Orthodontic Aligner Treatment: A Review of Materials, Clinical Management, and Evidence

Description:

For almost 20 years, clear aligners have seen growing popularity in addressing patients' demands for orthodontic treatment that is also discreet and esthetically inconspicuous. Especially for the adult patient, these almost invisible systems are in considerable demand.

Supported by solid clinical evidence, this new work introduces and discusses all the presently available thermoplastically formed products that apply a predetermined strain to the teeth and jaw, with the goal of correcting malpositioned teeth, while also being esthetically acceptable for the patient.

Key Features:

More than a dozen contributions by top international experts

Includes the most recent guidelines on clinical management with aligners

Scientific approach presents evidence from material properties research, forces generated with aligners, and treatment outcome assessments

Valuable information on changes in oral microbiota, potential side effects, biocompatibility, and more

Orthodontic Aligner Treatment will be welcomed by all orthodontic specialists, as well as graduate students, researchers, and clinical faculty in the field.

Table of Contents:

Section I Introduction: Types and Material Properties

1 Aligner Treatment: An Overview

1.1 Introduction

1.2 Esthetic Treatment Demands

1.3 Clear Aligner Therapy

1.4 Orthodontic Tooth Movement with Clear Aligners

1.5 Material Properties of Clear Aligners

1.6 Conclusion

References

2 Material Properties of Aligners

2.1 Introduction

2.2 Chemical Composition

2.3 Material Properties

2.3.1 Mechanical Properties

2.3.2 Water Absorption

2.3.3 Transparency

References

Section II Clinical Management

3 Early Treatment in Preteens and Teenagers Using Aligners

3.1 Introduction

3.2 Fixed Expansion

3.3 Removable Anterior Bite Plate Appliance

3.4 Removable Posterior Bite Plate Appliance

3.5 Functional Appliance

3.6 Invisalign First

3.7 Invisalign Treatment with Mandibular Advancement

3.7.1 Mandibular Advancement with Precision Wings and Aligners

3.7.2 Mandibular Advancement with Magnet-Activated Aligners

3.8 Treatment in Early Mixed Dentition

3.9 Treatment in Late Mixed Dentition

3.10 Treatment in Permanent Dentition in Young Adolescents

3.11 Conclusion

References

4 Teen Treatments with Aligners

4.1 System Check

4.2 Treatment Strategies

4.2.1 Class II Malocclusion Treatment

4.2.2 Class III Malocclusion Treatment

4.3 Space Management

4.3.1 Spacing (Excess of Space)

4.3.2 Lack of Space

4.4 Vertical Problems

4.4.1 Open Bite

4.4.2 Deep Bite

4.5 Dislocated Impacted Canines

4.6 Interdisciplinary Treatments

4.6.1 Auxiliaries

4.6.2 Elastics

4.6.3 TADs

4.6.4 Power Arms/Lever Arms

4.6.5 Braces, Sectionals

4.7 Retention

5 Routine Mechanics and Aligners (Extraction/Nonextraction)

5.1 Introduction

5.2 Initial Appointments and Informed Consent

5.3 Nonextraction Plans (Class I, II, and III Malocclusions)

5.3.1 Class I Malocclusion Considerations

5.3.2 Class II Malocclusion Considerations

5.3.3 Class III Malocclusion Considerations

5.4 Extraction Plans (Extraction Plans, Anchorage Control, Compensatory Movements)

5.4.1 Considerations in Extraction Plans

5.4.2 ClinCheck and Treatment Planning

5.4.3 Planning and Execution

5.4.4 Shape-Driven Orthodontics

5.4.5 Compensatory Movements

5.4.6 Attachment Designs

5.4.7 Class I Malocclusion Considerations

5.4.8 Class II Malocclusion Considerations

5.4.9 Class III Malocclusion Considerations

5.5 Conclusion

References

6 Precautions with Aligner Treatment

6.1 Special Care with Aligner Therapy

6.2 Conclusion

References

Appendices (Aligner Efficiency in Individual Tooth Movements)

