497 results on '"Invisalign"'
Search Results
2. HOW RELIABLE IS THE AMOUNT OF INTERPROXIMAL REDUCTION CLINCHECK SOFTWARE RECOMMENDS?
- Author
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TUNCA, Yasemin, FAHRZADEH, Nihal, and TUNCA, Murat
- Subjects
MALOCCLUSION ,RADIOTHERAPY treatment planning ,DENTAL occlusion ,MAXILLA ,MANDIBLE - Abstract
Objective: This study was conducted to evaluate the reliability of Bolton analysis results obtained with ClinCheck software and the interproximal reduction (IPR) ratios the software recommends. Materials and Methods: From the Invisalign® clear aligner system database, 120 individuals were divided into three groups according to Angle classification: dental class I (n=43), dental class II (n=49), and dental class III (n=28) malocclusions. The Bolton analysis data and the IPR amounts determined by Align Technology’s digital treatment planning interface, ClinCheck, were evaluated separately for the maxilla and mandible for each individual. A discrepancy was defined as the condition in which the Bolton ratio the software determined and the suggested IPR amount for the anterior ratio and the overall ratio exceeded 2 mm. The average anterior Bolton ratio and suggested anterior Bolton ratio, along with the total Bolton ratio and suggested total Bolton ratio for all individuals, were compared using Cronbach’s alpha. Results: It was determined that the average suggested anterior Bolton ratio for individuals with class I malocclusion was higher than that for individuals with other malocclusions (p=0.008). Cronbach’s alpha for the anterior Bolton ratio and the suggested anterior Bolton ratio was 0.131 whereas the overall ratio and the suggested overall Bolton ratio value were determined to be 0.41. Both values are defined as indicating weak reliability. Conclusion: A weak reliability relationship was detected between the Bolton values obtained with the ClinCheck software and the IPR suggestions provided in treatment planning. [ABSTRACT FROM AUTHOR]
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- 2024
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3. A Systematic Review of Interventions—Does Invisalign Move Teeth as Effectively as Orthodontic Fixed Appliances?
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Alam, Mohammad Khursheed, Awawdeh, Mohammed, Alhazmi, Nora, Alamoud, Khalid A., Iyer, Kiran, Abutayyem, Huda, Alswairki, Haytham Jamil, Hajeer, Mohammad Younis, and Lupi, Saturnino Marco
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CORRECTIVE orthodontics , *ORTHODONTIC appliances , *ODDS ratio , *RESEARCH protocols , *TREATMENT duration - Abstract
Background: Despite the large number of studies that have been done in this area, there is still a gap in the literature when it comes to comparing the orthodontic tooth movement (OTM) efficacy of Invisalign and fixed orthodontic appliances. The primary objectives of this study were to evaluate and compare the efficacy of Invisalign and fixed orthodontic appliances in terms of the amount and rate of OTM. Specifically, the study aimed to determine if there was a statistically significant difference between these two treatment modalities in achieving OTM and to assess whether treatment duration differs significantly between Invisalign and traditional fixed appliances. This investigation seeks to address the existing gaps in the literature by providing a clear comparison based on recent empirical evidence, thereby contributing to more informed treatment decisions in orthodontic practices. Methodology: Relevant MeSH keywords and Boolean operators were selected by a team of reviewers to search several online databases for papers that were in accordance with the objectives of our review. Results: At the end of the search protocol, 10 studies were deemed to be eligible for inclusion in the review. The pooled analysis revealed a statistically significant reduction in treatment time for patients using Invisalign compared to those with fixed appliances, with a total OR of 0.61 [95% CI 0.43, 0.85]. No significant heterogeneity was detected (I2 = 0%), and the test for overall effect was significant (Z = 2.86, p = 0.004). Furthermore, a nonsignificant trend favoring Invisalign was shown, with an odds ratio of 1.43 and a confidence interval that included 1 (0.97, 2.10). The p value was 0.07, and there was negligible heterogeneity among studies, as indicated by an I2 of 0%. Conclusion: Based on the findings from the selected studies, it can be concluded that Invisalign and fixed orthodontic appliances have similar overall efficacy in eliciting OTM. However, Invisalign treatment requires significantly less time to complete than fixed orthodontic appliances. Despite these observations, further studies are required to explore the long‐term stability of OTM achieved with Invisalign and fixed orthodontic appliances. Registration and Protocol: Registration was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) standards (CRD42023405593). The research protocol was created to meet the goals and was properly filed with PROSPERO; however, it has not been prospectively registered. [ABSTRACT FROM AUTHOR]
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- 2024
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4. Surgery First and Aligners: A Case Report Combining In-House Surgical Guides and Pre-Adapted Titanium Plates.
- Author
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Sefidroodi, Mohammedreza, Shino, Inleel Lundgård, Vassis, Stratos, Hammer, Karen Eich, Kristensen, Kasper Dahl, Pedersen, Thomas Klit, Nørholt, Sven Erik, and Buhl, Jytte
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ORTHODONTIC appliances ,SURGICAL complications ,ORTHOGNATHIC surgery ,TEMPOROMANDIBULAR joint ,QUALITY of life - Abstract
Continuous advancements in technology have made it possible to integrate clear aligner therapy (CAT) with orthognathic surgery. This case report presents a novel, individually-planned workflow, combining CAT with a surgery-first orthognathic approach (SFOA) in collaborating with engineers for an in-house production of surgical guides and customized titanium plates. The patient was evaluated subjectively, using the Oral Health-Related Quality of Life-14 (OHIP-14) questionnaire and Orthognathic Quality of Life questionnaire (OQLQ), and objectively with the Peer Assessment Rating (PAR) index. The patient displayed the planned occlusal relationship with no report of discomfort in the temporomandibular joint (TMJ) or post-surgical complications. The surgical and occlusal outcomes have remained consistent and stable after debonding. A decreased score was reported in both questionnaires and the PAR after treatment, thereby indicating improvements in both subjective and objective evaluations. This case report demonstrates that with proper individual planning, satisfactory subjective and objective outcomes can be achieved when combining SFOA with CAT. [ABSTRACT FROM AUTHOR]
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- 2024
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5. Clinical audit of an artificial intelligence (AI) empowered smile simulation system: a prospective clinical trial
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Samar M. Adel, Yashodhan M. Bichu, Srirengalakshmi Muthuswamy Pandian, Waddah Sabouni, Chandani Shah, and Nikhillesh Vaiid
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Smile aesthetics ,Invisalign ,Invisalign SmileView ,Artificial intelligence ,Smile prediction ,Medicine ,Science - Abstract
Abstract Smile aesthetics is an important factor to consider during orthodontic treatment planning. The aim of the present study is to assess the predictability of Invisalign SmileView for digital AI smile simulation in comparison to actual smile treatment outcomes, using various smile assessment parameters. A total of 24 adult subjects (12 females and 12 males; mean age 22 ± 5.2 years) who chose to be treated using Invisalign were prospectively recruited to have their pretreatment smiles captured using the Invisalign SmileView to simulate their new smiles before treatment was started. Patients were then treated using upper and lower Invisalign aligners with average treatment time of 18 ± 6 months. Full post-treatment records were obtained and full smile frame images of simulated smile and actual final smile of each subject were evaluated by an independent examiner using an objective assessment sheet. Ten smile variants were used to assess the characteristics of the full smile images. Significance level was set at P 0.7 & > 0.9). The Independent t test was performed amongst the quantitative variables. The P value was not significant for all except maxillary inter canine width (P = 0.05), stating that for the five variables namely; philtrum height, commissure height, smile width, buccal corridor and smile index, actual mean values were similar to the simulation mean values. For the qualitative variables, the Kappa value ranged between 0.66 and − 0.75 which showed a substantial level of agreement between the examiners. Additionally, the Chi square test for the qualitative variables, revealed that the P value was found to be significant in all except lip line. This implies that only the lip line values are comparable. More optimal lip lines, straighter smile arcs and more ideal tooth display were achieved in actual post treatment results in comparison to the initially predicted smiles. Five quantitative smile assessment parameters i.e., philtrum height, commissure height, smile width, buccal corridor, and smile index, could be used as reliable predictors of smile simulation. Maxillary inter canine width cannot be considered to be a reliable parameter for smile simulation prediction. A single qualitative parameter, namely the lip line, can be used as a reliable predictor for smile simulation. Three qualitative parameters i.e., most posterior tooth display, smile arc, and amount of lower incisor exposure cannot be considered as reliable parameters for smile prediction. Trial Registration number and date: NCT06123585, (09/11/2023)
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- 2024
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6. Evaluating the efficacy and predictability of distalization protocols for maxillary molars in Class II treatment with clear Aligners: A narrative review.
