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1.
Orthod Fr ; 92(1): 95-113, 2021 Mar 01.
Artículo en Francés | MEDLINE | ID: mdl-33871372

RESUMEN

Digital dental technologies for design, simulation and fabrication are constantly evolving. It is possible to digitally simulate dental movements, as well as displacements of both arches and to produce thermoformed splints manufactured from this simulation. The authors present the coupling of intraoral 3D scanning with low-dose radiation 3D radiography that allows for a very precise surgical setup, preparation of repositioning aligners, and fabrication of osteosynthesis plates. The orthodontic-surgical management protocol with aligners used by the first author will be described in detail. The authors present, through clinical cases, the progress made in orthognathic surgery thanks to 3D and the Invisalign® thermoformed tray system. Looking at the three clinical cases presented, it can be seen that the average treatment time was much less than the average time for usual orthodontic-surgical protocols.


Asunto(s)
Aparatos Ortodóncicos Removibles , Cirugía Ortognática , Procedimientos Quirúrgicos Ortognáticos , Humanos
2.
Artículo en Inglés | MEDLINE | ID: mdl-33799682

RESUMEN

In recent years, clear aligners have diversified and evolved in their primary characteristics (material, gingival margin design, attachments, divots, auxiliaries), increasing their indications and efficiency. We overviewed the brands of aligners used in Italy and reviewed the literature on the evolution of clear aligners based on their characteristics mentioned above by consulting the main scientific databases (PubMed, Scopus, Lilacs, Google Scholar, Cochrane Library). Inclusion and exclusion criteria were established. The data were collected on a purpose-made data collection form and analyzed descriptively. From the initial 580 records, 527 were excluded because they were not related to the subject of the review or because they did not meet the eligibility criteria. The remaining 31 studies were deemed comprehensive for the purpose of the review, although the "gingival margin design" feature and "auxiliaries" tool are not well represented in the more recent literature. Current knowledge on invisible aligners allows us to have a much clearer idea of the basic characteristics of aligner systems. There remains a need to deepen the use of systems other than Invisalign™ to give greater evidence to aligners that are very different based on the characteristics analyzed here and that are very widespread on the market.


Asunto(s)
Aparatos Ortodóncicos Removibles , Derivación y Consulta , Bases de Datos Factuales , Equipo Médico Durable , Italia
3.
Br Dent J ; 230(7): 397, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33837333
4.
J Clin Orthod ; 55(1): 9, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33822757
9.
BMC Oral Health ; 21(1): 199, 2021 04 19.
Artículo en Inglés | MEDLINE | ID: mdl-33874922

RESUMEN

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 < 0.05). 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.


Asunto(s)
Aparatos Ortodóncicos Removibles , Adolescente , Adulto , Niño , Arco Dental , Esmalte Dental , Dentición Permanente , Femenino , Humanos , Masculino , Maxilar , Diente Molar , Adulto Joven
10.
Eur J Paediatr Dent ; 22(1): 26-30, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33719479

RESUMEN

AIM: The current study aimed to analyse the dentoskeletal effects of the Invisalign mandibular advancement (MA) device in the treatment of skeletal Class II malocclusions. MATERIALS AND METHODS: Pre-treatment and post-treatment lateral skull radiographs from patients treated with MA versus TB (Twin-Block Appliance) at the Department of Orthodontics of the University of L'Aquila, Italy, were traced. Eligibility criteria included SNB<78; ANB>4; no previous orthodontic treatments; and vertebral maturation stage (CVM) CS3. Radiographs from patients with craniofacial anomalies, or who underwent extraction treatments, were excluded. Totally, 20 patients were examined, 10 of whom treated with MA and 10 treated with TB. All the radiographs were traced by one expert operator, blind to the groups. A preliminary method error study was performed to exclude intra-operator differences. RESULTS: Baseline characteristics of the participants were similar between the groups. Both appliances demonstrated a reduction of SNB and ANB angle, and a decrease in overjet. TB demonstrated a higher efficacy in increasing mandibular dimensions. A significant retroinclination of the upper incisive was observed in the TB group, where a decrease of SNA angles was additionally observed. The resulting differences between the two groups could be attributed to the different design of the appliances. CONCLUSIONS: The present data show the effectiveness of both TB and MA in the management of skeletal Class II malocclusions due to mandibular retrusion. But some differences exist in the dentoalveolar effect of the two appliances. MA seems indicated in Class II cases where a control of the upper frontal teeth position is needed.


