can be considered clinically equivalent.