- Author
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Hmud, Raghad and Alamri, Abdulaziz
- Abstract
Clear aligner therapy (CAT) has become a popular orthodontic treatment option for adolescent and adult patients for its aesthetic, patient's comfort, and convenient features. It involves a programmed and simulated virtual planning, tracking, and quantifying of tooth movement to target positions. Over the years, the therapeutic scope of CAT has increased dramatically to include a wider range of malocclusions with the aid of orthodontic auxiliaries as adjunctive biomechanics. This narrative review aims at summarizing and evaluating current practices, efficacy and predictability of sequential distalization protocol for maxillary molars in class II treatment using CAT. A systematic search for this review included electronic literature databases of MEDLINE via Pubmed, Web of Science, ProQuest and Embase to include all available published articles including systematic reviews, books, cases reports, and narrative literature reviews. Most published studies are retrospective examining small sample size. Current literature should be interpreted carefully as studies differ in their outcome measurement process and timing. Although reports show 2-3 mm of molar distalization is possible, a distinguish between bodily movement and molar tip back should be made. There is a discrepancy between computer-assisted predicted outcome and actual clinical outcome reported in literature. Molar distalization using CAT is possible. However, randomised trials with large sample size are necessary to draw more definitive conclusion about its efficacy and predictability. Due to the discrepancy between computer-assisted predicted outcome and actual clinical outcome, case refinement and possible altered treatment duration should be discussed with the patient in the planning stage. Since the process of molar distalization using CAT involves undesirable reaction force, it is essential to reinforce anchorage with suitable auxiliaries like composite attachments, class II/III elastics, and TADs. [ABSTRACT FROM AUTHOR]
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- 2024
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7. Clinical audit of an artificial intelligence (AI) empowered smile simulation system: a prospective clinical trial.
- Author
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Adel, Samar M., Bichu, Yashodhan M., Pandian, Srirengalakshmi Muthuswamy, Sabouni, Waddah, Shah, Chandani, and Vaiid, Nikhillesh
- Subjects
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ARTIFICIAL intelligence , *SMILING , *ORTHODONTIC appliances , *CHI-squared test , *SIMULATION methods & models - Abstract
Smile aesthetics is an important factor to consider during orthodontic treatment planning. The aim of the present study is to assess the predictability of Invisalign SmileView for digital AI smile simulation in comparison to actual smile treatment outcomes, using various smile assessment parameters. A total of 24 adult subjects (12 females and 12 males; mean age 22 ± 5.2 years) who chose to be treated using Invisalign were prospectively recruited to have their pretreatment smiles captured using the Invisalign SmileView to simulate their new smiles before treatment was started. Patients were then treated using upper and lower Invisalign aligners with average treatment time of 18 ± 6 months. Full post-treatment records were obtained and full smile frame images of simulated smile and actual final smile of each subject were evaluated by an independent examiner using an objective assessment sheet. Ten smile variants were used to assess the characteristics of the full smile images. Significance level was set at P < 0.05. The ICC for the quantitative parameters showed that there was an overall excellent & good internal consistency (alpha value > 0.7 & > 0.9). The Independent t test was performed amongst the quantitative variables. The P value was not significant for all except maxillary inter canine width (P = 0.05), stating that for the five variables namely; philtrum height, commissure height, smile width, buccal corridor and smile index, actual mean values were similar to the simulation mean values. For the qualitative variables, the Kappa value ranged between 0.66 and − 0.75 which showed a substantial level of agreement between the examiners. Additionally, the Chi square test for the qualitative variables, revealed that the P value was found to be significant in all except lip line. This implies that only the lip line values are comparable. More optimal lip lines, straighter smile arcs and more ideal tooth display were achieved in actual post treatment results in comparison to the initially predicted smiles. Five quantitative smile assessment parameters i.e., philtrum height, commissure height, smile width, buccal corridor, and smile index, could be used as reliable predictors of smile simulation. Maxillary inter canine width cannot be considered to be a reliable parameter for smile simulation prediction. A single qualitative parameter, namely the lip line, can be used as a reliable predictor for smile simulation. Three qualitative parameters i.e., most posterior tooth display, smile arc, and amount of lower incisor exposure cannot be considered as reliable parameters for smile prediction. Trial Registration number and date: NCT06123585, (09/11/2023) [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
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8. Invisalign para tratamento de mordida aberta anterior.
- Author
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Prado de SOUZA, José Eduardo, Stefhanie de ALMEIDA, Thalita, Moreira PROCÓPIO, Danielle, and Salvatore de FREITAS, Karina Maria
- Abstract
Copyright of Clinical Orthodontics is the property of Dental Press International and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2024
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9. A Cross‐Sectional Survey of the Use of Clear Aligners by General Dentists in Australia.
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Meade, Maurice J. and Weir, Tony
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ORTHODONTIC appliances ,DENTISTS ,PATIENT compliance ,MEDICAL personnel ,TREATMENT effectiveness - Abstract
Objectives: The primary aim of the investigation was to survey clear aligner therapy (CAT) use among general dentists in Australia. A secondary aim was to evaluate the factors that influenced general dentists in Australia not to provide CAT. Material and Methods: General dentists registered with the Australian Health Practitioner Regulation Agency were invited to participate in a structured cross‐sectional electronic survey. The survey covered demographics, preferred CAT systems and practices, relevant treatment planning and retention protocols, patient‐reported CAT issues, pertinent respondent opinions, and reasons for not providing CAT. Descriptive statistics were computed via GraphPad Prism v10 (GraphPad Software Inc., La Jolla, CA, USA). Results: Most of the 264 (n = 172; 65.2%) respondents indicated that they provided CAT. The majority (n = 82; 58.6%) reported that they treated between 1 and 20 patients with CAT annually. Invisalign was the most used system (n = 83; 61.2%), with 55 (41.7%), indicating that they used more than one system. Most (n = 124; 98.4%) were comfortable using CAT for mild crowding, whereas 73.4% (n = 94) were not comfortable in treating severe crowding with CAT. The median (IQR) number of patients per respondent treated with extraction of a permanent incisor or premolar was 0 (0). Issues regarding tooth positions were reportedly always or mostly in need of change in the initial treatment plan by 68.7%. Problems regarding patient compliance with CAT wear protocols (n = 67; 45.6%) and the predictability of treatment outcomes (n = 31; 21.1%) were the most identified themes of the free‐text comments. Over 80% of those who did not provide CAT indicated that they preferred to refer to an orthodontist for management. Conclusion: Almost two‐thirds of the respondents provided CAT. Invisalign was the most used system. The majority use CAT combined with nonextraction treatment. Most of those who did not provide CAT preferred to refer to an orthodontist for patient management. Summary: The use of CAT is increasing globally.The present survey is among the first to explore CAT practices of general dentists. As such, it provides novel baseline information related to a wide range of factors related to CAT practices and protocols.In the absence of robust evidence regarding CAT, it informs clinicians about colleagues' use, experiences, and problems with, and opinions of, CAT.The study will enable clinicians to provide insight regarding their own utility of CAT by comparing their own practices to the study's findings. [ABSTRACT FROM AUTHOR]
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- 2024
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10. Knowledge differences between general practitioners and orthodontists about Invisalign clear aligner treatment – a cross-sectional survey-based study
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Montaha Alsultan, Jana Nasser Alqefari, and Nabeel Almotairy
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Clear aligner ,Invisalign ,perception ,orthodontist ,dentist ,dentists ,Dentistry ,RK1-715 - Abstract
Purpose This study investigated the knowledge differences between general practitioners and orthodontists about the Invisalign system.Materials and methods A web-based survey regarding 10 Invisalign treatment domains was distributed to 161 orthodontists and 213 general practitioners. The responses were ranked using a Likert-type scale and analysed with the Chi-square test and Bonferroni adjustment.Results The response rate was 52.1% for general practitioners and 63.4% for orthodontists. Comparing Invisalign to conventional fixed appliances, orthodontists agreed/strongly agreed that Invisalign aligners are suitable for all types of cases (p = 0.001). Orthodontists also agreed that it causes less tooth discomfort (p = 0.01) and an increased number of attachments can affect its esthetic perception (p = 0.014) but general practitioners opted for the ‘Do Not Know’ option (p ≤ 0.01). General practitioners also responded ‘Do Not Know’ to whether Invisalign treatment finishes in a shorter duration (p = 0.001), achieves all types of tooth movement (p
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- 2024
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11. Effectiveness of Clear Aligners on Sequential Maxillary Molar Distalization: Discrepancy between Treatment Goal and Outcome.
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Mamani, Jatuphol, Sessirisombat, Chidchanok, Hotokezaka, Hitoshi, Yoshida, Noriaki, and Sirisoontorn, Irin
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MOLARS , *ORTHODONTIC appliances , *CORRECTIVE orthodontics , *TEETH , *FEMALES - Abstract
Objectives: The purpose of this preliminary study was to determine the differences between planned and actual maxillary molar movements after the completion of treatment with an initial set of clear aligners including sequential maxillary molar distalization. Methods: The data records of 14 non-growing patients who completed orthodontic treatment with sequential maxillary molar distalization using clear aligners were retrospectively evaluated (n= 14, 4 males and 10 females, 33.61 ± 8.57 years). Data on planned tooth movements were obtained from ClinCheck software (ClinCheck Pro version 5.3). The amounts of actual tooth movements were obtained by performing superimposition of lateral cephalograms taken before and after treatment. The amounts of distal translation and tipping between planned and actual maxillary molar movements were compared with the paired Student's t-test. Results: The statistically significant differences between planned and actual translation movements of maxillary first and second molars were shown after completing treatment with the first series of aligners (p < 0.05). The average actual amount of molar distalization on maxillary first molars was less than the planned amount by 1.32 ± 0.42 mm. Similarly, the average actual amount of molar distalization on maxillary second molars was less than the planned amount by 1.57 ± 0.45 mm. The accuracy for molar distalization, namely, the percentage of actual distal translation to planned movement, was 40.11% for maxillary first molars and 35.39% for maxillary second molars. However, the difference between the planned and actual angulation movements was not significant (p > 0.05). Conslusions: In conclusion, the amounts of actual distal translation of maxillary molars through the utilization of clear aligners were significantly lower than planned. However, there were no statistically significant differences between the degrees of actual and planned molar angulation movement. [ABSTRACT FROM AUTHOR]
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- 2024
- Full Text
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12. Treatment of an adolescent with mandibular retrusion through premolar extraction and bite jumping with clear aligners.
