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Recent Advances in Orthodontics and Clear Aligner Therapy

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Guest Editor
Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY 14620, USA
Interests: orthodontics and dentofacial orthopedics; clear aligner therapy; local and systemic factors influencing orthodontic tooth movement; low-level-laser therapy; mini-screw implants

Special Issue Information

Dear Colleagues,

The clinical practice of orthodontics has changed drastically in recent decades. Various treatment modalities have been proposed to improve the outcome of orthodontic therapy (OT) in terms of decreasing the overall treatment time and/or preventing side effects of OT. For instance, low-level-laser therapy has been shown to increase the rate of orthodontic tooth movement (OTM) while decreasing orthodontically related root resorption and pain. In addition, periodontally accelerated osteogenic orthodontics has gained popularity among adult patients, as it decreases the duration of OT and increases the boundaries of conventional OTM. Various substances such as probiotics and herbal and essential-oil-based extracts have been used as mouthwashes to improve oral health in patients undergoing fixed OT. Moreover, the use of artificial intelligence has offered advantages in the orthodontic diagnosis and treatment planning process. Digital technology, including intra-oral scanning and 3D printing, has provided customized, translucent 3D-printed brackets which utilize digital treatment planning and workflow to improve clinical practice efficiency. Furthermore, due to a higher need for “invisible” orthodontic appliances, clear aligner therapy (CAT) has gained tremendous popularity among adults. However, high-quality studies assessing the predictability of CAT and the risk factors that may compromise the outcomes of CAT remain scarce. Finally, the COVID-19 pandemic has accelerated the incorporation of teledentistry into clinical orthodontic practice and related research. Although teleorthodontics offers advantages in terms of patient accessibility to care and remote virtual patient monitoring, risks and ethical concerns regarding its application remain unclear. With this background, I would like to invite my colleagues to submit high-quality research articles critically assessing recent advances in fixed OT and CAT, and exploring future directions and possibilities. Original papers, review articles, short commentaries and well-documented case reports/series are welcomed.

Dr. Dimitrios Michelogiannakis
Guest Editor

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Keywords

  • artificial intelligence
  • clear aligner therapy
  • low-level-laser therapy
  • periodontally accelerated osteogenic orthodontics
  • 3D-printed orthodontic brackets
  • teleorthodontics
  • direct-to-consumer orthodontics

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Published Papers (7 papers)

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Editorial

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6 pages, 396 KiB  
Editorial
Influence of E-Cigarette and Cannabis Vaping on Orthodontically Induced Tooth Movement and Periodontal Health in Patients Undergoing Orthodontic Therapy
by Dimitrios Michelogiannakis and Irfan Rahman
Int. J. Environ. Res. Public Health 2022, 19(11), 6518; https://doi.org/10.3390/ijerph19116518 - 27 May 2022
Cited by 3 | Viewed by 3512
Abstract
The frequency of e-cigarette vaping of nicotine and marijuana products is increasing among adolescents and young adults; the detrimental effects of vaping on general and oral health have not yet been thoroughly defined [...] Full article
(This article belongs to the Special Issue Recent Advances in Orthodontics and Clear Aligner Therapy)
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Research