Asunto(s)
Maloclusión de Angle Clase II , Avance Mandibular , Aparatos Ortodóncicos Funcionales , Aparatos Ortodóncicos Removibles , Cefalometría , Humanos , Italia , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/terapia , Mandíbula , Estudios Retrospectivos , Resultado del Tratamiento
11.
BMC Oral Health ; 21(1): 109, 2021 03 10.
Artículo en Inglés | MEDLINE | ID: mdl-33691673

RESUMEN

BACKGROUND: Pathologic tooth migration (PTM) is a common complication of mild to severe periodontitis and proper orthodontic treatment is helpful to alleviate periodontal diseases. The goal of this study is to explore an optimal orthodontic displacement of clear aligner using a three-dimensional (3D) finite element model (FEM). METHODS: The cone beam computed tomography (CBCT) data of a patient received invisible orthodontics without diabetes and other systemic diseases were collected. Based on the new classification scheme for periodontal diseases in 2017 (stage I: mild periodontitis, [M1]; stage II: moderate periodontitis, [M2]; stage III: severe periodontitis, [M3]), 3D-FEMs of mandible were established using MIMICS 10.0 and ABAQUS 6.5 softwares. The 3D stress distribution diagrams and stress value of the teeth (left lower incisor, left lower central incisor, right lower lateral incisor, and right lower central incisor) under three different periodontal conditions (M1, M2, and M3) with axial inclination 90° and 100° were obtained by ABAQUS 6.5. RESULTS: The stress of anterior teeth was concentrated in the teeth neck, and became greater when the periodontal condition was worse. The stress value of anterior teeth and the strain at the top of the alveolar crest are greater as the displacement increasing. The stress value of anterior teeth and the strain at the top of the alveolar crest in axial inclination 100° are relatively great compared to those of axial inclination 90°. For patients with excessively inclined anterior teeth (such as 100°), the optimal orthodontic displacement is 0.18 mm. In order to ensure that alveolar ridge crest is not deformed, the displacement is less than 0.18 mm (strain for 0.165 mm), 0.15 mm (strain for 0.167 mm) and 0.10 mm (strain for 0.117 mm) respectively when alveolar bone is normal, resorption 1/3 or 1/3-1/2. CONCLUSIONS: The optimal orthodontic displacement for patients (M1, M2, and M3) with excessively inclined anterior teeth (axial inclination 100°) is 0.18 mm. To avoid the strain at the top of the alveolar crest, the optimal displacements for M1, M2 and M3 periodontal disease patients are less than 0.18 mm, 0.15 mm and 0.10 mm, respectively.


Asunto(s)
Incisivo , Aparatos Ortodóncicos Removibles , Proceso Alveolar , Análisis de Elementos Finitos , Humanos , Incisivo/diagnóstico por imagen , Mandíbula , Técnicas de Movimiento Dental
12.
Am J Orthod Dentofacial Orthop ; 159(4): e343-e362, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33653640

RESUMEN

INTRODUCTION: Research on clear aligner treatment (CAT) has increased in recent years. In this study, we aimed to perform a bibliometric and visualized analysis to identify and critically assess the 50 most highly cited articles on CAT. METHODS: Web of Science was selected as a data source and consulted until March 2020 to identify all articles potentially relevant to the analysis. All the eligible articles were collected until 50 manuscripts were listed. Article-based parameters, journal-based parameters, and author-based parameters were registered to perform the bibliometric analysis. Keywords were automatically harvested from the selected articles to implement the visualized analysis. RESULTS: The search identified a total of 378 articles; the total number of citations of the selected articles varied from 15 to 112. The average number of citations per year varied from 1.15 to 13.83. The predominant study design was clinical (31.7%). Over the 15 journals in which the most cited articles were published, the American Journal of Orthodontics and Dentofacial Orthopedics published the majority of those included in the list (14) and also received the greatest number of citations (671). A total of 195 authors contributed to the 50 most cited articles; a significant portion of them (26) were unaffiliated with academic institutions. A total of 184 keywords were gathered from the article list. CONCLUSIONS: The number of citations on CAT is expected to grow steadily in parallel with the rising number of research projects. The present work identifies the most influential articles on CAT and their characteristics, placing emphasis on the journals, the authors, and the topics addressed.