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Jialun Li, Huiyi Hong, Lingling Pu, Qi Fan, Xuechun Yuan, Ghaleb, Omar M., Wenli Lai, and Hu Long
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ORTHODONTIC appliances ,TREATMENT effectiveness ,BICUSPIDS ,TEENAGERS ,MALOCCLUSION ,THERAPEUTICS - Abstract
This case report describes the successful treatment of an 11-year-old girl with skeletal Class II malocclusion, mandibular retrognathism and anterior crowding using clear aligners. The treatment strategy included extraction of the four first premolars to resolve dental crowding, the use of Class II elastics to achieve bite jumping and canine and molar Class I occlusion, and delicate vertical control to improve the patient’s lateral profile. After 4 years of treatment, all the treatment objectives, including dental alignment, mandibular repositioning and improvement of the lateral profile, were achieved successfully. The present case demonstrates the effectiveness of and advantages offered by clear aligners and Class II elastics as an alternative treatment option for adolescent patients with Class II malocclusion and severe crowding. [ABSTRACT FROM AUTHOR]
- Published
- 2024
13. Interdisciplinary treatment with aligner orthodontics followed by minimally invasive restorations.
- Author
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Haubrich, Julia, Schupp, Werner, and Boisserée, Wolfgang
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MINIMALLY invasive dentistry ,ORTHODONTIC appliances ,TOOTH loss ,INCISORS ,TEETH - Abstract
Aligner therapy offers a valuable alternative to fixed appliance treatment in young and adult patients, making it possible to reduce potential side effects and providing an aesthetic therapeutic option. In some patients, abrasions, changes of tooth shape or loss of tooth substance require an additional tooth restoration to obtain an optimal outcome that satisfies the patient. Instead of reducing healthy tooth substance for the preparation of a crown or veneer, the development of composite in the past few years has led to improved results in terms of both longevity and aesthetics. The present article outlines different patient examples of interdisciplinary treatment with aligner orthodontics followed by minimally invasive restorations with composites on anterior teeth. [ABSTRACT FROM AUTHOR]
- Published
- 2024
14. Correção da Classe II com apinhamento e mordida cruzada posterior em paciente adulto utilizando MARPE e alinhadores ortodônticos Invisalign.
- Author
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PARANHOS, Flavia
- Abstract
Copyright of Clinical Orthodontics is the property of Dental Press International and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2024
- Full Text
- View/download PDF
15. Clear aligner therapy practice among orthodontists in the United Kingdom and the Republic of Ireland: A cross-sectional survey of the British Orthodontic Society membership.
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Meade, Maurice J, Weir, Tony, Seehra, Jadbinder, and Fleming, Padhraig S
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ORTHODONTIC appliances ,ORTHODONTISTS ,MEDICAL protocols ,HYPODONTIA ,INTERNET surveys - Abstract
Objective: To investigate clear aligner therapy (CAT) practice among orthodontists in the British Orthodontic Society (BOS). Design: A cross-sectional online survey. Methods: An electronic survey was distributed to members of the BOS in 2022. The survey comprised questions regarding respondent demographics, general use of CAT, the choice of proprietary CAT appliances, CAT planning, case selection, treatment protocols and orthodontist-reported CAT problems. Results: Overall, there were 233 (19.5%) respondants with the majority (n = 121, 53.1%) being female. Most respondents reported practising in England (n = 171, 74.7%). The majority (n = 177, 77.3%) indicated that they used CAT in their practice, with 48.1% (n = 81) treating 1–20 patients with CAT annually. The most frequently prescribed CAT system was Invisalign (n = 138, 81.2%). One to three changes to the initial digital treatment plan were made by 72.9% (n = 121) with final tooth positions being the most common reason for adjustment (64.4%). Most (n = 97, 60.3%) rarely or never performed premolar extractions with CAT. Of the respondents, 23 12.7%) reported that they always or mostly used a remote monitoring system in conjunction with CAT, with a wide range of aligner change protocols reported. The median number of months required to complete non-extraction CAT reported by the respondents was 12. Most respondents (n = 77, 51.7%) did not feel that CAT provides superior outcomes compared with fixed appliance therapy. Conclusion: CAT practice varied widely among the surveyed orthodontists. A predilection for the use of Invisalign and utility in less severe cases was noted. [ABSTRACT FROM AUTHOR]
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- 2024
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16. Unplanned tooth movement in deepbite correction with Invisalign: A retrospective study.
- Author
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Sadek, Mais M. and Alhashmi, Reem
- Abstract
• Unplanned linear and angular movements occur with deepbite correction with Invisalign. • Unplanned movements were more evident posteriorly than anteriorly. • Unplanned angular movements were more frequent than linear movements for all teeth. • Unplanned movements can affect predictability of deepbite correction with aligners. This study aimed to investigate unplanned tooth movements in deepbite correction with Invisalign. The sample consisted of 34 adult patients with deepbite malocclusion treated with Invisalign. Pretreatment and predicted digital models were exported from ClinCheck software, while the post-treatment model was obtained from an intraoral scan taken at the end of the first set of aligners. Digital models' superimposition was done using the eModel "Compare" software. Frequency and percentage of occurrence of unplanned linear and angular movements, their magnitude, and direction were then determined. In addition, comparison of unplanned movements was performed between anterior and posterior teeth as well as between linear and angular measurements. The percentage of unplanned movements ranged from 1.68% to 25.63% in the maxilla and 3.36% to 23.95% in the mandible, being most evident in the first and second molars. Unplanned movements were statistically significantly more frequent in posterior teeth compared with the anterior teeth (P > 0.05). In addition, the frequency of angular movements was statistically significantly higher for each tooth than linear movement (P < 0.05) with a higher mean value. Unplanned mesiodistal movements were the least frequent. Unplanned linear as well as angular movements were evident in almost all teeth. Unplanned faciolingual inclination and mesiodistal angulation movements were the most frequently observed. Unplanned vertical movements can affect the predictability of deepbite correction and thus merit particular attention in those cases. [ABSTRACT FROM AUTHOR]
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- 2024
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17. Efficacy of clear aligner wear protocols in orthodontic tooth movement—a systematic review.
- Author
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Monisha, J and Peter, Elbe
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CORRECTIVE orthodontics ,ORTHODONTIC appliances ,PAIN perception ,OPEN access publishing ,DATABASE searching - Abstract
Background and objectives Different expedited aligner wear protocols are currently in practice. This review was undertaken to systematically appraise the available evidence on the comparative efficacy of orthodontic tooth movement (OTM) across the different wear protocols. Search methods Two assessors conducted comprehensive searches of electronic databases, including MEDLINE (via PubMed), Scopus, Embase, Web of Science, Google Scholar, Directory of Open Access Journals, Cochrane Library, OpenGrey, and Clinical Trial Registry, till 18 February 2024. Titles and abstracts were independently screened. Selection criteria Prospective or retrospective studies comparing expedited wear protocols with the conventional 14-day protocol were included. Data collection and analysis A pre-piloted data extraction form was used. Risk of bias (RoB) assessment employed the Cochrane RoB 2.0 tool for randomized-controlled trials (RCTs) and the Newcastle–Ottawa scale for non-RCTs. The quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation Pro tool. Results Six studies, including 3 RCTs and 3 non-RCTs, were selected from 9076 records. Four studies (two RCTs and two retrospective cohort) found no statistically significant difference (P > 0.05) in the OTM efficacy between expedited and conventional protocols. Two studies (one RCT and one prospective cohort) found greater efficacy (P < 0.05) with the 14-day protocol, with the RCT reporting greater efficacy for certain movements, such as maxillary posterior intrusion, maxillary posterior distal tipping and buccal torquing, and mandibular posterior intrusion and extrusion. One RCT reported statistically insignificant difference (P > 0.05) in pain perception between the 10-day and 14-day protocols. Two studies demonstrated low RoB, two moderate, and two high RoB. The evidence level was very-low for OTM efficacy and high for pain perception. Meta-analysis was precluded due to significant heterogeneity among the studies. Conclusions Within the limitations of the study, the 7-day, 10-day, and 14-day protocols did not show any significant difference in OTM efficacy, except for certain movements that exhibited superior outcomes with the 14-day wear. Hence, a 'hybrid aligner-wear protocol', based on clinical judgement, might serve a better alternative in complex situations. Registration PROSPERO CRD42021288179 [ABSTRACT FROM AUTHOR]
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- 2024
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18. Orthodontic treatment of a patient with dentinogenesis imperfecta using a clear aligner system.
