Management of a Facilitated Aesthetic Orthodontic Treatment with Clear Aligners and Minimally Invasive Corticotomy

Abstract

Accelerating orthodontic tooth movement has become a topical issue and the corticotomy seems to be the only effective and safe technique reported in the literature. Simultaneously, aesthetic orthodontic treatment with removable clear aligners has become commonly requested. The aim of this paper is to illustrate the management of facilitated aesthetic orthodontic treatment, a combined approach including piezocision corticotomy and clear aligners for orthodontic treatment. Orthodontic planning for traditional clear aligners should be modified to take advantage of the corticotomy technique in order to facilitate the most difficult orthodontic movements needed to achieve treatment completion, where each aligner will be used for four days rather than 15 days for a total time of four months. A corticotomy with a modified minimally invasive flapless piezocision technique should be performed in both jaws at the same time, before the time window of the orthodontic treatment, where the most difficult orthodontic movements are planned. Treatment planning where difficult orthodontic movements, such as anterior open-bite closure and extraction space closure, are easily managed with clear aligners and are presented as examples of facilitated aesthetic orthodontic treatment application. The combination between aesthetic treatment with clear aligners and modified piezocision corticotomy, if carefully planned, seems to represent a synergy that achieves the current goals of orthodontic treatment. The primary objectives of this combination should be facilitating difficult orthodontic movements and reducing treatment duration.

Short-Term Effect of Orthodontic Treatment with Clear Aligners on Pain and sEMG Activity of Masticatory Muscles

“…Clear aligners are an orthodontic system that has been introduced as an answer to this request. Recent systematic reviews have shown that orthodontic treatment with clear aligners has been effective in obtaining a proper alignment and leveling of the dental arches during the last decade, even in more complex cases and in children or adolescents [ 3 , 4 ]. Moreover, compared to treatment with fixed appliances, orthodontic treatment with removable appliances and especially clear aligners has shown better preservation of periodontal indexes and oral hygiene, related to a lower risk of periodontal damage or enamel demineralization and caries [ 5 , 6 , 7 , 8 ].…”

Primary Evaluation of Shape Recovery of Orthodontic Aligners Fabricated from Shape Memory Polymer (A Typodont Study)

“…Due to the stepwise shape changing property, this material was proposed to be used for the fabrication of orthodontic aligners, as it may successfully be used to overcome the rate-limiting staging of conventional aligners, in a way that one aligner may be able to replace three subsequent conventional aligners. Consequently, the number of aligners used per treatment could be reduced, beside saving money and time, especially for long and more complex therapies such as molar distalization and severe open/deep bite correction that are frequently performed nowadays [ 28 , 29 , 30 ].…”

The Importance of Using Physical Tridimensional Models for the Management and Planning of Extended Osseous Odontogenic Lesions

“…Apart from educational purposes, these models can be used when resective surgeries have to be performed in highly anatomically sensitive areas, such as neurologic passage landmarks and maxillary sinuses. Preventive planning is performed on the virtual 3D model [6], while planning is then performed on the physical model before the actual intervention takes place on the patient. Surgeons' opinions regarding the benefits of stereolithographic model use as a pre-surgical tool confirm the optimization of the diagnostic as well as surgical act by means of reducing operating room time, improving visualization of the patient's unique structures, and increasing pre-surgical commitment after surgical rehearsal on 3D models [5].…”