Orthodontic Aligners: Current Perspectives for the Modern Orthodontic Office
Abstract
:1. Introduction
2. Beginning with the End in Mind
3. Clinical Effectiveness of Orthodontic Aligner Therapy
4. Materials
5. Commercial Aligner Companies
6. OAT Differentiations
7. Direct-to-Consumer (DTC) Aligners
8. Clinical Performance of Orthodontic Clear Aligners
9. Future Research
- Factors that determine the choice of 7-, 10-, or 14-day protocols for an aligner change.
- The in vivo performance of optimized versus conventional attachments for all types of tooth movements besides rotation and extrusion.
- The accuracy of the amount of interproximal reduction in the enamel determined by the software to facilitate the required tooth movement that will be clinically achieved.
- The magnitude and degree of overcorrection for the various types of tooth movements in order to compensate for the inherent limitation of the plastic material to fully express the desired tooth movement or to counteract unwanted tooth movement.
- The mid- and long-term outcomes of unplanned molar intrusion on the vertical settling of functional occlusion during retention.
- An improvement in the predictability of the software simulations of treatment outcomes that are realistically achievable clinically.
- The accuracy of the prediction of gingival margin height changes with tooth movement such as extrusion and intrusion.
10. Conclusions and Final Thoughts
Author Contributions
Funding
Informed Consent Statement
Conflicts of Interest
References
- Hartshorne, J.; Wertheimer, M.B. Emerging insights and new developments in clear aligner therapy: A review of the literature. AJO-DO Clin. Companion 2022, 2, 311–324. [Google Scholar] [CrossRef]
- Abu-Arqub, S.; Ahmida, A.; Da Cunha Godoy, L.; Kuo, C.L.; Upadhyay, M.; Yadav, S. Insight into clear aligner therapy protocols and preferences among members of the American Association of Orthodontists in the United States and Canada. Angle Orthod. 2023, 93, 417–426. [Google Scholar] [CrossRef] [PubMed]
- Baxmann, M.; Timm, L.H.; Schwendicke, F. Who Seeks Clear Aligner Therapy? A European Cross-National Real-World Data Analysis. Life 2022, 13, 65. [Google Scholar] [CrossRef] [PubMed]
- Best, A.D.; Shroff, B.; Carrico, C.K.; Lindauer, S.J. Treatment management between orthodontists and general practitioners performing clear aligner therapy. Angle Orthod. 2017, 87, 432–439. [Google Scholar] [CrossRef]
- Wheeler, T. Invisalign clinical trials needed. Am. J. Orthod. Dentofac. Orthop. 2005, 127, 527. [Google Scholar] [CrossRef] [PubMed]
- McKenna, S. Invisalign: Technology or mythology? J. Mass. Dent. Soc. 2001, 50, 8–9. [Google Scholar]
- Meade, M.J.; Ng, E.; Weir, T. Digital treatment planning and clear aligner therapy: A retrospective cohort study. J. Orthod. 2023, 14653125231166015. [Google Scholar] [CrossRef]
- Miller, K.B.; McGorray, S.P.; Womack, R.; Quintero, J.C.; Perelmuter, M.; Gibson, J.; Dolan, T.A.; Wheeler, T.T. A comparison of treatment impacts between Invisalign aligner and fixed appliance therapy during the first week of treatment. Am. J. Orthod. Dentofac. Orthop. 2007, 131, 302.e1–302.e9. [Google Scholar] [CrossRef]
- Kau, C.H.; Feinberg, K.B.; Christou, T. Effectiveness of Clear Aligners in Treating Patients with Anterior Open Bite: A Retrospective Analysis. J. Clin. Orthod. 2017, 51, 454–460. [Google Scholar]
- Zhao, Z.H. Clear aligner therapy: Risks and clinical strategies. Zhonghua Kou Qiang Yi Xue Za Zhi 2019, 54, 798–802. [Google Scholar]