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Meng, Chenda, Le, Di, Wang, Xin, Song, Yaling, and Song, Guangying
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PATIENT safety , *DENTINOGENESIS imperfecta , *ORTHODONTIC appliances , *JAW abnormalities , *LIPS - Abstract
Orthodontic treatment for patients with dentinogenesis imperfecta (DGI) can be risky because of the fragility of their dental hard tissue. Although the Invisalign (Align Technology) clear aligner system should be a suitable orthodontic appliance for patients with DGI, to the authors' knowledge, there has been no related research. A 28-year-old woman with DGI sought treatment with a 1 mm open bite, edge-to-edge occlusion of the central incisors, and a bilateral Class III cusp-to-cusp molar relationship. Invisalign was applied for her treatment, and after 3 and one-half years of orthodontic therapy, a normal overjet and overbite were achieved, accompanied by retraction of the lower lip as well as a bilateral Class I molar relationship. In addition, there was no iatrogenic injury to the patient's teeth. The Invisalign system may be a suitable orthodontic appliance for patients with DGI because clear aligners lessen the tensile stress to the teeth, decrease the number and area of bonds to the teeth, and offer protective effects through a full wrap of plastic that covers the crowns of the teeth. [ABSTRACT FROM AUTHOR]
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- 2024
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19. Efficacy of clear aligner therapy over conventional fixed appliances in controlling orthodontic movement: A systematic review.
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AlMogbel, AbdulMajeed, Alshawy, Ebrahim S., and Alhusainy, Abdulmageed
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ORTHODONTIC appliances ,EVIDENCE-based dentistry ,CLINICAL trials ,RESEARCH questions ,MEDICAL research - Abstract
OBJECTIVE: The purpose of the current systematic review was to answer the clinical research question "Is Clear Aligner Therapy (CAT) effective in controlling the orthodontic movement?" by bringing together the most up-to-date information about the available evidence for CAT. METHODOLOGY: On January 1, 2023, a search was conducted in PubMed, ERIC, Embase, and CINHAL for any research papers published in the previous 10 years that provided an overview of the PICO questions. Both the titles and abstracts of the selected studies were evaluated independently by two different authors, and if there was any disagreement between the two review authors, a third reviewer was brought in to settle it. RESULTS: Among included studies, three were retrospective non-randomized and two studies were prospective randomized clinical trials. Various authors reported better outcome for fixed orthodontic appliances than for clear aligner treatment (CAT) in relation to mandibular incisor proclination. The mean objective grading system score was better for braces (17) than for CAT (12) with no clinically significant difference, while staging had a significant impact on treatment efficacy. CONCLUSION: The results of this study suggest that clear aligners may be an effective alternative to traditional braces, but more research is needed to confirm these findings and determine the optimal size of future prospective studies evaluating this treatment. [ABSTRACT FROM AUTHOR]
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- 2024
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20. Comparative Analysis of Braces and Aligners: Long-Term Orthodontic Outcomes
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Sayyad Aref, Preetham Ravuri, Ajay K. Kubavat, Cherukupalli Sowmya, Leela Venkata Soujanya Nallamilli, Nilesh Bhanawat, and Rahul Tiwari
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conventional braces ,correction of malocclusion ,invisalign ,length of treatment ,orthodontic therapy ,patient satisfaction ,stability over time ,Pharmacy and materia medica ,RS1-441 ,Analytical chemistry ,QD71-142 - Abstract
Objectives: The purpose of this retrospective study was to evaluate the long-term results of orthodontic treatment with traditional braces and Invisalign, with a particular emphasis on treatment length, patient satisfaction, correction of malocclusion, and long-term stability. Methods: Between 2020 and 2022, individuals who had orthodontic treatment at a tertiary care center had their data analysed. Patients with mild to severe malocclusions treated with conventional braces or Invisalign between the ages of 12 and 18 met the inclusion criteria. Assessments were done on results, length of treatment, degree of malocclusion, and long-term stability. With significance set at P < 0.05, statistical analyses comprised t-tests for treatment duration and Chi-square testing for malocclusion correction. Findings: The mean treatment time for Invisalign was much shorter (18 months) than for conventional braces (24 months) (P < 0.001). With 88–90% success rates, both techniques demonstrated remarkable success rates in malocclusion treatment. Even though Invisalign was associated with a somewhat greater percentage of relapse instances, the difference was not statistically significant (P > 0.05). Conclusion: In conclusion, Invisalign showed a much shorter treatment period than conventional braces, yet both showed excellent malocclusion correction. The choice of modality should be based on patient satisfaction, treatment objectives, and case complexity, taking into account the trade-offs between treatment length and potential variations in long-term stability.
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- 2024
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21. Long-term Outcomes of Traditional Braces versus Invisalign in Orthodontic Treatment
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Seelam Prudhvi Das Reddy, Manjunath Chekka, Ruchi Shah, Afreen Kauser, Manish Pisarla, Praveen Kumar Varma Datla, and Akriti Mahajan
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invisalign ,longstanding outcomes ,orthodontic treatment ,patient satisfaction ,traditional braces ,Pharmacy and materia medica ,RS1-441 ,Analytical chemistry ,QD71-142 - Abstract
Objective: This research targets to compare the longstanding outcomes of traditional braces versus Invisalign in orthodontic treatment, focusing on dental alignment, occlusal stability, patient satisfaction, and treatment duration. Methods: A retrospective cohort research with 200 subjects was piloted. One hundred subjects received traditional braces, while the other 100 received Invisalign. Dental models, cephalometric radiographs, and intraoral photographs were obtained at baseline, post-treatment, and at 1, 2, and 5 years follow-up. Patient satisfaction surveys were administered at each follow-up visit. Results: Both traditional braces and Invisalign effectively improved dental alignment and occlusal stability over the 5-year follow-up period. Patient satisfaction scores were consistently higher in the Invisalign group compared to the traditional braces group. However, there were no significant differences in treatment duration between the two groups. Conclusion: Invisalign may offer comparable or superior longstanding outcomes compared to traditional braces in orthodontic treatment, with higher patient satisfaction levels. These findings support the use of Invisalign as a viable alternative to traditional braces, particularly for subjects seeking esthetic and convenient orthodontic solutions.
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- 2024
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22. A Cross‐Sectional Survey of the Use of Clear Aligners by General Dentists in Australia
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Maurice J. Meade and Tony Weir
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clear aligner therapy ,general dentist ,Invisalign ,questionnaire ,survey ,Dentistry ,RK1-715 - Abstract
ABSTRACT Objectives The primary aim of the investigation was to survey clear aligner therapy (CAT) use among general dentists in Australia. A secondary aim was to evaluate the factors that influenced general dentists in Australia not to provide CAT. Material and Methods General dentists registered with the Australian Health Practitioner Regulation Agency were invited to participate in a structured cross‐sectional electronic survey. The survey covered demographics, preferred CAT systems and practices, relevant treatment planning and retention protocols, patient‐reported CAT issues, pertinent respondent opinions, and reasons for not providing CAT. Descriptive statistics were computed via GraphPad Prism v10 (GraphPad Software Inc., La Jolla, CA, USA). Results Most of the 264 (n = 172; 65.2%) respondents indicated that they provided CAT. The majority (n = 82; 58.6%) reported that they treated between 1 and 20 patients with CAT annually. Invisalign was the most used system (n = 83; 61.2%), with 55 (41.7%), indicating that they used more than one system. Most (n = 124; 98.4%) were comfortable using CAT for mild crowding, whereas 73.4% (n = 94) were not comfortable in treating severe crowding with CAT. The median (IQR) number of patients per respondent treated with extraction of a permanent incisor or premolar was 0 (0). Issues regarding tooth positions were reportedly always or mostly in need of change in the initial treatment plan by 68.7%. Problems regarding patient compliance with CAT wear protocols (n = 67; 45.6%) and the predictability of treatment outcomes (n = 31; 21.1%) were the most identified themes of the free‐text comments. Over 80% of those who did not provide CAT indicated that they preferred to refer to an orthodontist for management. Conclusion Almost two‐thirds of the respondents provided CAT. Invisalign was the most used system. The majority use CAT combined with nonextraction treatment. Most of those who did not provide CAT preferred to refer to an orthodontist for patient management.
