RESUMEN
OBJECTIVES: Aligners are an effective and esthetic orthodontic treatment option for permanent and mixed dentition. There are only a few studies dealing with the effectiveness of orovestibular tooth movement using aligners and applying adequate examination methods. In the present retrospective study, the aligner efficiency of orovestibular movements for the entire dentition was systematically evaluated using 3D superimposition, taking into account the influence of jaw, tooth type and Invisalign® system. METHODS: Group 1 (n = 18 adults, Invisalign®) and Group 2 (n = 17 adolescents, Invisalign® Teen) were treated with Invisalign® Ex30 aligner material and Invisalign® specific auxiliary means. In this non-interventional retrospective study, pre- and post-treatment maxillary and mandibular plaster cast models were scanned and superimposed with ClinChecks® via Surface-Surface Matching Algorithm on unmoved teeth providing stable references. Effectivity of planned versus clinically realized movements was evaluated for each tooth. Statistics were performed with a t-test and Bonferroni-Holm correction (α = 0.05). RESULTS: Orovestibular movement efficiency was excellent without statistical significance regarding jaw, tooth type or Invisalign® system. Mandibular translational tooth movements were highly effective, and outstanding for premolars (91-98%). Maxillary translational tooth movements were successful for incisors and premolars, but less effective for canines and molars. Almost all teeth were moderately or very effectively corrected by crown tipping, performing better for mandibular (70-92%) than maxillary (22-31%) canines as much as for adolescent upper front teeth (81-85%) and lower canines (92%). CONCLUSIONS: Aligners are able to effectively implement translational orovestibular movements, supported by tilting the crowns for even more efficient implementation of the movements. This phenomenon was observed in our studies for all teeth in both jaws, regardless of the Invisalign® system used. Treatment planning should nevertheless take into account the individual patient parameters with regard to the movements to be performed in order to make the aligner therapy as successful as possible in terms of realizing the desired therapeutic goal.
RESUMEN
OBJECTIVES: To compare cone beam computed tomography (CBCT) and magnetic resonance tomography (MRT) in patients with temporomandibular joint (TMJ) arthralgia in respect of the evaluation of bony structures, and to correlate joint space distances measured in CBCT with the morphology and the position of the disc visualized in MRT. MATERIALS & METHODS: 26 temporomandibular joints (TMJs) in 13 patients clinically diagnosed with TMJ arthralgia were examined by both CBCT and MRT. All images were evaluated by use of a form. The results were compared in regard of conformability of the diagnoses of osseous structures established by each imaging method. Anterior, superior and posterior joint space distances measured in CBCT-images were related to disc morphology and position visualized in MRT. RESULTS: Conformability of CBCT and MRT in the evaluation of bony TMJ structures ranged from 69.3 to 96.6 %. Osseous alterations such as erosions, osteophytes and cysts detected by CBCT could partly not be discerned by MRT. The correlation of joint space distances with disc morphology (biconcave or not biconcave) was not statistically significant. The correlation of joint space distances and disc position was statistically significant only for the superior joint distance. CONCLUSION: CBCT outclasses MRT in the visualization of osseous alterations, which are diacritic in the differentiation of simple arthralgia from osteoarthritis. Therefore, CBCT imaging is appropriate in patients clinically diagnosed with TMJ arthralgia.Superior joint space distance not being the highest joint space in sagittal CBCT indicates an anterior disc displacement.For the visualization of structural changes or displacement of the disc frequently associated with osseous changes, MRT is the optimal tool. Thus, the combination of the two imaging methods allows a comprehensive diagnosis in TMJ arthralgia patients.
Asunto(s)
Terapia por Luz de Baja Intensidad/métodos , Maloclusión Clase I de Angle/terapia , Técnicas de Movimiento Dental/métodos , Adulto , Femenino , Humanos , Terapia por Luz de Baja Intensidad/instrumentación , Maloclusión Clase I de Angle/radioterapia , Mordida Abierta/radioterapia , Mordida Abierta/terapia , Planificación de Atención al Paciente , Factores de Tiempo , Técnicas de Movimiento Dental/instrumentaciónAsunto(s)
Diseño de Aparato Ortodóncico , Extracción Dental/métodos , Técnicas de Movimiento Dental/instrumentación , Adulto , Diente Premolar/patología , Cefalometría/métodos , Diente Canino/patología , Estética Dental , Femenino , Humanos , Incisivo/patología , Maloclusión Clase II de Angle/terapia , Métodos de Anclaje en Ortodoncia/instrumentación , Planificación de Atención al Paciente , Técnicas de Movimiento Dental/métodos , Resultado del TratamientoAsunto(s)
Mordida Abierta/terapia , Diseño de Aparato Ortodóncico , Ortodoncia Correctiva/instrumentación , Adolescente , Adulto , Femenino , Estudios de Seguimiento , Humanos , Aparatos Ortodóncicos Removibles , Extrusión Ortodóncica/instrumentación , Retenedores Ortodóncicos , Cierre del Espacio Ortodóncico/instrumentación , Técnicas de Movimiento Dental/instrumentaciónRESUMEN
The temporomandibular joint is one of the most complex joint systems in the human body. Craniomandibular disorders (CMD) are a common condition in which symptoms and signs may vary within a single individual and from one person to another. As anatomic and functional aspects of the craniomandibular system (CMS) and the upper cervical spine are closely interconnected, CMD need a close interdisciplinary approach combining orthopedics, manual medicine, orthodontics and dentistry. Splints as a therapeutic treatment instrument in CMD patients are widely accepted. The association of splint therapy and the Invisalign(®) system not only provides comfortable and almost invisible treatment but also constitutes a powerful instrument for the orthodontic treatment of the CMD patient. To this end, precise knowledge of the temporomandibular joint, temporomandibular disorders and treatment using removable and fixed splints is indispensable.