- Kesling, H.D. Coordinating the predetermined pattern and tooth positioner with conventional treatment. Am. J. Orthod. Oral Surg. 1946, 32, 285–293. [Google Scholar] [CrossRef]
- Sheridan, J.J.; McMinn, R.; LeDoux, W. Essix thermosealed appliances: Various orthodontic uses. J. Clin. Orthod. 1995, 29, 108–113. [Google Scholar] [PubMed]
- Ponitz, R.J. Invisible retainers. Am. J. Orthod. 1971, 59, 266–272. [Google Scholar] [CrossRef] [PubMed]
- McNamara, J.A.; Kramer, K.L.; Juenker, J.P. Invisible retainers. J. Clin. Orthod. 1985, 19, 570–578. [Google Scholar] [PubMed]
- Vlaskalic, V.; Boyd, R.L. Clinical evolution of the Invisalign appliance. J. Calif. Dent. Assoc. 2002, 30, 769–776. [Google Scholar] [CrossRef]
- Gierie, W.V. Clear aligner therapy: An overview. J. Clin. Orthod. 2018, 52, 665–674. [Google Scholar]
- Lim, Z.W.; Meade, M.J.; Weir, T. The predictability of maxillary curve of Spee leveling with the Invisalign appliance. Angle Orthod. Epub ahead of print. 2023. [Google Scholar] [CrossRef] [PubMed]
- Xie, J.; Liu, F.; Sang, T.; Wu, J. Factors affecting the efficacy of Invisalign in anterior tooth rotation. Am. J. Orthod. Dentofac. Orthop. 2023, 163, 540–552.e2. [Google Scholar] [CrossRef]
- Tien, R.; Patel, V.; Chen, T.; Lavrin, I.; Naoum, S.; Lee, R.J.; Goonewardene, M.S. The predictability of expansion with Invisalign: A retrospective cohort study. Am. J. Orthod. Dentofac. Orthop. 2023, 163, 47–53. [Google Scholar] [CrossRef]
- Kumar, M.; Goyal, M.; Kaur, A. Has Invisalign improved? Am. J. Orthod. Dentofac. Orthop. 2021, 159, e73. [Google Scholar] [CrossRef]
- Ma, S.; Wang, Y. Clinical outcomes of arch expansion with Invisalign: A systematic review. BMC Oral Health 2023, 23, 587. [Google Scholar] [CrossRef] [PubMed]
- Ojima, K.; Dan, C.; Nishiyama, R.; Ohtsuka, S.; Schupp, W. Accelerated extraction treatment with Invisalign. J. Clin. Orthod. 2014, 48, 487–499. [Google Scholar] [PubMed]
- Wang, J.; Bukhari, A.; Tai, S.K.; Zou, B. Dimensional changes in the palate associated with Invisalign First System: A pilot study. Angle Orthod. 2023, 93, 524–530. [Google Scholar] [CrossRef]
- Lucchese, A.; Nocini, R.; Tacchino, U.; Ghislanzoni, L.H.; Bertossi, D.; Ricciardi, G.; Bassani, L.; Korolija, S.; Giudice, A.L.; Croce, S.; et al. Invisalign appliance: Aesthetic and efficiency. Minerva Stomatol. 2020, 69, 329–334. [Google Scholar] [CrossRef]
- Kau, C.H.; Christou, T.; Sharma, S. Contemporary Smile Design: An Orthodontic Perspective. Dent. Clin. N. Am. 2022, 66, 459–475. [Google Scholar] [CrossRef]
- Djeu, G.; Shelton, C.; Maganzini, A. Outcome assessment of Invisalign and traditional orthodontic treatment compared with the American Board of Orthodontics objective grading system. Am. J. Orthod. Dentofac. Orthop. 2005, 128, 292–298. [Google Scholar] [CrossRef] [PubMed]
- Papageorgiou, S.N.; Koletsi, D.; Iliadi, A.; Peltomaki, T.; Eliades, T. Treatment outcome with orthodontic aligners and fixed appliances: A systematic review with meta-analyses. Eur. J. Orthod. 2020, 42, 331–343. [Google Scholar] [CrossRef]
- Li, Y.; Deng, S.; Mei, L.; Li, Z.; Zhang, X.; Yang, C.; Li, Y. Prevalence and severity of apical root resorption during orthodontic treatment with clear aligners and fixed appliances: A cone beam computed tomography study. Prog. Orthod. 2020, 21, 1. [Google Scholar] [CrossRef]
- Santucci, V.; Rossouw, P.E.; Michelogiannakis, D.; El-Baily, T.; Feng, C. Assessment of posterior dentoalveolar expansion with Invisalign in adult patients. Int. J. Environ. Res. Public Health 2023, 20, 4318. [Google Scholar] [CrossRef]