Asunto(s)
Aparatos Ortodóncicos Removibles , Ortopedia , Bibliometría
13.
Am J Orthod Dentofacial Orthop ; 159(4): 453-459, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33573897

RESUMEN

INTRODUCTION: The effects of Invisalign clear aligner treatment with and without Dental Monitoring (DM) were compared for treatment duration, number of appointments, refinements and refinement aligners, and accuracy of Invisalign in achieving predicted tooth positions (aligner tracking). The null hypothesis was that there are no differences between Invisalign with and without DM in these parameters. METHODS: A sample of 90 consecutively treated Invisalign patients (45 control, 45 DM) fitted the inclusion and exclusion criteria. Treatment duration, number of refinements, number of refinement aligners, time to first refinement, number of appointments, number of emergency visits, and accuracy of predicted tooth movement were observed for differences. RESULTS: The 2 groups were homogeneous (P >0.05) for sample size, age, gender, Angle classification, maxillary and mandibular irregularity index, and the number of initial aligners. There was a significant (P = 0.001) reduction in the number of appointments by 3.5 visits (33.1%) in the DM group. There was also a significant (P = 0.001) reduction in the time to the first refinement (1.7 months) in the DM group. Compared with Invisalign predicted tooth positions, actual tooth positions were statistically (P <0.05) more accurate for the DM group for the maxillary anterior dentition in rotational movements and mandibular anterior dentition for buccal-lingual linear movement. Invisalign therapy without DM was closer to predicted tooth positions for the maxillary posterior dentition for the tip. None of these differences surpassed the clinically significant thresholds (>0.5 mm or >2°); however, the DM group achieved this in 1.7 fewer months. CONCLUSIONS: DM with Invisalign therapy resulted in a reduced number of appointments by 3.5 visits (33.1%). The DM group also achieved a clinically similar accuracy in obtaining predicted tooth movements compared with the control group in 1.7 fewer months, indicating improved aligner tracking in the DM group.


Asunto(s)
Maloclusión , Aparatos Ortodóncicos Removibles , Humanos , Maloclusión/terapia , Mandíbula , Estudios Retrospectivos , Técnicas de Movimiento Dental
14.
Am J Orthod Dentofacial Orthop ; 159(3): e275-e280, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33518439

RESUMEN

INTRODUCTION: The purpose of this study was to compare predicted anterior teeth intrusion measurements with the actual clinical intrusion measurements using cone-beam computed tomography. Understanding the precision of the software in anticipating changes may help practitioners predict the need for overcorrection. METHODS: Twenty-two patients, with a mean age of 23.74 years, who underwent Invisalign (Align Technology, Santa Clara, Calif) clear aligners treatment for both arches only after having completed treatment with an initial series of aligners were included in this study. The pretreatment and posttreatment cone-beam computed tomography scans after the initial series were acquired by a single orthodontist practitioner. ClinCheck measurements were recorded with Align Technology. The long axis of the anterior tooth intrusion movement was measured in 142 teeth. A comparison between the predicted and actual measurements of anterior intrusion of the teeth was performed, and the intraclass correlation coefficients showed an almost perfect agreement in the linear measurements. RESULTS: A statistically notable difference between the predicted and actual measurements of anterior intrusion. The predicted intrusion movement of the maxillary canines (P = 0.001), maxillary lateral incisors (P <0.0001), and maxillary central incisors (P <0.0001) significantly differed from the actual values. Similarly, the intrusion movement in the mandibular teeth seemed to be inaccurate, with significant differences in the mandibular canines (P <0.0001) and mandibular lateral and central incisors (P <0.0001). CONCLUSIONS: The mean precision of true anterior intrusion with Invisalign clear aligners was 51.19%, and the mean amount of correction was 48.81%. The use of other supplementary methods of anterior teeth intrusion may be helpful to reduce the rate of midcourse corrections and refinements.


Asunto(s)
Diseño de Aparato Ortodóncico , Aparatos Ortodóncicos Removibles , Adulto , Tomografía Computarizada de Haz Cónico , Humanos , Incisivo/diagnóstico por imagen , Técnicas de Movimiento Dental , Adulto Joven
15.
Am J Orthod Dentofacial Orthop ; 159(2): 224-233, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33546827

RESUMEN

This case report describes the treatment of a 16-year-old female patient with a skeletal open bite and temporomandibular dysfunction. Clear aligners and miniscrews were used to control the occlusal plane and improve the skeletal problem. At the end of treatment, the mandible had rotated counterclockwise, allowing bite closure, upgrading dental and facial esthetics, and improving temporomandibular dysfunction.