Appendix A: Alignment

Appendix B: Labiolingual Inclination: Tipping

Appendix C: Labiolingual Inclination: Torque

Appendix D: Transverse Plane

Appendix E: Vertical Plane: Intrusion

Appendix F: Vertical Plane: Extrusion

Appendix G: Rotations

7 Clear Plastic Appliances as Retainers

7.1 Introduction

7.2 Historical Background to Clear Plastic Retainers

7.3 Worldwide Use of Clear Plastic Retainers

7.4 Types of Materials and Methods of Production

7.5 Polyethylene and Polypropylene Retainers

7.6 Polyurethane Retainers

7.7 Multilayer Clear Plastic Retainers

7.8 Thickness of Retainers

7.9 Production of Retainers

7.10 Design of Clear Plastic Retainers

7.11 How Often to Wear Clear Plastic Retainers?

7.12 Indications for Use

7.13 Clear Plastic Retainers: An Evidence-Based Approach

7.14 Clear Plastic Retainers versus Hawley Retainers

7.15 Clear Plastic Retainers versus Begg Retainers

7.16 Clear Plastic Retainers versus Bonded (Fixed) Retainers

7.17 Clear Plastic Retainers: Full Coverage versus Modified Clear Plastic Retainers

7.18 Safety and Clear Plastic Retainers

7.19 Longevity of Clear Plastic Retainers

7.20 Compliance with Clear Plastic Retainers

7.21 The Future

References

8 Digital Workflow in Aligner Therapy

8.1 Introduction

8.2 Dental Records

8.3 Data Acquisition

8.4 Diagnostics

8.5 Planning

8.6 Outcome Simulation

8.7 Designing Aligners and Management Portals

8.8 Manufacturing Aligners

References

Section III Evidence

9 Outcome Assessment and Evidence on the Clinical Performance of Orthodontic Aligners

9.1 Background

9.2 Appraisal of Evidence from Existing Clinical Studies

9.3 Characteristics of Existing Clinical Studies Comparing Aligners to Fixed Appliances

9.4 Treatment Efficacy in Terms of Occlusal Outcome

9.5 Treatment Efficiency in Terms of Duration and Adverse Effects

9.6 Strength of Current Recommendations and Threats to Their Validity

9.7 Conclusion

References

10 Forces and Moments Generated by Aligner-Type Appliances for Orthodontic Tooth Movement

10.1 Introduction

10.2 Existing Evidence

10.2.1 Aligner Thickness

10.2.2 Type of Tooth Movement

10.2.3 Aligner Material

10.2.4 Internal Validity of the Existing Evidence

10.3 Conclusion

References

11 Aligners and the Oral Microbiome

11.1 Introduction

11.2 Oral Hygiene during Orthodontic Treatment

11.3 Effect of Orthodontic Treatment on the Oral Microbiome

11.4 Cariogenic Bacteria

11.5 Periodontopathic Bacteria

11.6 Conclusion

References

12 Intraoral Aging and Changes on Aligner Mechanical Properties

12.1 Introduction

12.2 Mechanical Properties after In Vivo Aging

12.3 Hardness

12.4 Elastic Modulus

12.5 Tensile Strength

12.6 Creep–Relaxation

12.7 Mechanisms of Degradations of Mechanical Properties

References

13 Color Changes of Aligners and Thermoplastic Retainers during Intraoral Service

13.1 Introduction

13.2 Mechanisms of Discoloration of Aligners and Thermoplastic Retainers

13.3 Other Phenomena Influencing Color of Aligners and Thermoplastic Retainers

13.4 Research on Discoloration of Aligners and Thermoplastic Retainers

13.4.1 In Vitro Studies

13.4.2 In Vivo Studies

13.5 Conclusion

References

14 Biological Properties of Aligners

14.1 Introduction

14.2 Plastic Toxicity

14.2.1 General Aspects

14.2.2 Dental Environment

14.2.3 Orthodontic Materials

14.2.4 Invisalign

References

15 Aligner Treatment from the Patient Perspective

15.1 Introduction

15.2 Oral Health-Related Quality of Life

15.3 Assessment of Health and Oral Health-Related Quality of Life

15.4 Oral Health-Related Quality of Life and Malocclusion

15.5 Oral Health-Related Quality of Life and Clear Aligner Treatment

15.6 Pain Experience

15.7 Satisfaction with Treatment

15.8 Conclusion

References

Index