Integrating skeletal anchorage into fixed and aligner biomechanics

Roberts, W. Eugene; Chang, Chris H.; Chen, Jie; Brezniak, Naphtali; Yadav, Sumit

doi:10.1016/j.ejwf.2022.04.001

Cited by 11 publications

(5 citation statements)

References 94 publications

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“…[6] Maxillary labial TADs might be the most effective way to prevent extrusion of the maxillary anterior teeth during retraction, thus avoiding the so-called "roller coaster" effects. [7] "Active vertical control" in this context, means not only preventing extrusion but also eliciting true intrusion of the teeth, which is the effective mechanic for the treatment of the gummy smile and/or hyperdivergent malocclusion. [2,5] Hyperdivergent skeletal Class II malocclusion with mandibular retrognathia requires counter-clockwise rotation of the mandible through active vertical control to improve the facial profile.…”

Section: Discussionmentioning

confidence: 99%

Preformed intrusion bulbs on clear aligners facilitate active vertical control in a hyperdivergent skeletal Class II case with extraction: A case report with 4-year follow-up

et al. 2023

APOS

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Active vertical control is critical in the treatment of hyperdivergent skeletal Class II malocclusion. The mechanics have been well shown as successful in the fixed appliance system with temporary anchorage devices (TADs); however, there are few relevant case reports in clear aligner therapy (CAT). The present case report describes the treatment of a severe hyperdivergent skeletal Class II case using CAT with the extraction of four premolars. Active vertical control was performed with TADs, which was facilitated by intrusion bulbs (IBs), that is, digitally designed and preformed vacuum bulbs on clear aligners for wearing intrusive elastics. The challenging camouflage case was finished with an improved profile and occlusion; specifically, the upper central incisors were intruded for 3 mm and the first molars for 1.8 mm, with counter-clockwise rotation of the mandible for 2.2° and a decrease of the ∠ANB for 2.6°. After a 4-year follow-up (the latter 2 years without retainers), the treatment results remain stable on the whole. According to the case report, camouflage treatment of hyperdivergent skeletal Class II case can be successfully achieved with active vertical control using TADs, facilitated by preformed IBs on the clear aligners.

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Section: Discussionmentioning

confidence: 99%

Preformed intrusion bulbs on clear aligners facilitate active vertical control in a hyperdivergent skeletal Class II case with extraction: A case report with 4-year follow-up

et al. 2023

APOS

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“…Orthodontic mini-implants can also be used in hybrid treatments, adding components of the fixed appliance treatment, with the aim of amplifying skeletal maxillary expansion in Class III malocclusion. 30…”

Section: Do Auxiliary Devices Increase the Efficiency Of Aligners?mentioning

confidence: 99%

Orthodontic aligners: between passion and science

MENDES RIBEIRO,

ARAGÓN,

ESPINOSA

et al. 2023

Dental Press J. Orthod.

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Introduction: The benefits and safety of using orthodontic aligners have been reported more by clinical experience and expert opinion than by scientific evidence. Another important aspect is that aligners are constantly evolving. It is important to obtain evidence that allows for new updates in manufacturing technology, in the development of new movement planning protocols, in the incorporation and design of attachments, and in the aid of skeletal anchorage. Methods: Evidence retrieved from six electronic databases (CINAHL, MEDLINE, EMBASE, Psych Info, the Cochrane Library and the Joanna Briggs Library) is presented by means of questions and answers. Conclusions: There is evidence that the aligners presented different levels of difficulty in performing each type of movement, with rotational and vertical movements being the most difficult to perform. Regarding perception of pain due to tooth movement, it seems to have less impact at the beginning of treatment; but dealing with more phonoarticulatory changes seems to require more treatment time in more complex cases. Aligners do not prevent the occurrence of root resorption, although the incidence and severity of resorption may be reduced, making oral hygiene easier and accepting the risk of white spots, caries and periodontal disease. Given the conflicting evidence, the release of bisphenol-A from the aligner cannot be denied. Solutions must be found to reduce the environmental impact of aligners disposal. There is an urgent need for well-designed randomized controlled trials.

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“…This hybrid approach, called "G-block," has demonstrated success in treating a Class II malocclusion. TADs were placed between the maxillary first and second molars to provide direct and indirect anchorage [99]. This approach resulted in a solid Class I occlusion, improving esthetics and reducing the need for elastics, thus simplifying the treatment of posterior teeth and improving orthodontic control [78].…”

Section: Tadsmentioning

confidence: 99%

Predictability of Dental Distalization with Clear Aligners: A Systematic Review

Inchingolo,

Carpentiere

et al. 2023

Bioengineering

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The current review aims to evaluate the scientific evidence relating to the effectiveness of treatment with clear aligners (CAs) in controlling distalization orthodontic tooth movement. “Orthodontics, aligners” and “distalization” were the search terms used on the Scopus, Web of Science and Pubmed databases with the Boolean operator “AND”. The results of the last ten years of research were 146 studies; of these, 19 publications were included for this review. The distalization movement is possible with invisible masks alone, but the risk of losing anchorage in the anterior sectors is very probable. The stability of the results and the reduction of unwanted effects can be guaranteed by the use of skeletal anchoring devices and interproximal enamel reduction (IPR), with which compensations are obtained to reduce the initial overjet. Temporary anchorage devices (TADs) can be used to manage posterior anchorage after distalization of maxillary molars with aligners. This hybrid approach has demonstrated the greatest orthodontic success. TADs are useful aids to provide direct and indirect skeletal anchorage. The opposite effect must be considered when planning dental distalization, especially of the molars, in patients with large overjet, and corrective measures or the use of auxiliaries may be necessary to prevent midcourse corrections. This systematic review provides a critical evidence-based assessment of the predictability of dental distalization with CAs, an ever-evolving orthodontic technique.

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Integrating skeletal anchorage into fixed and aligner biomechanics

Cited by 11 publications

References 94 publications

Preformed intrusion bulbs on clear aligners facilitate active vertical control in a hyperdivergent skeletal Class II case with extraction: A case report with 4-year follow-up

Preformed intrusion bulbs on clear aligners facilitate active vertical control in a hyperdivergent skeletal Class II case with extraction: A case report with 4-year follow-up

Orthodontic aligners: between passion and science

Predictability of Dental Distalization with Clear Aligners: A Systematic Review

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