Jump to: Editorial, Other

8 pages, 1245 KiB  
Article
Assessment of Posterior Dentoalveolar Expansion with Invisalign in Adult Patients
by Vincent Santucci, Paul Emile Rossouw, Dimitrios Michelogiannakis, Tarek El-Baily and Changyong Feng
Int. J. Environ. Res. Public Health 2023, 20(5), 4318; https://doi.org/10.3390/ijerph20054318 - 28 Feb 2023
Cited by 8 | Viewed by 2954 | Correction
Abstract
Purpose: The primary aim was to evaluate dentoalveolar expansion with Invisalign clear aligners comparing linear measurements in ClinCheck vs. cone beam computed tomography (CBCT). This would enable an assessment of to what extent expansion gained from Invisalign clear aligners was due to buccal [...] Read more.
Purpose: The primary aim was to evaluate dentoalveolar expansion with Invisalign clear aligners comparing linear measurements in ClinCheck vs. cone beam computed tomography (CBCT). This would enable an assessment of to what extent expansion gained from Invisalign clear aligners was due to buccal tipping and/or bodily translation of the posterior teeth. The study also evaluated the predictive value of Invisalign ClinCheck® (Align Technology, San Jose, CA, USA) to final outcomes. Methods: The orthodontic records of thirty-two (32) subjects comprised the sample to conduct this study. Linear values of the upper arch width were measured for premolars and molars at two different points (occlusal and gingival) utilized for ClinCheck® measurements and three different points for CBCT measurements before (T0 and after treatment (T1). Paired T-tests at a significance level of 0.05 were used for analyses. Results: Expansion was found to be possible with Invisalign clear aligners. However, more expansion was measured at the cusp tips compared to gingival margins (p < 0.0001), indicating more tipping was occurring than bodily translation. ClinCheck® also showed a significant overestimation of the amount of expansion capable, with nearly 70% expression in the first premolar area, and the expression decreased as one moved posteriorly with only 35% expressed at the first molar area (p < 0.0001). Conclusions: Dentoalveolar expansion with Invisalign is achieved through buccal tipping of posterior teeth and bodily translation; and there is a significant overestimation of the amount of expansion achieved between ClinCheck® and clinical results. Full article
(This article belongs to the Special Issue Recent Advances in Orthodontics and Clear Aligner Therapy)
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10 pages, 520 KiB  
Article
Perception of Need for Further Refinement in a Clear Aligner Treatment among Orthodontists, Dentists and Laypeople: A Retrospective Study
by Patrícia Oliveira, Iman Bugaighis, Hélder Nunes Costa and Pedro Mariano Pereira
Int. J. Environ. Res. Public Health 2022, 19(23), 15498; https://doi.org/10.3390/ijerph192315498 - 23 Nov 2022
Cited by 2 | Viewed by 2377
Abstract
Clear aligner treatment often requires further refinement to improve the orthodontic treatment outcome. However, the perceptions of treatment outcomes evaluated by orthodontists and dentists are sparse, and laypeople’s perceptions have yet to be explored. Here, we explore the perceptions of orthodontists, dentists, and [...] Read more.
Clear aligner treatment often requires further refinement to improve the orthodontic treatment outcome. However, the perceptions of treatment outcomes evaluated by orthodontists and dentists are sparse, and laypeople’s perceptions have yet to be explored. Here, we explore the perceptions of orthodontists, dentists, and laypeople concerning the treatment outcomes achieved after completing the first sequence of aligners. This cross-sectional study involved 37 orthodontists, 67 dentists, and 93 laypeople. We administered an online questionnaire containing intra-oral photographs of nine completed cases with pre- and post-first sequences of aligners. As a control, we used a digital prediction system for the treatment outcome. Self-perception was reported using a visual analog scale. Both orthodontists and dentists had similar perceptions about treatment outcomes (p = 0.363) but significantly differed from laypeople (p ≤ 0.0001). Both orthodontists and dentists recommended further treatment; orthodontists were more critical than dentists (p ≤ 0.001). Orthodontists were more critical than dentists in their evaluations of the need for further treatments; however, their perceptions of treatment outcomes were similar. Laypeople were more satisfied with the treatment outcomes, were less concerned with occlusion, and were more focused on the aesthetic results of the treatment. Full article
(This article belongs to the Special Issue Recent Advances in Orthodontics and Clear Aligner Therapy)
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11 pages, 349 KiB  
Article
Associations between Oral Health and Cannabis Use among Adolescents and Young Adults: Implications for Orthodontists
by Austin Le, Edmund Khoo and Joseph J. Palamar
Int. J. Environ. Res. Public Health 2022, 19(22), 15261; https://doi.org/10.3390/ijerph192215261 - 18 Nov 2022
Cited by 1 | Viewed by 2132
Abstract
Cannabis use is prevalent among adolescents and young adults in the US. Virtually all modes of cannabis consumption involve the oral cavity, and previous studies have linked cannabis use with poorer oral health. We sought to identify associations between cannabis use and various [...] Read more.
Cannabis use is prevalent among adolescents and young adults in the US. Virtually all modes of cannabis consumption involve the oral cavity, and previous studies have linked cannabis use with poorer oral health. We sought to identify associations between cannabis use and various oral health outcomes and behaviors among individuals 12–25 years of age, and to discuss implications for orthodontists who largely interact with this age group over an extended period of treatment time. We examined data from patient electronic health records (N = 14,657) obtained between 2015 and 2021. Associations between lifetime and current self-reported cannabis use and several oral health outcomes or related behaviors that reflect periodontal health, caries status, oral lesions, and physical integrity of tooth structure and restorations were examined in a bivariable and multivariable manner, controlling for patient age, sex, and self-reported tobacco and alcohol use. Reporting lifetime cannabis use was associated with higher risk for having oral lesions (aPR = 1.41, 95% CI: 1.07–1.85), bruxism (aPR = 1.31, 95% CI: 1.09–1.58), and frequent consumption of sugary beverages and snacks (aPR = 1.27, 95% CI: 1.12–1.41). Reporting current cannabis use was associated with higher risk for oral lesions (aPR = 1.45, 95% CI: 1.03–2.06) and frequent consumption of sugary beverages and snacks (aPR = 1.26, 95% CI: 1.07–1.48). Cannabis users aged 12–25 are at increased risk for bruxism, oral lesions, and frequent consumption of sugary beverages and snacks. Orthodontists and other dental professionals should probe for drug use and be cognizant of increased risk for oral health problems in patients that report actively using cannabis. Full article
(This article belongs to the Special Issue Recent Advances in Orthodontics and Clear Aligner Therapy)