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- 2024
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23. The Impact of the COVID-19 Pandemic on Orthodontic Adult Patients’ Characteristics and Decision on Orthodontic Appliance
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Kuo YY, Fang JCC, Wang IK, Huang CS, Chen HL, and Yen TH
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covid-19 ,pandemic ,orthodontic ,invisalign ,bracket ,dental malocclusion ,sagittal skeletal relationship ,index of complexity outcome and need ,degree of treatment difficulty ,Medicine (General) ,R5-920 - Abstract
Yun-Yu Kuo,1 Jason Chen-Chieh Fang,2 I-Kuan Wang,3 Chiung-Shing Huang,4 Hui-Ling Chen,1,* Tzung-Hai Yen5,* 1Department of Dentistry and Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taoyuan, Linkou, 333, Taiwan; 2Chang Gung Memorial Hospital, Keelung, 204, Taiwan; 3Department of Nephrology, China Medical University Hospital, and College of Medicine, China Medical University, Taichung, 406, Taiwan; 4Department of Craniofacial Orthodontics, Craniofacial Research Center, Chang Gung Memorial Hospital, Taipei, 105, Taiwan; 5Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou, and College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan*These authors contributed equally to this workCorrespondence: Hui-Ling Chen; Tzung-Hai Yen, 5 Fu-Hsing Street, Taoyuan, Kweishan, 333, Taiwan, Tel +886 3 3281200 ext 7840, Fax +886 3 3282173, Email ma3608@cgmh.org.tw; m19570@cgmh.org.twPurpose: There is an overall paucity of data examining the specific details of orthodontic patients’ patterns or orthodontic service disruptions possibly influenced by COVID-19 pandemic. Therefore, this study aimed to explore the impact of the COVID-19 pandemic on orthodontic clinic disruption regarding the change in adult patients’ characteristics and decisions of orthodontic treatment devices.Patients and Methods: A retrospective sample of 311 patients receiving orthodontic treatment from 2018 to 2022 were collected and divided into two groups: before (n = 167) and during (n = 144) the COVID-19 pandemic. Demographics, dental indices, the index of complexity outcome and need (ICON), and the degree of treatment difficulty were analyzed.Results: There were fewer students among patients during the COVID-19 pandemic than before (24.5% versus 35.9%, P = 0.036). Compared with patients before the pandemic, more patients selected ceramic brackets or Invisalign during the pandemic (P = 0.022). There were higher percentage of class I dental malocclusions among patients during than before the COVID-19 pandemic (P = 0.044). Moreover, the ICON score and the score of the degree of treatment difficulty were both significantly lower for patients during than before the COVID-19 pandemic (63.9± 14.0 versus 58.3± 15.3, P=0.001 and 7.4± 2.6 versus 6.8± 2.6, P=0.049, respectively).Conclusion: The COVID-19 pandemic influenced the characteristics and decisions of orthodontic patients. Those who still came to the orthodontic clinic despite the COVID-19 outbreak may have been those with less malocclusion severity and treatment difficulty. Besides, during the time of covid-19 pandemic, more patients chose ceramic bracket and Invisalign as their orthodontic treatment device rather than conventional or self-ligating metal brackets.Keywords: COVID-19, pandemic, orthodontic, Invisalign, bracket, dental malocclusion, sagittal skeletal relationship, index of complexity outcome and need, degree of treatment difficulty
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- 2024
24. Evaluation of the Quality and Reliability of YouTubeTM Videos Created by Orthodontists as an Information Source for Clear Aligners
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Emre Cesur, Koray Tuncer, Duygu Sevgi, Barkın Cem Balaban, and Can Arslan
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clear aligners ,invisalign ,invisible orthodontics ,video quality ,youtube ,Dentistry ,RK1-715 - Abstract
Objective: This study aimed to evaluate the quality, reliability, and content usefulness of videos created by orthodontists on clear orthodontic aligners. Methods: Videos were screened using YouTubeTM by conducting a search for “Invisalign”. After a preliminary evaluation of the first 250 results, 61 videos that met the selection criteria were scored and their length, days since upload, and numbers of views, likes, dislikes, and comments were recorded. These data were used to calculate the interaction index and viewing rate. Video reliability was assessed using a five-item modified DISCERN index, and video quality was assessed using the Video Information and Quality Index. A 10-item content usefulness index was created to determine the usefulness of the video content. Descriptive statistics of the parameters were calculated, and correlation coefficients were calculated to evaluate the relationships between the parameters. Results: The mean reliability score was 2.75±1.02 (out of 5), and the total quality score was 11.80±3.38 (out of 20). The total content usefulness index was quite low, with a mean score of 2.52±2.14 (out of 10). Interaction index and viewing rate were positively correlated with reliability score (r=0.463, p
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- 2024
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25. Does aligner refinement have the same efficiency in deep bite correction?: A retrospective study
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Jessica Kang, Hyeran Helen Jeon, and Nishat Shahabuddin
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Deep bite ,Invisalign ,Clear aligners ,Predictability ,Refinement ,Dentistry ,RK1-715 - Abstract
Abstract Background Refinements are very common in clear aligner treatments. The aim of this study is to assess whether the predictability of deep overbite correction is similar over several refinements using clear aligners (Invisalign, Align Technology, San Jose, Calif) and examine the accuracy of vertical movement and inclination change of individual teeth. Methods This retrospective study included 20 deep bite patients (7M and 13F; 32.63 ± 11.88 years old; an initial overbite of 5.09 ± 0.98 mm), consecutively treated from September 2016 and March 2023, who completed at least two sets of aligners, including refinements. The initial, predicted, and achieved models were exported from ClinCheck or OrthoCAD (Cadent Inc, Carlstadt, NJ) and superimposed via best-fit surface-based registration using SlicerCMF (version 4.9.0; cmf.slicer.org). We also examined 15 out of 20 patients who completed treatments. The overbite correction and changes in vertical movement and inclination for individual teeth were measured. Descriptive statistics and a paired t-test or Wilcoxon signed-rank test were performed. P
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- 2024
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26. Surgery First and Aligners: A Case Report Combining In-House Surgical Guides and Pre-Adapted Titanium Plates
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Mohammedreza Sefidroodi, Inleel Lundgård Shino, Stratos Vassis, Karen Eich Hammer, Kasper Dahl Kristensen, Thomas Klit Pedersen, Sven Erik Nørholt, and Jytte Buhl
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clear aligner therapy ,aligners ,invisalign ,surgery-first orthognathic approach ,orthognathic surgery ,quality of life ,Technology ,Engineering (General). Civil engineering (General) ,TA1-2040 ,Biology (General) ,QH301-705.5 ,Physics ,QC1-999 ,Chemistry ,QD1-999 - Abstract
Continuous advancements in technology have made it possible to integrate clear aligner therapy (CAT) with orthognathic surgery. This case report presents a novel, individually-planned workflow, combining CAT with a surgery-first orthognathic approach (SFOA) in collaborating with engineers for an in-house production of surgical guides and customized titanium plates. The patient was evaluated subjectively, using the Oral Health-Related Quality of Life-14 (OHIP-14) questionnaire and Orthognathic Quality of Life questionnaire (OQLQ), and objectively with the Peer Assessment Rating (PAR) index. The patient displayed the planned occlusal relationship with no report of discomfort in the temporomandibular joint (TMJ) or post-surgical complications. The surgical and occlusal outcomes have remained consistent and stable after debonding. A decreased score was reported in both questionnaires and the PAR after treatment, thereby indicating improvements in both subjective and objective evaluations. This case report demonstrates that with proper individual planning, satisfactory subjective and objective outcomes can be achieved when combining SFOA with CAT.
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- 2024
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27. Does aligner refinement have the same efficiency in deep bite correction?: A retrospective study
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Kang, Jessica, Jeon, Hyeran Helen, and Shahabuddin, Nishat
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- 2024
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28. How important is the individual operator's aligner expertise for treatment quality?
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Woo-Ttum Bittner and Miethke, Rainer-Reginald
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ORTHODONTIC appliances ,MEDICAL quality control ,ORTHODONTISTS ,TREATMENT duration ,PATIENT compliance - Published
- 2024
29. Association between Gingival Phenotype and Periodontal Disease Severity—A Comparative Longitudinal Study among Patients Undergoing Fixed Orthodontic Therapy and Invisalign Treatment.
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Alasiri, Mansour M., Almalki, Abdullah, Alotaibi, Saud, Alshehri, Abdullah, Alkhuraiji, Alhanouf A., and Thomas, Julie Toby
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PERIODONTAL disease prevention ,ORTHODONTICS ,RESEARCH funding ,T-test (Statistics) ,GINGIVA ,PILOT projects ,QUESTIONNAIRES ,CHI-squared test ,ORTHODONTIC appliances ,LONGITUDINAL method ,ANALYSIS of variance ,COMPARATIVE studies ,CONFIDENCE intervals ,PHENOTYPES - Abstract
This longitudinal study aimed to compare the association between gingival phenotype (thin vs. thick) and periodontal disease severity in patients undergoing fixed orthodontic therapy (FOT) and Invisalign treatment over a six-month follow-up period. Clinical periodontal parameters, including full mouth plaque score (FMPS), full mouth bleeding score (FMBS), gingival index (GI), probing pocket depth (PPD), clinical attachment loss (CAL), gingival recession (GR), keratinized tissue width (KTW), transgingival probing, and gingival biotype assessment, were recorded at baseline and 6 months into treatment for both orthodontic groups and a control group. Statistical analysis evaluated differences in parameters between groups and across time points. In the thick phenotype, both Invisalign and FOT groups showed a significant mean reduction in FMPS (baseline to 6 months) by −24.8707 and −12.3489, respectively (p < 0.05). The gingival index decreased significantly for both groups, with Invisalign and FOT showing reductions of −0.83355 and −1.10409, respectively (p < 0.05). FMBS (baseline to 6 months) decreased significantly for Invisalign and FOT, with mean differences of −9.10298 and −12.6579 (p < 0.05). Probing pocket depth (baseline to 6 months) was also significantly reduced for both Invisalign and FOT groups while CAL showed non-significant differences in both groups (p > 0.05). Similar changes were seen in the thin phenotype too. This study highlights the positive influence of both Invisalign and fixed orthodontic therapy on periodontal health, particularly in patients with thin and thick gingival biotypes. These findings, with significant reductions in key periodontal parameters, offer valuable insights to guide orthodontic treatment decisions and enhance patient outcomes. [ABSTRACT FROM AUTHOR]
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- 2024
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30. The Use of Clear Aligners in Multi-Segmental Maxillary Surgery: A Case–Control Study in Cleft Lip and Palate and Skeletal Class III Patients.