- Palone, M.; Pignotti, A.; Morin, E.; Pancari, C.; Spedicato, G.A.; Cremonini, F.; Lombardo, L. Analysis of overcorrection to be included for planning clear aligner therapy: A retrospective study. Angle Orthod. 2023, 93, 11–18. [Google Scholar] [CrossRef]
- Jiang, T.; Jiang, Y.N.; Chu, F.T.; Lu, P.J.; Tang, G.H. A cone-beam computed tomographic study evaluating the efficacy of incisor movement with clear aligners: Assessment of incisor pure tipping, controlled tipping, translation, and torque. Am. J. Orthod. Dentofac. Orthop. 2021, 159, 635–643. [Google Scholar] [CrossRef] [PubMed]
- Rossini, G.; Parrini, S.; Castroflorio, T.; Deregibus, A.; Debernardi, C.L. Efficacy of clear aligners in controlling orthodontic tooth movement: A systematic review. Angle Orthod. 2015, 85, 881–889. [Google Scholar] [CrossRef]
- Haouili, N.; Kravitz, N.D.; Vaid, N.R.; Ferguson, D.J.; Makki, L. Has Invisalign improved? A prospective follow-up study on the efficacy of tooth movement with Invisalign. Am. J. Orthod. Dentofac. Orthop. 2020, 158, 420–425. [Google Scholar] [CrossRef] [PubMed]
- Charalampakis, O.; Iliadi, A.; Ueno, H.; Oliver, D.R.; Kim, K.B. Accuracy of clear aligners: A retrospective study of patients who needed refinement. Am. J. Orthod. Dentofac. Orthop. 2018, 154, 47–54. [Google Scholar] [CrossRef]
- Li, B.; Xu, Y.; Shi, R.; Hu, Y.; Liu, S.; Gu, Z. Accuracy of progress assessment with clear aligners. Hua Xi Kou Qiang Yi Xue Za Zhi 2022, 40, 698–703. [Google Scholar]
- Condo’, R.; Pazzini, L.; Cerroni, L.; Pasquantonio, G.; Lagana’, G.; Pecora, A.; Mussi, V.; Rinaldi, A.; Mecheri, B.; Licoccia, S.; et al. Mechanical properties of “two generations” of teeth aligners: Change analysis during oral permanence. Dent. Mater. J. 2018, 37, 835–842. [Google Scholar] [CrossRef]
- Feinberg, K.B.; Souccar, N.M.; Kau, C.H.; Oster, R.A.; Lawson, N.C. Translucency, Stain Resistance, and Hardness of Composites Used for Invisalign Attachments. J. Clin. Orthod. 2016, 50, 170–176. [Google Scholar] [PubMed]
- Cremonini, F.; Zabini, F.; Oliverio, T.; Bianchi, A.; Scalia, S.; Siciliani, G.; Lombardo, L. Optical properties of seven types of clear aligners before and after in vitro aging. J. Clin. Orthod. 2022, 56, 149–157. [Google Scholar] [PubMed]
- Elshazly, T.M.; Nang, D.; Golkhani, B.; Elattar, H.; Keilig, L.; Bourauel, C. Effect of thermomechanical aging of orthodontic aligners on force and torque generation: An in vitro study. J. Mech. Behav. Biomed. Mater. 2023, 143, 105911. [Google Scholar] [CrossRef] [PubMed]
- Koletsi, D.; Panayi, N.; Laspos, C.; Athanasiou, A.E.; Zinelis, S.; Eliades, T. In vivo aging-induced surface roughness alterations of Invisalign((R)) and 3D-printed aligners. J. Orthod. 2022. epub ahead of print. [Google Scholar] [CrossRef]
- Bichu, Y.M.; Alwafi, A.; Liu, X.; Andrews, J.; Ludwig, B.; Bichu, A.Y.; Zou, B. Advances in orthodontic clear aligner materials. Bioact. Mater. 2023, 22, 384–403. [Google Scholar] [CrossRef]
- Grant, J.; Foley, P.; Bankhead, B.; Miranda, G.; Adel, S.M.; Kim, K.B. Forces and moments generated by 3D direct printed clear aligners of varying labial and lingual thicknesses during lingual movement of maxillary central incisor: An in vitro study. Prog. Orthod. 2023, 24, 23. [Google Scholar] [CrossRef]
- Hertan, E.; McCray, J.; Bankhead, B.; Kim, K.B. Force profile assessment of direct-printed aligners versus thermoformed aligners and the effects of non-engaged surface patterns. Prog. Orthod. 2022, 23, 49. [Google Scholar] [CrossRef]
- Koenig, N.; Choi, J.-Y.; McCray, J.; Hayes, A.; Schneider, P.; Kim, K.B. Comparison of dimensional accuracy between direct-printed and thermoformed aligners. Korean J. Orthod. 2022, 52, 249–257. [Google Scholar] [CrossRef]
