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American Journal of Orthodontics and... Jan 2021This research aimed to determine whether Class II malocclusion can be treated with clear aligners after completing treatment with the initial set of aligners.
INTRODUCTION
This research aimed to determine whether Class II malocclusion can be treated with clear aligners after completing treatment with the initial set of aligners.
METHODS
A sample of 80 adult patients were divided into Group 1 with Class I molar malocclusions (n = 40 [11 men and 29 women]; 38.70 ± 15.90 years) and Group 2 with Class II molar malocclusions (n = 40 [11 men and 29 women]; 35.25 ± 15.21 years). All patients had finished treatment with the initial set of Invisalign aligners (Align Technology, Santa Jose, Calif) without known centric occlusion-centric relation discrepancies, issues of compliance, or overcorrection. The 7 measurements using the American Board of Orthodontics (ABO) Model Grading System and millimetric measurements for anteroposterior (AP) and vertical dimensions were assessed and compared between the 2 groups at pretreatment, posttreatment ClinCheck (Align Technology) prediction, and posttreatment.
RESULTS
No improvements were observed in the AP correction. The amount of AP correction in patients with Class II malocclusion was 6.8% of the predicted amount. The amount of overbite correction achieved was 28.8% and 38.9% of the predicted amounts in patients with Class I and Class II malocclusion, respectively. Significant improvements in alignment and interproximal contact scores were observed, with only slight improvements in total ABO scores. An increase in mean occlusal contacts score was observed after treatment. No patient with Class II malocclusions would meet the ABO standards after Invisalign treatment.
CONCLUSIONS
The Invisalign system successfully achieves certain tooth movements but fails to achieve other movements predictably. No significant Class II correction or overjet reduction was observed with elastics for an average of 7-month duration in the adult population. Additional refinements may be necessary to address problems created during treatment, as evidenced by a posterior open bite incidence.
Topics: Adult; Cephalometry; Female; Humans; Male; Malocclusion; Malocclusion, Angle Class I; Malocclusion, Angle Class II; Orthodontic Appliances, Removable; Tooth Movement Techniques
PubMed: 33223374
DOI: 10.1016/j.ajodo.2020.08.016 -
Nutrients Nov 2020The purpose of this systematic review was to analyze the available literature about the influence of breastfeeding in primary and mixed dentition on different types of...
BACKGROUND
The purpose of this systematic review was to analyze the available literature about the influence of breastfeeding in primary and mixed dentition on different types of malocclusions.
METHODS
Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines were used to perform the present review. The following electronic databases were searched: Pubmed, Evidence-Based Medicine Reviews (EBMR), Embase, Cochrane Library, Medline, Web of Science and Ovid.
RESULTS
A primary research found a total of 279 articles. Two more papers were also considered from the gray literature. Two hundred sixty-three articles were excluded as they were deemed irrelevant on the basis of: duplicates, title, abstract, methods and/or irrelevant contents. Eighteen papers were selected and included in the qualitative analysis.
CONCLUSIONS
breastfeeding is a positive factor that seems to reduce the incidence of posterior crossbite, skeletal class II and distoclusion in primary and mixed dentition. A sort of positive relationship between months of breastfeeding and risk reduction seems to exist. More longitudinal research is needed to avoid bias in the results, with data collected prospectively on the months of exclusive breastfeeding, by means of specific questionnaires and successive clinical evaluation of the occlusal condition at the primary dentition, mixed dentition and permanent dentition stages.
Topics: Bottle Feeding; Breast Feeding; Databases, Factual; Dentition; Evaluation Studies as Topic; Humans; Malocclusion; Meta-Analysis as Topic; Randomized Controlled Trials as Topic
PubMed: 33265907
DOI: 10.3390/nu12123688 -
Clinical Oral Investigations Mar 2022To evaluate the available evidence regarding clinical effectiveness of clear aligner treatment (CAT). (Review)
Review
OBJECTIVE
To evaluate the available evidence regarding clinical effectiveness of clear aligner treatment (CAT).
MATERIALS AND METHODS
A comprehensive literature search was conducted for systematic reviews investigating effectiveness of CAT published up to July 15, 2021. This was accomplished using different electronic databases. No language restriction was applied. Screening, quality assessment, and data extraction were performed by two authors independently. Information was categorized and narratively synthesized for the key findings from moderate and high-quality reviews.