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Meazzini, Maria Costanza, Demonte, Leonardo Paolo, Cohen, Noah, Battista, Valeria Marinella Augusta, Rabbiosi, Dimitri, and Autelitano, Luca
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- *
ORTHODONTIC appliances , *CLEFT lip , *CLEFT palate , *ORTHOGNATHIC surgery , *PALATE surgery , *CASE-control method , *OPERATIVE surgery - Abstract
Background: Maxillary hypoplasia and mandibular asymmetry may be corrected with orthognathic surgery after growth completion. For most stable results, some cases may require segmental Le Fort I osteotomies. Unfortunately, Invisalign's software (6.0 version) still has some inherent limitations in predicting outcomes for complex surgeries. This study explores the potential of aligners, particularly in multiple-piece maxillary osteotomies in both cleft and non-cleft patients. Method: Thirteen patients who underwent pre-surgical treatment with Invisalign were retrospectively matched in terms of diagnosis, surgical procedure, and orthodontic complexity with thirteen patients treated using fixed appliances. Virtual curves following the lower arch were employed to guide the correct pre-surgical positions of the upper teeth with a simple superimposition technique. The amount of impressions required in both groups to achieve satisfactory pre-surgical alignment of the segmented arches was compared. Results: one or no refinement phases were needed in the Invisalign group to reach an acceptable pre-surgical occlusion, while the amount of pre-surgical impressions needed to reach adequate coordination with fixed appliance treatment was slightly higher (p > 0.05). Conclusions: it appears that clear aligner could serve as an effective treatment for individuals necessitating segmental Le Fort I osteotomies when aided by the suggested simple superimposition approach. [ABSTRACT FROM AUTHOR]
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- 2024
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31. Does age influence deep overbite correction with Invisalign? A prospective study evaluating mandibular incisor intrusion in adolescents vs adults.
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Kravitz, Neal D., Hansa, Ismaeel, Vaid, Nikhilesh R., Moshiri, Mazyar, and Adel, Samar M.
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INCISORS ,MALOCCLUSION ,TEENAGERS ,ADULTS ,LONGITUDINAL method ,PATIENTS - Abstract
The article focuses on comparing the accuracy of mandibular incisor intrusion with Invisalign in adolescents versus adults, revealing significantly higher accuracy in adolescents. Topics include factors influencing Invisalign's challenges, advancements in technology to enhance correction, and implications for treatment planning, suggesting reduced overcorrection for adolescents with deep overbites.
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- 2024
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32. Evaluation of the Quality and Reliability of YouTube™ Videos Created by Orthodontists as an Information Source for Clear Aligners.
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Cesur, Emre, Tuncer, Koray, Sevgi, Duygu, Cem Balaban, Barkın, and Arslan, Can
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ORTHODONTISTS ,ORTHODONTIC appliances ,DESCRIPTIVE statistics ,DATA analysis - Abstract
Objective: This study aimed to evaluate the quality, reliability, and content usefulness of videos created by orthodontists on clear orthodontic aligners. Methods: Videos were screened using YouTubeTM by conducting a search for "Invisalign". After a preliminary evaluation of the first 250 results, 61 videos that met the selection criteria were scored and their length, days since upload, and numbers of views, likes, dislikes, and comments were recorded. These data were used to calculate the interaction index and viewing rate. Video reliability was assessed using a five-item modified DISCERN index, and video quality was assessed using the Video Information and Quality Index. A 10-item content usefulness index was created to determine the usefulness of the video content. Descriptive statistics of the parameters were calculated, and correlation coefficients were calculated to evaluate the relationships between the parameters. Results: The mean reliability score was 2.75±1.02 (out of 5), and the total quality score was 11.80±3.38 (out of 20). The total content usefulness index was quite low, with a mean score of 2.52±2.14 (out of 10). Interaction index and viewing rate were positively correlated with reliability score (r=0.463, p<0.01; r=0.295, p<0.05) and total quality score (r=0.365, p<0.01; r=0.295, p<0.01, respectively). The reliability score was positively correlated with the total quality score (r=0.842, p<0.01) and total content usefulness index (r=0.346, p<0.01). Conclusion: Videos about orthodontic aligner treatment have average reliability and quality but largely insufficient content. [ABSTRACT FROM AUTHOR]
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- 2024
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33. Tratamento da Classe II subdivisão por meio de distalização com Invisalign: relato de caso clínico.
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PRADO, Eduardo
- Abstract
Copyright of Clinical Orthodontics is the property of Dental Press International and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2024
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34. Awareness Regarding the use of Clear Aligners as an Orthodontic Treatment Modality among the General Population of Maharashtra, India: A Cross-sectional Survey
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Renuka Pawar, Tanya Prasad, chanamallapa r ganiger, Sandesh Phaphe, Yusuf Ahammed, Pratap Mane, and Seema Patil
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clear trays ,invisalign ,modern orthodontic treatment ,removable orthodontic appliances ,Medicine - Abstract
Introduction: Fixed orthodontic treatment has been the standard method to treat malocclusions for decades; however, the number of adults seeking more inconspicuous ways to enhance their smiles has significantly increased. This trend has led to the rising popularity of clear aligners among the general population, hailed as the 'invisible treatment' for correcting misaligned teeth. Aim: To assess the level of awareness among residents of Maharashtra regarding clear aligners. Materials and Methods: A cross-sectional study was conducted at the Department of Orthodontics and Dentofacial Orthopaedics, School of Dental Sciences, Krishna Vishwa Vidyapeeth (KVV) Karad, Maharashtra, India with a sample size of 423 participants. An online survey on awareness and perceptions of clear aligners among the general population of Maharashtra was carried out for one month through the dissemination of an online questionnaire. The questionnaire was administered using Google Forms and consisted of 12 closed-ended questions. The online data was collected and analysed while assessing its content validity. Results: The mean age of the study participants was 28.4±5.88 years. According to the survey, 203 (47.99%) participants had visited an orthodontist, with 87 (43.03%) receiving clear aligner recommendations as a treatment option. Notably, 266 (62.88%) were already familiar with clear aligners, and 268 (63.36%) considered them to be an effective treatment. Conclusion: The study findings indicated that 62.88% of participants had prior knowledge of clear aligners, while only 47.99% had visited an orthodontist.
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- 2024
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35. Assessment of dental, skeletal, and soft tissue changes following mandibular advancement with Invisalign in skeletal Class II
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Hassan Al Subaie, Ghassan Alturki, Fahad Alsulaimani, Salma Ghoneim, and Hosam Baeshen
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Class II ,Invisalign ,Clear aligner ,Malocclusion ,Mandibular advancement ,Functional appliances ,Medicine ,Dentistry ,RK1-715 - Abstract
Objective: This study evaluated the dentoskeletal and soft tissue changes for Class II malocclusion patients treated with Invisalign clear aligners with mandibular wings (IAMW). Methods: This retrospective study included 50 skeletal Class II patients treated with Invisalign clear aligner with mandibular wings. Records of 20 subjects were collected from the AAOF Legacy Collection (The Case Western Bolton Brush Growth Study) and were used as a control. The dental, skeletal, and facial soft tissue changes were assessed by digitizing and analyzing lateral cephalograms using Dolphin Imaging software (version 11.95 Premium; Dolphin Imaging & Management Solutions, Chatsworth, Calif). Paired t-tests and independent t-tests were used to assess the changes before and after and to compare between the IAMW and control groups. Results: The different measurements of the maxilla have shown that IAMW effect on the maxilla included minimal, non-significant retraction compared to the control group. The SNB and mandibular base position increased by 1.17° (±2.63) and 3.79 (±8.13), respectively. The mandible advanced significantly in the treatment group compared to the control group. Dentally, the lower incisors tipped slightly buccally, but the change was not significant (p > 0.05). The facial convexity angle decreased by 1.16° (±4.36). Conclusion: Invisalign clear aligner with mandibular advancer wings was able to correct the Class II malocclusion. This correction was mainly skeletal with some dental changes. This device can be used to address the growth modification problem in Class II malocclusion at the same time as addressing the other occlusal problems.
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- 2024
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36. Effectiveness of the Invisalign Mandibular Advancement Appliance in Children with Class II Division 1 Malocclusion
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So-Youn An, Hyeon-Jin Kim, Ho-Uk Lee, Sang-Ho Bak, Hyo-Jin Kang, and Youn-Soo Shim
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class ii malocclusion ,clear aligner ,invisalign ,mandibular advancement ,Dentistry ,RK1-715 - Abstract
Background: This study aimed to determine the skeletal and dental effects in pediatric and adolescent Korean patients with Class II Division 1 malocclusion treated using the Invisalign Mandibular Advancement (MAⓇ) appliance. Methods: The study included patients aged 6 to 18 years who received orthodontic treatment with the MAⓇ appliance for Class II Division 1 malocclusion at the Department of Pediatric Dentistry, Wonkwnag University Daejeon Dental Hospital, between July 1, 2018, and December 31, 2021. The treatment group consisted of 20 patients, 10 boys and 10 girls. The control participants were also 10 boys and 10 girls. Lateral cephalometric radiographs were taken before and after treatment, and 41 measurements of skeletal and dental changes were measured and analyzed using the V-CephTM 8.0 (Osstem Implant). All analyses were performed using SPSS software (IBM SPSS for Windows, ver 26.0; IBM Corp.), and statistical significance was tested using paired and independent samples t-tests for within-group and between-group comparisons, respectively. Results: The patients in the treatment group showed significant decreases in ANB (A point, Nasion, B point), maxillary protrusion, maxillary anterior incisor labial inclination, and maxillary protrusion after treatment. However, when compared with the growth changes observed in the control group, only ANB and maxillary protrusion decreased, with no significant differences in SNA, SNB, and mandibular length. Conclusion: Collectively, the results of this study confirm that the use of MAⓇ appliance in pediatric and adolescent Korean patients with Class II Division 1 malocclusion results in a reduction of anteroposterior skeletal and dental disharmony.
