BackgroundThe aim of this study was to investigate the efficacy of orthodontic treatment using the Invisalign® system. Particularly, we analyzed the influence of auxiliaries (Attachment/Power Ridge) as well as the staging (movement per aligner) on treatment efficacy.MethodsWe reviewed the tooth movements of 30 consecutive patients who required orthodontic treatment with Invisalign®. In all patients, one of the following tooth movements was performed: (1) Incisor Torque >10°, (2) Premolar derotation >10° (3) Molar distalization >1.5 mm. The groups (1)-(3) were subdivided: in the first subgroup (a) the movements were supported with the use of an attachment, while in the subgroup (b) no auxiliaries were used (except incisor torque, in which Power Ridges were used). All tooth movements were performed in a split-mouth design. To analyze the clinical efficacy, pre-treatment and final plaster cast models were laser-scanned and the achieved tooth movement was determined by way of a surface/surface matching algorithm. The results were compared with the amount of tooth movement predicted by ClinCheck®.ResultsThe overall mean efficacy was 59% (SD = 0.2). The mean accuracy for upper incisor torque was 42% (SD = 0.2). Premolar derotation showed the lowest accuracy with approximately 40% (SD = 0.3). Distalization of an upper molar was the most effective movement, with efficacy approximately 87% (SD = 0.2).ConclusionIncisor torque, premolar derotation and molar distalization can be performed using Invisalign® aligners. The staging (movement/aligner) and the total amount of planned movement have an significant impact on treatment efficacy.

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OBJECTIVES While permanent retention is today the method of choice to stabilize orthodontic treatment outcomes, recent studies have increasingly reported posttreatment changes in tooth position during permanent retention. We conducted this study to analyze changes in the anterior mandible, whether the changes follow an underlying movement pattern, and, aiming for a preventive strategy, whether any risk factors could be identified comparing findings with the pretreatment situations. METH-ODS We included 30 patients who had worn fixed Twistflex retainers (UK 3-3) extending from canine to canine in the mandible. Casts reflecting the intraoral situations before orthodontic treatment (T0), directly after completion of active therapy (T1), and 6 months later (T2) were scanned and superimposed using Imageware Surfacer software. Posttreatment changes (T2-T1) of tooth position within the retainer block were analyzed on 3D virtual models and were compared to pretreatment (T0) and treatment-related (T1-T0) findings to identify potential risk factors. RESULTS Almost all analyzed patients revealed three-dimensional changes in tooth position within the retainer block. Comparing these movements, we repeatedly found rotated retainer blocks in labio-oral direction, while the center of rotation was located at the first incisors. This pattern was associated with intercanine expansion and excessive overjet correction during orthodontic treatment. The canines underwent the most pronounced (rotational and translational) movements. CONCLUSIONS In general permanent lingual retainers are safe but in special clinical cases retainers can induce undesired tooth movement. Risk factors seem to be intercanine expansion and excessive overjet correction during orthodontic treatment. In specific cases an additional retention device might be needed. AbstractObjectives. While permanent retention is today frequently the method of choice to stabilize orthodontic treatment outcomes, recent studies have increasingly reported posttreatment changes in tooth position during permanent retention. We conducted this study to analyze such changes in the anterior mandible, whether these follow an underlying movement pattern, and, aiming for a preventive strategy, whether any risk factors could be identified by comparing findings to the pretreatment situations. Methods.We included 30 patients who had worn a fixed Twistflex retainer extending from canine to canine in the mandible. Casts reflecting the intraoral situations before orthodontic treatment (T0), directly upon completion of active therapy (T1), and 6 months into retention (T2) were scanned and superposed using Imageware Surfacer software. Posttreatment changes (T2−T1) in tooth position inside the retainer block were analyzed on 3D virtual models and were compared to pretreatment (T0) and treatment-related (T1−T0) findings to identify potential risk factors.Results. Almost all patients revealed three-dimensional changes in tooth position within the retainer block. On comparing these movements...

The position of the centre of resistance (CR) is an essential parameter regarding the planning of orthodontic tooth movements. In the present investigation, the combined CR of the upper four incisors was determined numerically using the finite-element (FE) method. Based on a commercially available three-dimensional data set of a maxilla, including all 16 teeth, as well as known and earlier determined material parameters, FE models of the upper incisors and their surrounding tooth-supporting structures were generated. In the FE system, the model of the anterior segment was loaded with torques of 10 Nmm each at the lateral incisors. The FE model indicated that the individual incisors moved independently, although they were blocked with a steel wire of dimension 0.46 x 0.65 mm(2). The individual CRs were located at 5 mm distal and 9 and 12 mm apical to the centre of the lateral brackets. Thus, the classical view of a combined CR for the anterior segment was disproved and the planning of orthodontic tooth movements of the upper incisors should no longer be based on that concept.