Asunto(s)
Mordida Abierta , Aparatos Ortodóncicos Removibles , Adolescente , Cefalometría , Femenino , Humanos , Mandíbula , Mordida Abierta/diagnóstico por imagen , Mordida Abierta/terapia
18.
Angle Orthod ; 91(2): 164-170, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33434276

RESUMEN

OBJECTIVES: To investigate the skeletal and dentoalveolar effects of Invisalign's G5 protocol with virtual bite ramps in the treatment of adults with skeletal deep bites. MATERIALS AND METHODS: This retrospective study was conducted on consecutively treated adults presenting with skeletal deep bites as defined by the Overbite Depth Indicator (ODI). Subjects were divided into 2 groups: Invisalign group (n = 24) treated with the Invisalign G5 protocol and a full fixed appliance (FFA) group (n = 24) treated with edgewise FFAs and matched to the Invisalign group by ODI, sex, type of malocclusion, and non-extraction treatment. Pretreatment (T1) and post-comprehensive treatment (T2) lateral cephalograms were obtained and analyzed. RESULTS: Both the Invisalign and FFA groups showed significant changes from T1 to T2 in ODI and other skeletal and dentoalveolar measurements. The mean change in ODI was -1.5° (P < .001) for the Invisalign group and -2.0° (P < .001) for the FFA group. The mean decrease in overbite was 1.3 mm (P < .001) and 2.0 mm (P < .001) for the Invisalign and FFA groups, respectively. The mean increase in mandibular plane angle (Sn-GoGn) was 0.65° (P = .003) for the Invisalign group and 1.15° (P < .001) for the FFA group. When the groups were compared with each other, both ODI (P = .03) and overbite (P = .003) were significantly different in addition to other measurements. CONCLUSIONS: Although FFA treatment had more apparent skeletal changes for deep bite adult patients when compared with Invisalign, both systems were effective in opening deep bites at dentoalveolar and skeletal levels.


Asunto(s)
Maloclusión de Angle Clase II , Maloclusión , Aparatos Ortodóncicos Removibles , Sobremordida , Adulto , Cefalometría , Humanos , Maloclusión/diagnóstico por imagen , Maloclusión/terapia , Mandíbula , Estudios Retrospectivos
19.
BMC Oral Health ; 21(1): 36, 2021 01 21.
Artículo en Inglés | MEDLINE | ID: mdl-33478458

RESUMEN

BACKGROUND: The effectiveness of anterior crossbite treatment in preschool-aged children depends on the treatment design and patient compliance. Common early treatment appliances with steel wires and acrylic resin can bring about numerous problems, such as toothache, sore gums and mucous membrane injury. The aim of this study was to propose a new clear removable appliance to provide preschool-age children with an improved experience of early occlusal interference treatment. METHODS: Appliances were designed with the help of 3-dimensional (3D) digital reconstruction oral models and fabricated using 3D printing technology and the pressed film method. Then, the mechanical properties of the original dental coping sheet and thermoformed aligners were assessed in a simulated intraoral environment. Preschool-age participants who displayed anterior crossbite were recruited in this study. Records (photographs and impressions) were taken before the treatment (T1), during the treatment (T2) and at the end of the treatment (T3). The effects of treatment were evaluated by clinical examination and questionnaires. RESULTS: Normal degrees of overbite and overjet in the primary dentition were achieved using this new appliance. Dental and soft tissue relationships were improved. Questionnaires showed that the safety evaluation, degree of comfort and convenience grades of the appliance were all relatively high. CONCLUSION: This explorative study demonstrates that our new clear removable appliance is able to correct early-stage anterior crossbite in a safe, comfortable, convenient and efficient way. Thus, it is a promising method to correct a certain type of malocclusion, and its clinical use should be promoted in the future.


Asunto(s)
Maloclusión , Aparatos Ortodóncicos Removibles , Sobremordida , Niño , Preescolar , Dentición Mixta , Humanos , Maloclusión/terapia , Ferulas Oclusales
20.
Ned Tijdschr Tandheelkd ; 128(1): 13-20, 2021 Jan.
Artículo en Holandés | MEDLINE | ID: mdl-33449052

RESUMEN

Oral care for children with autism spectrum disorder requires a distinctive approach often involving a lot of effort, energy, and time. It puts the perseverance of parents and carers severely to the test. This is very recognisable to the orthodontics department of the Erasmus Medical Center. Negative experiences with conventional orthodontic appliances in this group of patients were the reason to start using the clear aligner system in January 2018. This article deals extensively with the treatment process, the advantages of the clear aligner system, and the need for an adapted, autism-friendly management style in orthodontic care for children with autism.


Asunto(s)
Trastorno del Espectro Autista , Aparatos Ortodóncicos Removibles , Cuidadores , Niño , Humanos , Padres
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