- Elshazly, T.M.; Keilig, L.; Alkabani, Y.; Ghoneima, A.; Abuzayda, M.; Talaat, S.; Bourauel, C.P. Primary Evaluation of Shape Recovery of Orthodontic Aligners Fabricated from Shape Memory Polymer (A Typodont Study). Dent. J. 2021, 9, 31. [Google Scholar] [CrossRef]
- Bruni, A.; Serra, F.G.; Deregibus, A.; Castroflorio, T. Shape-Memory Polymers in Dentistry: Systematic Review and Patent Landscape Report. Materials 2019, 12, 2216. [Google Scholar] [CrossRef]
- McKay, A.; McCray, J.; Bankhead, B.; Lee, M.M.; Miranda, G.; Adel, S.M.; Kim, K.B. Forces and moments generated during extrusion of a maxillary central incisor with clear aligners: An in vitro study. BMC Oral Health 2023, 23, 495. [Google Scholar] [CrossRef]
- Belgal, P.; Mhay, S.; Patel, V.; Nalliah, R.P. Adverse Events Related to Direct-To-Consumer Sequential Aligners—A Study of the MAUDE Database. Dent. J. 2023, 11, 174. [Google Scholar] [CrossRef]
- Hunsaker, R.J.; Shroff, B.; Carrico, C.; Alford, B.; Lindauer, S.J. A comparison of patient testimonials on YouTube of the most common orthodontic treatment modalities: Braces, in-office aligners, and direct-to-consumer aligners. Am. J. Orthod. Dentofac. Orthop. 2022, 161, 355–363.e3. [Google Scholar] [CrossRef]
- Olson, J.C.; Shroff, B.; Carrico, C.; Boyle, J.; Lindauer, S.J. Comparison of patient factors influencing the selection of an orthodontist, general dentist, or direct-to-consumer aligners. Am. J. Orthod. Dentofac. Orthop. 2020, 157, 526–532.e2. [Google Scholar] [CrossRef]
- Kravitz, N.D.; Kusnoto, B.; BeGole, E.; Obrez, A.; Agran, B. How well does Invisalign work? A prospective clinical study evaluating the efficacy of tooth movement with Invisalign. Am. J. Orthod. Dentofac. Orthop. 2009, 135, 27–35. [Google Scholar] [CrossRef]
- Papadimitriou, A.; Mousoulea, S.; Gkantidis, N.; Kloukos, D. Clinical effectiveness of Invisalign® orthodntic treatment: A systematic review. Prog. Orthod. 2018, 19, 37–50. [Google Scholar] [CrossRef]
- Robertson, L.; Kaur, H.; Fagundes, N.C.F.; Romanyk, D.; Major, P.; Mir, C.F. Effectiveness of clear aligner therapy for orthodontic treatment. Orthod. Craniofacial Res. 2020, 23, 133–142. [Google Scholar] [CrossRef]
- Kravitz, N.D.; Dalloul, B.; Zaid, Y.A.; Shah, C.; Vaid, N.R. What percentage of patients switch from Invisalign to braces? A retrospective study evaluating the conversion rate, number of refinement scans, and length of treatment. Am. J. Orthod. Dentofac. Orthop. 2023, 163, 526–530. [Google Scholar] [CrossRef]
- Talens-Cogollos, L.; Vela-Hernández, A.; Peiró-Guijarro, M.A.; García-Sanz, V.; Montiel-Company, J.M.; Gandía-Franco, J.L.; Bellot-Arcís, C.; Paredes-Gallardo, V. Unplanned molar intrusion after Invisalign treatment. Am. J. Orthod. Dentofac. Orthop. 2022, 162, 451–458. [Google Scholar] [CrossRef]
- Kau, C.H. Bench, Boundaries, and Benefits: Negotiating the Maze to a Successful Product in the United States. JDR Clin. Trans. Res. 2016, 1, 95–96. [Google Scholar] [CrossRef]
Year | Author | Study Design | Malocclusion | Patient Group | Extrusion | Intrusion | Rotation | Bodily Movement | Tipping |
---|---|---|---|---|---|---|---|---|---|
2022 | Palone et al. [30] aligner system: F22 Aligners Overall: approximately 20% (19.42%) | Retrospective need for overcorrection (measured the amount of correction required in the finishing phase to achieve the prescribed outcomes) | Class I malocclusion, minimal crowding (≤3 mm) | 150 patients (80 women and 70 men; mean age: 33.7 years) | 11.7% | 22% | Greatest correction necessary