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- 2023
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37. Clinical outcomes of arch expansion with Invisalign: a systematic review
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Songyang Ma and Yunji Wang
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Invisalign ,Aligner ,Expansion ,Efficacy ,Predictability ,Dentistry ,RK1-715 - Abstract
Abstract Objective This study aims to assess the scientific evidence regarding the clinical outcomes of Invisalign therapy in controlling orthodontic tooth movement. Materials and methods An electronic search was conducted on PubMed, Cochrane Library, Web of Science, Embase, and Scopus from November 2015 to November 2022 to identify relevant articles. Methodological shortcomings were highlighted, and an evaluation of the quality of the included studies was completed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. Results Fifteen non-randomized controlled trials were included in the analysis. Most non-randomized controlled trials (n=11; 73%) were rated with a moderate risk of bias according to the ROBINS-I tool. There were statistically significant differences between the pretreatment and posttreatment arches. The average expansion was significantly different from that predicted for each type of tooth in both the maxilla and mandible. Furthermore, the efficiency decreased from the anterior area to the posterior area in the upper arch. Conclusion Despite the fact that arch expansion with Invisalign® is not entirely predictable, clear aligner treatment is a viable option for addressing dentition crowding. The efficacy of expansion is greatest in the premolar area. More research focusing on treatment outcomes with different materials of aligners should be conducted in the future. Overcorrection should be considered when planning arch expansion with Invisalign. In the maxilla, the expansion rate decreases from the anterior to the posterior, and presetting sufficient buccal root torque of posterior teeth may result in improved efficiency of expansion.
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- 2023
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38. Effectiveness of invisalign treatment on open bite correction
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Lishna Karalikkattil T, Namit Batra, C R Vivek, Vivek Reddy, Priya Manimegalan, and Athul Tom
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clear aligners ,invisalign ,malocclusion ,open bite ,orthodontic treatment ,overbite correction ,Pharmacy and materia medica ,RS1-441 ,Analytical chemistry ,QD71-142 - Abstract
Background: Open bite is a common orthodontic malocclusion that can have functional and aesthetic implications. Traditional orthodontic treatments have been used to correct open bites, but the effectiveness of Invisalign, a clear aligner therapy, in open bite correction remains a topic of interest. Materials and Methods: A retrospective analysis was conducted on a cohort of 50 patients with open bites who underwent Invisalign treatment. Pre-treatment and post-treatment records, including cephalometric radiographs, dental models, and clinical photographs, were assessed. The open bite was defined as a negative overbite greater than 2 mm. Treatment duration, number of aligners used, and patient compliance were also recorded. Statistical analysis, including paired t-tests and subjective patient feedback, was employed to evaluate the treatment outcomes. Results: The mean pre-treatment open bite was -3.5 mm (SD = 1.2), and the mean treatment duration was 18 months (SD = 2.5). On average, patients received 24 sets of aligners (SD = 4.1) during the treatment. Post-treatment evaluation showed that the mean overbite improved to + 1.5 mm (SD = 0.8), indicating successful open bite correction. The paired t-test revealed a statistically significant difference between pre-treatment and post-treatment open bite measurements (P < 0.001). Patient satisfaction was high, with 90% of participants reporting improved aesthetics and comfort. Conclusion: Invisalign treatment demonstrates effectiveness in correcting open bites, with statistically significant improvements in overbite measurements.
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- 2024
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39. Predicted and achieved overjet and overbite measurements with the Invisalign appliance: a retrospective study.
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Meade, Maurice J. and Weir, Tony
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ORTHOGNATHIC surgery ,CORRECTIVE orthodontics ,RETROSPECTIVE studies ,ORTHODONTIC appliances - Abstract
The article informs about a retrospective study evaluating the alignment outcomes of Invisalign aligner treatment by comparing predicted and achieved overjet and overbite measurements. Topics include the methodology involving ClinCheck Pro data, statistical analyses revealing significant differences between predicted and achieved outcomes, and the conclusion that planned changes in overjet and overbite differed significantly from actual results.
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- 2024
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40. Predicted overbite and overjet changes with the Invisalign appliance: a validation study.
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Meade, Maurice J., Blundell, Haylea, and Weir, Tony
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CORRECTIVE orthodontics ,CONFIDENCE intervals ,MALOCCLUSION ,MEDICAL sciences ,ORTHODONTIC appliances - Abstract
The article informs about a validation study that investigated the consistency between predicted changes in overbite (OB) and overjet (OJ) in Align Technology's digital treatment plan for Invisalign and the actual changes measured with Geomagic Control X software. Topic include the results showed a high level of agreement, indicating that ClinCheck's digital treatment-planning facility provides valid data regarding OB and OJ changes during the prescribed Invisalign treatment.
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- 2024
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41. Assessment of dental, skeletal, and soft tissue changes following mandibular advancement with Invisalign in skeletal Class II.
- Author
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Al Subaie, Hassan, Alturki, Ghassan, Alsulaimani, Fahad, Ghoneim, Salma, and Baeshen, Hosam
- Abstract
This study evaluated the dentoskeletal and soft tissue changes for Class II malocclusion patients treated with Invisalign clear aligners with mandibular wings (IAMW). This retrospective study included 50 skeletal Class II patients treated with Invisalign clear aligner with mandibular wings. Records of 20 subjects were collected from the AAOF Legacy Collection (The Case Western Bolton Brush Growth Study) and were used as a control. The dental, skeletal, and facial soft tissue changes were assessed by digitizing and analyzing lateral cephalograms using Dolphin Imaging software (version 11.95 Premium; Dolphin Imaging & Management Solutions, Chatsworth, Calif). Paired t-tests and independent t-tests were used to assess the changes before and after and to compare between the IAMW and control groups. The different measurements of the maxilla have shown that IAMW effect on the maxilla included minimal, non-significant retraction compared to the control group. The SNB and mandibular base position increased by 1.17° (±2.63) and 3.79 (±8.13), respectively. The mandible advanced significantly in the treatment group compared to the control group. Dentally, the lower incisors tipped slightly buccally, but the change was not significant (p > 0.05). The facial convexity angle decreased by 1.16° (±4.36). Invisalign clear aligner with mandibular advancer wings was able to correct the Class II malocclusion. This correction was mainly skeletal with some dental changes. This device can be used to address the growth modification problem in Class II malocclusion at the same time as addressing the other occlusal problems. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
42. Comparison of the quality of 3D digital setups created by Invisalign and an orthodontist.
- Author
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Shelley, Jacob, Foley, Patrick, Bankhead, Brent, Adel, Samar M., and Ki Beom Kim
- Subjects
ORTHODONTISTS ,ORTHODONTICS ,DIGITAL health ,MALOCCLUSION ,TREATMENT effectiveness - Published
- 2024
43. Hybrid approach for resolution of severe crowding using a combination of aligners with modified expansion splints.
- Author
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Sayahpour, Babak, Eslami, Sara, Goteni, Malcolm, Majdani, Aleksandra, Plein, Nicolas, Kopp, Stefan, and Buehling, Sarah
- Subjects
PERIODONTAL splints ,ORTHODONTIC appliances ,TREATMENT duration ,MEDICAL care costs ,DENTAL arch - Published
- 2024
44. Levels of Inflammatory and Bone Metabolic Markers in the Gingival Crevicular Fluid of Individuals Undergoing Fixed Orthodontic Treatment in Comparison to Those Utilizing Invisalign.