Other

Jump to: Editorial, Research

1 pages, 245 KiB  
Correction
Correction: Santucci et al. Assessment of Posterior Dentoalveolar Expansion with Invisalign in Adult Patients. Int. J. Environ. Res. Public Health 2023, 20, 4318
by Vincent Santucci, Paul Emile Rossouw, Dimitrios Michelogiannakis, Tarek El-Bialy and Changyong Feng
Int. J. Environ. Res. Public Health 2023, 20(14), 6344; https://doi.org/10.3390/ijerph20146344 - 11 Jul 2023
Viewed by 868
Abstract
There was an error in the original publication [...] Full article
(This article belongs to the Special Issue Recent Advances in Orthodontics and Clear Aligner Therapy)
11 pages, 2855 KiB  
Systematic Review
Oral Health-Related Quality of Life throughout Treatment with Clear Aligners in Comparison to Conventional Metal Fixed Orthodontic Appliances: A Systematic Review
by Eleftherios G. Kaklamanos, Miltiadis A. Makrygiannakis and Athanasios E. Athanasiou
Int. J. Environ. Res. Public Health 2023, 20(4), 3537; https://doi.org/10.3390/ijerph20043537 - 17 Feb 2023
Cited by 9 | Viewed by 3436
Abstract
Background: Orthodontic clear aligners constitute an alternative and increasingly used orthodontic treatment modality, offering enhanced esthetics with potential consequences regarding patients’ oral health-related quality of life (OHRQoL). Objective: Summarize and systematically evaluate existing evidence on the OHRQoL of patients treated with orthodontic clear [...] Read more.
Background: Orthodontic clear aligners constitute an alternative and increasingly used orthodontic treatment modality, offering enhanced esthetics with potential consequences regarding patients’ oral health-related quality of life (OHRQoL). Objective: Summarize and systematically evaluate existing evidence on the OHRQoL of patients treated with orthodontic clear aligners compared to treatment with conventional metal, fixed appliances. Search methods: We searched without limitations six databases and searched manually the reference lists of relevant studies up to the end of October 2022. Selection criteria: We looked for data from prospective studies that compared OHRQoL, using instruments that had undergone full psychometric validation, between orthodontic patients with clear aligners and labial, fixed, metal orthodontic appliances. Data collection and analysis: We extracted the data from the located studies, and we assessed the risk of bias with the Cochrane Collaboration suggested tools. The quality of available evidence was based on the GRADE approach. Results: Three studies were identified. OHRQoL was impacted less by clear aligners compared to treatment with conventional labially placed, fixed, metal appliances. The exploratory meta-regression, with the time point of assessment as predictor, did not reveal any statistically significant effect. The quality of the available evidence ranged from very low to low. Conclusions: According to the exploratory synthesis of the limited available dataset, treatment with clear aligners could be associated with better OHRQoL ratings compared to treatment with conventional labially placed, metal, fixed appliances. However, the quality of the presented evidence renders further high-quality studies warranted to be able to reach safer conclusions. Full article
(This article belongs to the Special Issue Recent Advances in Orthodontics and Clear Aligner Therapy)
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11 pages, 3012 KiB  
Essay
Learning Games: A New Tool for Orthodontic Education
by Edmund Khoo, Austin Le and Mitchell J. Lipp
Int. J. Environ. Res. Public Health 2023, 20(3), 2039; https://doi.org/10.3390/ijerph20032039 - 22 Jan 2023
Cited by 3 | Viewed by 1594
Abstract
Learning games that are based on current scientific concepts are underutilized in dental education. This paper explores the relevant science of learning and discusses several principles that are conducive to learning and teaching in an educational setting, namely retrieval practice, feedback, motivation, and [...] Read more.
Learning games that are based on current scientific concepts are underutilized in dental education. This paper explores the relevant science of learning and discusses several principles that are conducive to learning and teaching in an educational setting, namely retrieval practice, feedback, motivation, and engagement. A discussion of learning games in health professional education ensues, followed by a description of relevant best practices in game design for learning. This paper concludes by presenting Dealodontics©, a card game developed at New York University College of Dentistry with the goal of helping second-year dental students review, practice, and apply basic skills relevant to their orthodontics competency requirements. Full article
(This article belongs to the Special Issue Recent Advances in Orthodontics and Clear Aligner Therapy)
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