Journal of Aligner Orthodontics, 01/2019

Objective: To describe the use of clear aligners to achieve mandibular molar distalization in patients with molar Angle Class III relationship. Materials and methods: Two patients, aged 31 and 23 years old, with molar Angle Class III relationship and canine Class III relationship are presented and discussed. The patients were non-growing patients, so treatment plans included the distalization of mandibular molars. Due to the aesthetic concerns, it was decided to correct the malocclusion only with clear aligners, without additional appliances. Results: Although the patients were non-growing, distalization of mandibular molars was obtained and Angle molar and canine Class I relationships were achieved. The perception of facial profile improvement was very motivating for patients and it helped to reinforce treatment compliance. Conclusions: The presentation of these case reports shows that the use of clear aligners was reliable in non-growing patients to correct canine and molar Class III relationships. Keywords: Class III malocclusion, Invisalign, mandibular molar distalization, non-growing patients

The control of anchorage is increasingly relevant as orthodontic treatment in adult patients, particularly using aesthetic aligners, becomes more common. The application of miniscrews as anchorage has allowed the resolution of complex clinical cases in a short period of time, eliminating some of the complications that present during standard orthodontic treatment, while preserving the patient's aesthetics. This article describes various clinical cases performed through the use of aligners and Temporary Anchorage Devices (TADs). The association of aligners and TADs is shown in different combinations. With the advent of the miniscrew, it is possible to gain control of reactive forces without recourse to the traditional methods of anchorage, to solve complex orthodontic cases through the association of miniscrews and aesthetic aligners. Keywords: aesthetic aligners, complex adult cases, Invisalign, miniscrew

In most cases the initial treatment approach for a temporomandibular disorder (TMD) is an occlusal splint. The occlusal splint has to be regarded as a reversible therapeutic method. A definitive continuing treatment in orthodontics can only take place after the splint has delivered an improvement of the symptoms. As well as its use for the therapeutic approach, the occlusal splint can also be used as a diagnostic tool, as it allows determination of the physiological, three-dimensional position of the mandible. From this position, definitive orthodontic treatment can be started. Keywords: occlusal splint, temporomandibular disorder (TMD), temporomandibular joint (TMJ)

Objectives: The objective of this study was to investigate the effect of minimally invasive corticotomy (micro-osteoperforation [MOP]) on the acceleration of tooth movement using clear aligners. Materials and methods: A sample of 46 patients who completed clear aligner treatment with a 3-day change of aligner and the MOP technique was compared to a control group consisting of 59 patients treated with the ordinary 14-day change of aligner. Three-dimensional models were registered to calculate linear and angular changes of teeth to evaluate the accuracy of orthodontic tooth movement, the differential effect of MOPs on gender, age, severity of the malalignment, and the likelihood of refinement treatment. CloudCompare software was used for image registration of the post-treatment/prediction scans to the pretreatment scans, and to measure the actual and predicted amount of displacement of each anterior tooth of both arches. Using the transformation matrices from toothto- tooth alignment, linear and angular displacements in three different planes were obtained and the linear discrepancy and the relative errors for the angular discrepancy were calculated. Results: Statistical analyses showed no significant difference between the experimental and control groups for the accuracy of anterior tooth movement, and the type of movement was unaffected using MOPs. No clinically significant differences were found between the predicted and the actual outcomes of aligner treatment for variables gender, age, and severity of malalignment. However, the frequency of refinement treatment was greater in the 3-day aligner change group with MOPs than in the 14-day change group. Conclusions: Compared to the 14-day change of aligner, the 3-day change of aligner with MOPs did not affect the accuracy of orthodontic tooth movement, suggesting that MOPs can be used to reduce the length of clear aligner treatment without compromising the quality of the clinical outcome. A higher frequency of refinement treatment may be necessary for more complex cases with increased number of aligners and crowding of anterior teeth. Keywords: accelerated tooth movement, clear aligner treatment, micro-osteoperforations, traction of clear aligners

Background: This article is the result of a debate at the European Journal of Orthodontics Open Session in 2013 in Reykjavik, Iceland. Objective: The aim of this article is to highlight some of the strengths and weakness of clinical orthodontic research, with particular emphasis on randomized controlled trials (RCT). The ultimate aim of improving clinical orthodontic research in general. Design: This article is organized into two sections with arguments for and against RCTs. The backgrounds to evidence- based evaluation and the level or quality of evidence in trials are discussed. The article emphasises what makes high quality clinical research, and gives practical advice including examples of tips and potential pitfalls for those undertaking clinical research. Results and Conclusion: The overriding message is constructive and it is hoped that the article serves as an aid in evaluating, designing, conducting, and reporting clinical research. Keywords: asthenia, clinical research, evidence-based practice, gold standard, Iceland, orthodontics