RESULTS
A total of 361 potentially eligible reviews were identified. After excluding the non-relevant/low-quality reviews, 18 systematic reviews were included. CAT was found to be effective for mild to moderate malocclusions, and was associated with inferior outcomes when treating severe cases or with achieving specific tooth movements. There were conflicting results regarding treatment duration; however, CAT may be associated with shorter treatment in mild to moderate cases. Relapse was greater with CAT, while periodontal health was better. The risk of root resorption tended to be lower with CAT. Regarding pain, the results were unclear, although CAT was found to be more comfortable and associated with a reduced impact on eating and chewing.
CONCLUSIONS
The level of evidence regarding CAT is moderate; hence, further high-quality randomized clinical trials are required. Evidence supports use of aligners as an alternate to fixed appliances in patients with mild-to-moderate malocclusion but not in severe cases. Advancement in technology could enhance the accuracy of CAT in delivering planned outcomes.
CLINICAL RELEVANCE
CAT can be used effectively for selected cases with mild to moderate malocclusion.
REGISTRATION
PROSPERO registration number: CRD42021246855.
Topics: Humans; Malocclusion; Orthodontic Appliances, Fixed; Orthodontic Appliances, Removable; Systematic Reviews as Topic; Treatment Outcome
PubMed: 34993617
DOI: 10.1007/s00784-021-04361-1 -
BMC Oral Health Mar 2022Malocclusion is highly reported among mixed dentition cases. Therefore, we aimed to determine the relationship of dental malocclusions in the vertical, transverse,...
BACKGROUND
Malocclusion is highly reported among mixed dentition cases. Therefore, we aimed to determine the relationship of dental malocclusions in the vertical, transverse, sagittal planes with deleterious habits in pediatric patients.
METHODS
A cross-sectional analytical study was carried out on 155 children aged 6-12 years attended at the clinic of the School of Dentistry of Universidad Nacional Mayor de San Marcos in 2017.
RESULTS
Among 155 evaluated patients, 45.3% had vertical malocclusion, 52.0% had sagittal malocclusion and 13.6% had transverse malocclusion. The most frequent type of malocclusion in the vertical plane was anterior deep bite (22.2%), in the transverse plane, the edge-to-edge bite (7.1%) and the anterior crossbite (6.5%) were less frequent. Finally, in the sagittal plane, Class II Div 1 (20%) and Class III (20.7%) were the most frequent. Among the most common deleterious habits, anteroposition (58.7%) and mixed breathing (51.0%) were observed in contrast to the habit of retroposition, lip sucking and mouth breathing, which were the least frequent. Considering age and sex, children who have an atypical swallowing habit are more likely to have malocclusion in all three planes of space.
CONCLUSIONS
It is concluded that there is an association between the deleterious habits with the different types of malocclusions in the different planes of the space, being the atypical swallowing a habit that should be early diagnosed and treated interdisciplinary.
Topics: Child; Cross-Sectional Studies; Dentition, Mixed; Fingersucking; Habits; Humans; Malocclusion; Prevalence
PubMed: 35321719
DOI: 10.1186/s12903-022-02122-4 -
American Journal of Orthodontics and... Nov 2023Anterior open bite correction with Invisalign has been claimed to have relatively good predictability because of the proposed function of clear aligners to function as...
INTRODUCTION
Anterior open bite correction with Invisalign has been claimed to have relatively good predictability because of the proposed function of clear aligners to function as occlusal bite-blocks, limiting extrusion of the posterior teeth or possibly even intruding posterior teeth. This proposal, however, remains relatively unsubstantiated. The objective of this study was to investigate and determine the accuracy of Invisalign treatment in correcting anterior open bite by comparing the predicted outcome from ClinCheck to the achieved outcome for the initial aligner sequence.
METHODS
A retrospective study used pretreatment and posttreatment intraoral scans and predicted outcomes (ClinCheck) stereolithography files of 76 adult patients from private specialist orthodontic practices. Inclusion criteria comprised nonextraction treatment, with a minimum of 14 dual arch Invisalign aligners. Geomagic Control X software was used to measure overbite and overjet in the pretreatment, posttreatment, and predicted outcomes stereolithography files for each patient.
RESULTS
Approximately 66.2% of the programmed open bite closure was expressed compared with the prescribed ClinCheck outcome. The use of posterior occlusal bite-blocks and prescribed movement of teeth via anterior extrusion, posterior intrusion, or a combination of the 2 made no difference to the efficacy of open bite closure. Two-week aligner changes resulted in 0.49 mm more bite closure on average.
CONCLUSIONS
The prescribed bite closure in ClinCheck software overestimates the bite closure that is clinically achieved.
