Department of Orthodontics, Medical University of Innsbruck, Innsbruck, Austria.
Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Innsbruck, Austria.
Clin Oral Investig. 2021 Jul;25(7):4671-4679. doi: 10.1007/s00784-021-03780-4. Epub 2021 Jan 20.
To evaluate the precision of aligner (Invisalign®) treatment with the current material (SmartTrack®) in achieving expansion or contraction of the maxilla and occlusal contacts as simulated in the proprietary planning software (ClinCheck®, CC).
Thirty patients thus treated were retrospectively evaluated. Four maxillary models were analyzed per patient: a pretreatment model, a scan-based CC model, a posttreatment clinical model, and a CC model reflecting the treatment outcome as initially simulated. Thirteen transverse parameters were measured on each model separately by two investigators. Occlusal contacts were also analyzed.
The measuring method was validated by both investigators arriving at similar results for the effectiveness by which the simulated treatment goals had been clinically achieved. Significant differences (p < 0.05; Wilcoxon signed-rank test) were observed for transfer precision from the casts to the planning software and between the simulated and clinical outcomes. Intense occlusal contacts in the simulations materialized less common (≈ 2%) than ideal contacts (≈ 60%) in the clinical outcomes.
The effectiveness of achieving the simulated transverse goals was 45% and was generally not found to be better with SmartTrack® than with the previously used Ex30® material. Out of 100 simulated occlusal contacts, 40 will never materialize, and achieving around 60 will adequately ensure a clinically favorable contact pattern.
With the caveat that any overcorrection will to some extent reduce the precision, it seems perfectly possible to make deliberate use of overcorrection in current aligner therapies for transverse maxillary expansion or contraction.
评估隐形矫治器（Invisalign®）治疗与当前材料（SmartTrack®）在实现上颌扩张或收缩以及模拟专有规划软件（ClinCheck®，CC）中的咬合接触方面的精确性。
对 30 名接受治疗的患者进行回顾性评估。每位患者分析 4 个上颌模型：治疗前模型、基于扫描的 CC 模型、治疗后临床模型以及反映初始模拟治疗结果的 CC 模型。两位研究者分别对每个模型进行了 13 项横向参数测量。还分析了咬合接触。
两位研究者均得出相似的结果，证明了模拟治疗目标的有效性，从而验证了测量方法的有效性。在从印模转移到规划软件以及模拟结果和临床结果之间观察到显著差异（p < 0.05；Wilcoxon 符号秩检验）。在模拟中，密集的咬合接触实现的情况比理想接触（≈60%）更少见（≈2%）。
实现模拟横向目标的有效性为 45%，并且通常发现 SmartTrack®材料并不比之前使用的 Ex30®材料更好。在 100 个模拟的咬合接触中，有 40 个永远不会实现，而实现大约 60 个就足以确保临床上有利的接触模式。
需要注意的是，任何过度矫正在某种程度上都会降低精度，但在当前的隐形矫治器治疗中，对横向上颌扩张或收缩进行刻意的过度矫正似乎是完全可行的。
