Prosthetically Guided Orthodontics (PGO): A Personalized Clinical Approach for Aesthetic Solutions Using Digital Technology

Abstract

Conformative rehabilitation generally involves the treatment of partial dentate or the application of veneers. In this regard, conformative rehabilitation aims to generate an aesthetic prosthetic solution minimizing the amount of tissue removal without generating occlusal input interfering with the equilibrium of neuro-muscular function. In fact, pre-prosthetic orthodontics aims to re-establishing the correct position/inclination of the neighboring or antagonist teeth, providing appropriate space for the prosthetic crown. Clear aligners therapy (CAT) represents a valuable tool in the management of prosthetic cases with a conformative approach, as it allows clinicians to plan orthodontic movements that are guided by the prosthetic outcomes. In the present manuscript, we argue the concept of prosthetic guided orthodontics (PGO) by presenting and discussing three cases treated with the Invisalign GO system, which has been developed for the clinical management of multidisciplinary orthodontic-prosthetic cases with a conformative approach. In this regard, the rationale of this paper is to address the effectiveness and predictability of the digital set-up and CAT for aesthetic conformative rehabilitations.

Digital orthodontic setup and clear aligners system for treating adult patients with periodontitis: a descriptive case report

“…Finally, another benefit of clear aligners system is the possibility of establishing and visualizing treatment outcomes using a digital setup (38). In truth, with clear aligners, clinicians are "obligated" to study and plan "a priori" the treatment strategy and the appropriate bio-mechanics in the digital platform, generating a more disciplined "proactive" approach compared to the decisionmaking process used with fixed appliance systems (39,40). At the beginning, clinicians can request a diagnostic set-up including different treatment options that are evaluated in terms of length of time in treatment, degree of difficulty of tooth movements, optimization of tooth size/arch length discrepancies, occlusal result, and aesthetic outcomes (41, 42).…”