Introduction : Les technologies numériques dentaires de conception, simulation et fabrication sont en constante évolution. Il est possible de simuler numériquement des mouvements dentaires, ainsi que des déplacements des deux arcades et de réaliser des gouttières thermoformées fabriquées à partir de cette simulation. Objectif : Les auteurs présentent le couplage de la numérisation 3D intra-buccale avec la radiographie 3D de basses doses d'irradiation qui permet de réaliser un setup chirurgical très précis, de préparer des gouttières de repositionnement et de fabriquer des plaques d' ostéosynthèse. Le protocole de prise en charge orthodontico-chirurgicale par aligneurs utilisé par le premier auteur sera décrit en détail. Matériels et méthodes : Les auteurs présentent, au travers des cas cliniques exposés, les progrès réalisés en chirurgie orthognathique grâce à la 3D et au système des gouttières thermoformées Invisalign ® . Résultats : En observant les trois cas cliniques présentés, on peut constater que la durée moyenne de traitement était bien inférieure à la durée moyenne des protocoles orthodontico-chirurgicaux traditionnels.

Objective To examine the skeletal, dental, and soft-tissue cephalometric effects of class II correction using Invisalign’s mandibular advancement feature in growing patients. Materials and Methods A retrospective cohort clinical study was performed on cases that were started between 2017 and 2019. A total of 32 patients (13 females, 19 males), with an average age of 13 years old (9.9-14.8 years) had undergone Invisalign treatment (Align Technology, Inc., San Jose, CA) wherein the mandibular advancement phase was completed were included. Photos, digital study models, and cephalograms were taken once during the patients’ initial visit and again upon completing the mandibular advancement phase of treatment. The number of aligners worn and the time of treatment in months was recorded for each subject. Cephalometric analysis was performed and overjet and overbite were measured. Statistical analysis was performed using SPSS statistical software (version 25; SPSS, Chicago, Ill) and the level of significance was set at P <0.05. Descriptive statistics were performed to generate means and differences for each cephalometric measurement as well as patient data including age, treatment time, and aligner number. Differences between measurements from patients before treatment (T1) and after treatment (T2) with the mandibular advancement feature were evaluated using a paired t -test. Results All 32 patients had multiple jumps staged for the precision wings, i.e., incremental advancement. The average length of treatment for the MA phase was 9.2 months (7.5-13.8 months) and the average number of aligners used during this time was 37 (30-55). Statistically significant differences between T1 and T2, in favor of class II correction, were observed in the ANB angle, WITS appraisal, facial convexity, and mandibular length. The nasolabial angle, overjet, and overbite also showed statistically significant changes between T1 and T2. Conclusion Invisalign aligners with the mandibular advancement feature took approximately 9 months for 1.5 mm of overjet correction. The lower incisor angulation was maintained during class II correction. The minimal skeletal changes are in favor of class II correction.

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To describe an esthetic orthodontic treatment using aligners in an adult patient with dental class II malocclusion associated with crowding. A 25-year-old female patient with skeletal class I, bilateral class II relation, increased overjet and overbite and crowding in both arches presented for orthodontic treatment. The patient refused conventional fixed multibracket treatment in favor of aligners. Pre-and post-treatment records are presented. Treatment objectives were achieved in 10 months, and the patient was satisfied with the functional and esthetic outcomes. Combining aligners with appropriate attachment location and geometry is an efficacious means of resolving orthodontic issues such as class II malocclusion in a time frame comparable to that of conventional fixed orthodontics.Staging in distalization increases the predictability of movement. Furthermore, this system is associated with optimal oral hygiene and excellent esthetics.

In open bite cases, a comprehensive diagnostic differentiation is crucial in determining the best corrective therapy. In non-surgical open bite treatment, fixed appliances, either labial or lingual, are usually employed. With the addition of extra-radicular screws, more sophisticated orthodontic movements may now be performed without the necessity for orthognathic surgery. Clear aligner therapy, on the contrary, has grown in popularity as a treatment option for more complex cases, such as open bite malocclusions. This article discusses three cases with an anterior open bite that were treated using various mechanics as dictated by the malocclusion. Case 1 was addressed wholly using clear aligner therapy, with careful consideration of attachment geometry and mechanics. Case 2 with clear aligner therapy, attachment geometry selection, and vertical elastics; and Case 3 with clear aligner therapy, attachments, and temporary anchorage devices.