Topics: Adult; Humans; Open Bite; Retrospective Studies; Malocclusion; Orthodontic Appliances, Removable; Malocclusion, Angle Class II; Tooth Movement Techniques; Overbite
PubMed: 37330726
DOI: 10.1016/j.ajodo.2023.04.017 -
Evidence-based Dentistry Mar 2020Design Systematic reviewStudy population Orthodontic patients undergoing treatment with removable thermoplastic retainers compared with conventional fixed orthodontic...
Design Systematic reviewStudy population Orthodontic patients undergoing treatment with removable thermoplastic retainers compared with conventional fixed orthodontic appliances. The mean age of patients was between 15 and 33 years. Data sources Six electronic databases including: Scopus, Web-of-Science, PubMed, Cochrane, Clinical Trials and Grey Literature were searched in addition to a search of references in eligible studies with no restriction of language. Out of 559 studies, 55 were eligible. Only four articles were included; three non-randomised and one randomised controlled trial (RCT) involving 96-182 patients. The studies included were completed within 2005-2016.Study selection Clinical trials involving orthodontic patients undergoing treatment using thermoplastic removeable aligners, namely Invisalign, in comparison to conventional fixed orthodontic appliances of either self-ligating or tip-edge bracket systems were included.Data extraction and synthesis Two members of the research team independently selected articles which fulfilled the inclusion criteria and compared results prior to data collection. A third party examiner was available to resolve disagreements. The study quality was analysed for presence of bias; three non-randomised studies were evaluated and scored using the Methodological Index for Non-Randomised Studies (MINORS), one study was considered high methodological quality, two were considered moderate. The RCT was assessed using the Cochrane Collaboration Common Scheme for Bias and was deemed to be low risk of bias. Results The results suggest that Invisalign can provide successful alignment, however, it poses difficulties in achieving occlusal contacts, buccolingual inclination and vertical movement of teeth. One study found that Invisalign cases are more susceptible to relapse, which can be explained through the tipping mechanism compared to bodily movement, of conventional fixed appliances. Furthermore some studies show that although using aligners can result in overall shorter treatment time the final occlusion was not favourable. The outcome of the RCT, showed that aligners can be successful in treating class I malocclusions in extraction cases.Conclusions This systematic review found that the use of clear aligners made no significant difference to treatment time compared with conventional appliances. Additionally, removable aligners were effective in crowding cases but had limitations in achieving favourable outcomes in the anterior-posterior position and final occlusion, as well as being more likely to relapse post treatment.
Topics: Adolescent; Adult; Esthetics, Dental; Humans; Malocclusion; Malocclusion, Angle Class I; Orthodontic Appliances, Fixed; Orthodontic Appliances, Removable; Young Adult
PubMed: 32221494
DOI: 10.1038/s41432-020-0079-5 -
The Angle Orthodontist Jul 2020To assess the efficacy and efficiency of treatment in adolescents presenting with mild malocclusions, comparing outcomes using clear aligners to fixed appliances.
OBJECTIVE
To assess the efficacy and efficiency of treatment in adolescents presenting with mild malocclusions, comparing outcomes using clear aligners to fixed appliances.
MATERIALS AND METHODS
Patients identified retrospectively and consecutively from one private practice had been treated with either clear aligners (Invisalign, Align Technology, Santa Clara, Calif) or fixed appliances (0.022 Damon, Ormco, Orange, Calif; n = 26/group). Assessments of occlusion were made using the American Board of Orthodontics Discrepancy Index (DI) for initial records and Cast-Radiograph Evaluation (CRE) for final records. Number of appointments, number of emergency visits, and overall treatment time were determined from chart reviews. Data were analyzed using Pearson's correlation, Wilcoxon rank tests, unpaired t-tests, and Chi-square tests, with significance set to P ≤ .05.
RESULTS
Pretreatment, the aligner and fixed groups showed no significant difference in overall severity (DI: 11.9 ± 5.3 vs 11.6 ± 4.8) or in any individual DI category. Posttreatment scores showed finishes for the aligner group had fewer discrepancies from ideal relative to the fixed appliance group (CRE: 30.1 ± 8.3 vs 37.0 ± 9.3; P < .01). Patients treated with aligners had fewer appointments (13.7 ± 4.4 vs 19.3 ± 3.6; P < .0001), fewer emergency visits (0.8 ± 1.0 vs 3.6 ± 2.5; P < .0001), and shorter overall treatment time (16.9 ± 5.7 vs 23.4 ± 4.4 months; P < .0001).
