Keilig Ludger, Fittgen Anna, Schneider Helen, Sifa Rafet, Schwarze Jörg, Bourauel Christoph, Konermann Anna
Oral Technology, University Hospital Bonn, 53111 Bonn, Germany.
Department of Prosthodontics, University Hospital Bonn, 53111 Bonn, Germany.
J Clin Med. 2024 Apr 16;13(8):2298. doi: 10.3390/jcm13082298.
The attainment of precise posterior occlusion alignment necessitates a deeper understanding of the clinical efficacy of aligner therapy. This study aims to determine whether the treatment goals defined in the virtual planning of aligner therapy are effectively implemented in clinical practice, with a particular focus on the influence of distalization distances on potential vertical side effects. In this retrospective, non-interventional investigation, a cohort of 20 individuals undergoing Invisalign treatment was examined. Pre- and post-treatment maxillary clinical and ClinCheck casts were superimposed utilizing a surface-surface matching algorithm on palatal folds, median palatine raphe, and unmoved teeth as the stable references. The effectivity of planned versus clinical movements was evaluated. Groupings were based on distalization distances, planned vertical movements, and Class II elastic prescription. Statistics were performed with a two-sample t-test and -value < 0.05. Clinically achieved distalization was significantly lower than virtually planned distalization, regardless of additional vertical movements, where a lack of implementation was contingent upon the extent of distalization, with no mitigating effects observed with the application of Class II elastics. Intriguingly, no adverse vertical side effects were noted; however, the intended intrusions or extrusions, as per the therapeutic plans, remained unattainable regardless of the magnitude of distalization. These findings underscore the imperative for future investigations to delve deeper into the intricacies surrounding translational mesio-distal and vertical movements, thereby enhancing predictability within orthodontic practice. To facilitate successful clinical implementation of vertical and translational movements via aligners, the incorporation of sliders emerges as a promising strategy for bolstering anchorage reinforcement.
要实现精确的后牙咬合对齐，需要更深入地了解隐形矫治器治疗的临床效果。本研究旨在确定隐形矫治器治疗虚拟计划中定义的治疗目标在临床实践中是否得到有效实施，特别关注远移距离对潜在垂直副作用的影响。在这项回顾性、非干预性研究中，对20名接受隐适美治疗的个体进行了检查。治疗前和治疗后的上颌临床模型和ClinCheck模型利用表面-表面匹配算法，以上腭皱襞、腭中缝和未移动的牙齿作为稳定参考进行叠加。评估计划移动与临床移动的有效性。分组基于远移距离、计划垂直移动和II类弹力牵引的使用情况。采用双样本t检验进行统计分析，P值<0.05。无论额外的垂直移动如何，临床实现的远移显著低于虚拟计划的远移，其中实施不足取决于远移的程度，使用II类弹力牵引未观察到缓解作用。有趣的是，未发现不良垂直副作用；然而，根据治疗计划预期的内收或伸长，无论远移程度如何，仍然无法实现。这些发现强调了未来研究有必要更深入地探究平移近远中向和垂直移动周围的复杂性，从而提高正畸实践中的可预测性。为了促进通过隐形矫治器成功实现垂直和平移移动，纳入滑动装置似乎是加强支抗的一种有前景的策略。