- Author
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Alnazeh, Abdullah A., Kamran, Muhammad Abdullah, Aseeri, Yahya, Alrwuili, Mohammad Raji, Aljabab, Mohammed Ahmed, Baig, Eisha Abrar, and Hameed, Mohammad Shahul
- Subjects
GINGIVAL fluid ,CORRECTIVE orthodontics ,GINGIVAL hemorrhage ,ENZYME-linked immunosorbent assay ,MAXILLARY expansion ,CEREBROSPINAL fluid - Abstract
Background and Objectives: Evaluation of the levels of cytokine and bone metabolic biomarkers (BMBs) in patients receiving fixed orthodontic therapy (FOT) and Invisalign. Materials and Methods: Sixty participants were enrolled after meeting the predefined inclusion criteria. Patients then underwent either FOT or Invisalign by allocating them randomly to each group (n = 30). The basic periodontal assessment was performed, including the plaque index (PI), gingival index (GI), and bleeding on probing (BoP), at baseline and again after 4 weeks. Gingival crevicular fluid (GCF) samples were taken from each individual at baseline and after 4 weeks. An enzyme-linked immunosorbent assay (ELISA) technique was used to determine the cytokine and BMB levels. An unpaired t-test compared the FOT and Invisalign group's means and SDs. Paired t-tests examined the difference between T0 baseline and T1. Results: Patients treated with either FOT or Invisalign presented no statistically significant difference in terms of periodontal parameters such as PI, GI, and BoP (p > 0.05). The levels of IL-6 were significantly higher in patients treated with FOT as compared to Invisalign at T1 (p < 0.05) The other tested cytokines, IL-10, 13, 17, and GM-CSF, were not significantly different in either the FOT or Invisalign group at baseline and 4 weeks follow-up (p > 0.05). Regarding BMBs, it was detected that NTx and OC levels in both of the investigated groups were not significantly different at baseline and after 4 weeks (p > 0.05). However, NTx levels rose significantly (p < 0.05) and OC levels fell from T0 to T1. Conclusions: FOT and Invisalign displayed comparable outcomes in terms of cytokine and BMB levels. However, only IL-6 and NTx were significantly different at week 4 from baseline. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
45. The predictability of maxillary curve of Spee leveling with the Invisalign appliance.
- Author
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Lim, Zi Wei, Meade, Maurice J., and Weir, Tony
- Subjects
CORRECTIVE orthodontics ,MOLARS ,MALOCCLUSION ,DENTAL arch ,INCISORS ,PERMANENT dentition ,ORTHODONTIC appliances - Abstract
The article discusses the predictability of the Invisalign appliance in leveling the maxillary curve of Spee, finding a significant difference between predicted and actual outcomes. Topics include the limitations of Invisalign in predicting vertical movements, challenges in managing deep overbites, and discrepancies in planned intrusive and extrusive movements for different teeth.
- Published
- 2023
- Full Text
- View/download PDF
46. Efficiency and Predictability of Coronal Maxillary Expansion Repercussion with the Aligners System: A Retrospective Study.
- Author
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Rocha, Ana Sofia, Gonçalves, Maria, Oliveira, Ana Catarina, Azevedo, Rui M. S., and Pinho, Teresa
- Subjects
MAXILLARY expansion ,ORTHODONTIC appliances ,PERMANENT dentition ,MOLARS ,CORRECTIVE orthodontics ,TOOTH mobility - Abstract
The Invisalign
® system (SmartForce® G8) aims to guarantee aesthetics and provide good orthodontic treatment results. Dentoalveolar expansion is possible with clear aligners and can be used to correct dentoalveolar crossbite, resolve crowding or modify the arch shape. Despite the treatment's effectiveness, there is still disagreement among professionals concerning its true clinical potential. This study aimed to analyze the effectiveness and predictability of coronal tooth expansion movement in permanent dentition in patients who had completed the first phase of treatment with Invisalign® orthodontic aligners. Materials and Methods: The tooth movement tables of 75 previously selected cases were analyzed in terms of dental-arch width and expansion efficiency, through the Invisalign® platform, considering the pre-treatment (T0), planned treatment (TP) and post-treatment models (T1) using ClinCheck Pro® 6.0 software. All patients were treated by an orthodontic specialist and Invisalign® Diamond Provider in a private practice (T.P.). Results: Difference between T1 and T0: for each maxillary and mandibular measurement, there was a statistically significant difference between pre- and post-aligner treatment values. The greatest amount of expansion occurred in both the upper and the lower premolars. Difference between TP and T1: for each maxillary measurement, statistically significant differences were verified for the molar and canine. At the mandibular level, statistically significant differences were only verified in the first molar. Conclusions: The Invisalign® clear aligners are effective for simultaneous intra-arch expansion in both jaws. [ABSTRACT FROM AUTHOR]- Published
- 2023
- Full Text
- View/download PDF
47. Awareness Regarding the use of Clear Aligners as an Orthodontic Treatment Modality among the General Population of Maharashtra, India: A Cross-sectional Survey.
- Author
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PAWAR, RENUKA, PRASAD, TANYA, GANIGER, CHANAMALLAPA R., PHAPHE, SANDESH, AHAMMED, YUSUF, MANE, PRATAP, and PATIL, SEEMA
- Subjects
- *
ORTHODONTIC appliances , *CORRECTIVE orthodontics , *TEST validity , *AWARENESS , *ORTHODONTICS - Abstract
Introduction: Fixed orthodontic treatment has been the standard method to treat malocclusions for decades; however, the number of adults seeking more inconspicuous ways to enhance their smiles has significantly increased. This trend has led to the rising popularity of clear aligners among the general population, hailed as the 'invisible treatment' for correcting misaligned teeth. Aim: To assess the level of awareness among residents of Maharashtra regarding clear aligners. Materials and Methods: A cross-sectional study was conducted at the Department of Orthodontics and Dentofacial Orthopaedics, School of Dental Sciences, Krishna Vishwa Vidyapeeth (KVV) Karad, Maharashtra, India with a sample size of 423 participants. An online survey on awareness and perceptions of clear aligners among the general population of Maharashtra was carried out for one month through the dissemination of an online questionnaire. The questionnaire was administered using Google Forms and consisted of 12 closed-ended questions. The online data was collected and analysed while assessing its content validity. Results: The mean age of the study participants was 28.4±5.88 years. According to the survey, 203 (47.99%) participants had visited an orthodontist, with 87 (43.03%) receiving clear aligner recommendations as a treatment option. Notably, 266 (62.88%) were already familiar with clear aligners, and 268 (63.36%) considered them to be an effective treatment. Conclusion: The study findings indicated that 62.88% of participants had prior knowledge of clear aligners, while only 47.99% had visited an orthodontist. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
48. Effectiveness of invisalign treatment on open bite correction.
- Author
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T, Lishna, Batra, Namit, Vivek, C, Reddy, Vivek, Manimegalan, Priya, and Tom, Athul
- Subjects
- *
TREATMENT effectiveness , *ORTHODONTIC appliances , *PATIENT satisfaction , *PATIENT compliance , *CORRECTIVE orthodontics - Abstract
Background: Open bite is a common orthodontic malocclusion that can have functional and aesthetic implications. Traditional orthodontic treatments have been used to correct open bites, but the effectiveness of Invisalign, a clear aligner therapy, in open bite correction remains a topic of interest. Materials and Methods: A retrospective analysis was conducted on a cohort of 50 patients with open bites who underwent Invisalign treatment. Pre-treatment and post-treatment records, including cephalometric radiographs, dental models, and clinical photographs, were assessed. The open bite was defined as a negative overbite greater than 2 mm. Treatment duration, number of aligners used, and patient compliance were also recorded. Statistical analysis, including paired t-tests and subjective patient feedback, was employed to evaluate the treatment outcomes. Results: The mean pre-treatment open bite was -3.5 mm (SD = 1.2), and the mean treatment duration was 18 months (SD = 2.5). On average, patients received 24 sets of aligners (SD = 4.1) during the treatment. Post-treatment evaluation showed that the mean overbite improved to + 1.5 mm (SD = 0.8), indicating successful open bite correction. The paired t-test revealed a statistically significant difference between pre-treatment and post-treatment open bite measurements (P < 0.001). Patient satisfaction was high, with 90% of participants reporting improved aesthetics and comfort. Conclusion: Invisalign treatment demonstrates effectiveness in correcting open bites, with statistically significant improvements in overbite measurements. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
49. The predictability of maxillary curve of Wilson leveling with the Invisalign appliance.
- Author
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Lim, Zi Wei, Weir, Tony, and Meade, Maurice J.
- Abstract
• Average maxillary curve of Wilson increased more than the prescribed outcome using Invisalign. • Inclination of maxillary posterior teeth demonstrated an unintended buccal crown tip. • Except for the second molars, arch width expansion was consistently underexpressed. • Second molars overexpressed expansion mostly because of an unintended buccal crown tip. This retrospective study aims to evaluate the predictability of the Invisalign appliance (Align Technology, Santa Clara, CA) in leveling the maxillary curve of Wilson (COW). 53 adult subjects treated by orthodontists who are experienced Invisalign providers, between 2013 and 2019 were selected. All patients had either Angle Class I or II malocclusions and were treated by non-extraction in the maxillary arch with a minimum of 14 Invisalign aligners with no bite ramps or auxiliaries. Initial, predicted, and actual outcomes were analyzed with Geomagic Control X software (3D systems, Rock Hill, SC; Version 2017.0.3). Despite planning mean (SD) COW leveling of 0.25 mm (1.91), the curve became significantly more pronounced by 1.15 mm (0.85) (P <.001). There was a significant overexpression of buccal inclinations between mean prescribed versus actual values from 0.10 mm (0.39) (P =.007) to 0.29 mm (0.47) (P <.001) from the first premolars to the second molars, respectively. These differences were more pronounced posteriorly. The differences between the predicted and actual arch width values were underexpressed for all teeth except the second molars; a mean underexpression between 0.28 mm (0.92) and 0.60 mm (1.14). The second molars were the only teeth to overexpress with a mean of 0.42 mm (1.02). Overall mean maxillary COW was not predictably controlled with Invisalign. The appliance tends to overexpress the buccal crown tip regardless of prescribed direction, especially posteriorly. Arch expansion was underexpressed at all levels of the arch except for second molars which overexpressed by almost four times. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
50. Root resorption after Invisalign therapy.
- Author
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Groß, Ann-Sophie, Haubrich, Julia, Schupp, Werner, and Bourauel, Christoph
- Subjects
ORTHODONTICS ,DENTISTRY ,ROOT resorption (Teeth) ,APICOECTOMY ,ORTHOPEDICS - Published
- 2023
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