CONCLUSIONS
Outcomes for treatment of mild malocclusions in adolescents showed equivalent effectiveness of clear aligners compared to fixed appliances, with significantly improved results for clear aligner treatment in terms of tooth alignment, occlusal relations, and overjet. Assessment of the number of appointments, number of emergency visits, and overall treatment time showed better outcomes for treatment with clear aligners.
Topics: Adolescent; Humans; Malocclusion; Orthodontic Appliance Design; Orthodontic Appliances, Fixed; Orthodontic Appliances, Removable; Outcome Assessment, Health Care; Retrospective Studies; Treatment Outcome
PubMed: 33378505
DOI: 10.2319/122919-844.1 -
Dental Press Journal of Orthodontics 2020Anterior crossbite (AC) is defined as a reverse sagittal relationship between maxillary and mandibular incisors. According to an evidence-based orthodontic triage, the...
INTRODUCTION
Anterior crossbite (AC) is defined as a reverse sagittal relationship between maxillary and mandibular incisors. According to an evidence-based orthodontic triage, the treatment need of AC is indicated if any occlusal interference is forcing the mandible towards a Class III growth pattern. Removable and fixed appliances have been suggested to correct AC.
OBJECTIVE
The present report aims at presenting the benefits of an alternative therapy for the early treatment of anterior crossbite using clear aligners.
METHODS
Two cases of anterior crossbite corrected using clear aligners in 8-years-old children are presented.
RESULTS
In both cases, AC was successfully corrected within 5 months. At the end of the treatment, overjet and overbite were corrected. No major discomfort or speech impairment was noticed by the parents.
CONCLUSIONS
Due to the perceived shortcomings of alternative approaches, the use of clear aligners for correcting AC in mixed dentition should be considered as a comfortable and well tolerated appliance for young patients.
Topics: Child; Dentition, Mixed; Humans; Malocclusion; Malocclusion, Angle Class II; Orthodontic Appliances, Removable; Overbite
PubMed: 32965385
DOI: 10.1590/2177-6709.25.4.033-043.oar -
Journal of Orofacial Orthopedics =... Jan 2023One goal of orthodontic treatment in mixed dentition is to expand the maxillary arch to allow proper tooth alignment and a correction of sagittal and vertical...
BACKGROUND
One goal of orthodontic treatment in mixed dentition is to expand the maxillary arch to allow proper tooth alignment and a correction of sagittal and vertical malocclusions. However, for most treatment protocols, expected outcome is not really clear to allow for a standardization of phase I orthodontic treatments. This lack of information makes it difficult for clinicians to predict tooth movements, including transverse expansion efficacy with Invisalign® (Align Technology, Santa Clara, CA, USA) in children. Therefore, the aim of the present study was to evaluate the transverse maxillary arch development with the Invisalign First System® in growing subjects.
METHODS
The study group included 23 subjects (9 females, 14 males, mean age 9.4 ± 1.2 years). Patients were treated nonextraction with Invisalign First System® clear aligners with no auxiliaries other than Invisalign® attachments. Transverse interdental widths were measured only in the upper arch on each model at the start (T1) and at the end (T2) of treatment. A paired t‑test was chosen to compare T2-T1 changes. The level of significance was set at 5%.
RESULTS
The greatest increase of maxillary width was detected at the level of the upper first deciduous molars (+3.7 ± 1.4 mm; P < 0.001), followed by the level of the second deciduous molars (+3.4 ± 1.6 mm; P < 0.001) and by the deciduous canine (+2.6 ± 2.0 mm; P < 0.001). Upper first molars showed a greater expansion in the intermolar mesial width (+3.2 ± 1.2 mm; P < 0.001) than in the intermolar distal (+1.7 ± 1.2 mm; P < 0.001) and transpalatal width (+1.2 ± 1.2 mm; P < 0.01).
CONCLUSIONS
The Invisalign First System® can be considered effective in growing patients who require maxillary arch development. The greatest net increase was detected at the level of upper first deciduous molars, whereas the upper first molars showed a greater expansion in the intermolar mesial width due to a rotation that occurs around its palatal root.
Topics: Male; Female; Humans; Dentition, Mixed; Prospective Studies; Dental Arch; Malocclusion; Orthodontic Appliances, Removable
PubMed: 34477905
DOI: 10.1007/s00056-021-00332-z -
American Journal of Orthodontics and... Dec 2023
Topics: Humans; Malocclusion; Orthodontics, Corrective
PubMed: 38008489
DOI: 10.1016/j.ajodo.2023.09.007