| 20.5% inclination (buccal–lingual crown tipping) 14.5% angulation (mesial–distal crown tipping) | |
2019 | Haouili et al. [33] aligner system: Invisalign Mean accuracy for all TMs: 50% | Prospective follow-up study | 22 Class I, 13 Class II, and 3 Class III | 38 patients Mean age: 36 years | Extrusion of the maxillary incisors (55%) had the highest accuracy, whereas extrusion of the maxillary and mandibular molars (40%) had the lowest accuracy | Incisor intrusion remained a challenge And did not improve (35%), whereas second molar intrusion had high accuracy (51%) | Lowest overall accuracy (46%)
| Buccal–lingual crown tip was overall most accurate (56%) tooth movement Labial crown tip max LI (70%)—most accurate | |
2019 | Jiang et al. [31] aligner system: Invisalign | Retrospective measurement of different types of incisor movements in sagittal plane | Crowding Non-extraction | 69 patients Age ≥ 20 years Overall efficacy: 55.58% | Translation: 49.50%
|
| |||
2018 | Charalampakis et al. [34] aligner system: Invisalign | Retrospective | Class I (mild, mod, severe)
| 20 adult patients Avg age: 37 years and 6 months |
|
|
| Horizontal movements of all incisors (buccal-lingual crown tip): accurate, with either small (0.20–0.25 mm) or insignificant differences | |
2015 | Rossini et al. [32] aligner system: Invisalign | Systematic review |
| Anterior intrusion is achievable with OAT and is comparable to that reported for the straight wire technique | OAT is not effective in controlling rotations, especially for rounded teeth | Orthodontic Aligner Therapy (OAT) is effective in controlling upper molar bodily movement when a distalization of 1.5 mm is prescribed |
Comprehensive | Normal | Basic | Limited | ||
---|---|---|---|---|---|
Patient Records | Clinical Pictures and Radiographs | X | X | X | |
Intra-Oral Scan Uploads / PVS Impressions | Dedicated | X | X | ||
3rd Party | X | X | |||
Software Interface | Interactive | X | X | ||
Static | X | X | |||
Tooth Movement | All Teeth | X | X | ||
Most Teeth | X | ||||
Some Teeth | X | ||||
Attachments | All Teeth | X | X | X | |
3D Controls | Real-Time Movements | X | X | X | |
Real-Time Attachments | X | X | |||
Real-Time IPR | X | ||||
Real-Time Simulation of Doctor Changes | X | ||||
Tray Cut-Outs | X | ||||
Complex Tooth Movements | Tooth Expansion | X | |||
Sagittal Correctors | X | ||||
Interactive Patient Tools | Predictive Simulation | X | X | ||
Compliance Indicators Built Into Aligners | X | ||||
Software | Subscription Fees | X | X | X | X |
Clinical Research | X | X | |||
Post Treatment | Provision of Invisible Retainers | X | X | ||
Duration of Coverage of Aligner Production Fees (Clearly Stated Fees) | X | X |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Kau, C.H.; Soh, J.; Christou, T.; Mangal, A. Orthodontic Aligners: Current Perspectives for the Modern Orthodontic Office. Medicina 2023, 59, 1773. https://doi.org/10.3390/medicina59101773
Kau CH, Soh J, Christou T, Mangal A. Orthodontic Aligners: Current Perspectives for the Modern Orthodontic Office. Medicina. 2023; 59(10):1773. https://doi.org/10.3390/medicina59101773
Chicago/Turabian StyleKau, Chung How, Jen Soh, Teti Christou, and Akanksha Mangal. 2023. "Orthodontic Aligners: Current Perspectives for the Modern Orthodontic Office" Medicina 59, no. 10: 1773. https://doi.org/10.3390/medicina59101773
APA StyleKau, C. H., Soh, J., Christou, T., & Mangal, A. (2023). Orthodontic Aligners: Current Perspectives for the Modern Orthodontic Office. Medicina, 59(10), 1773. https://doi.org/10.3390/medicina59101773