Moving towards precision orthodontics: An evolving paradigm shift in the planning and delivery of customized orthodontic therapy

Abstract

Advances in precision medicine portend similar progress in orthodontics and will be increasingly harnessed to achieve customized treatment approaches and enhance treatment efficiencies. Our goal is to provide a background on emerging advances in computer technologies and biomedicine and highlight their current and likely future applications to precision orthodontics. A review of orthodontically relevant technologies and advances in pertinent biological research was undertaken. Innovations in computer hardware and software, and 3D imaging technologies offer the ability for customized treatment and biomechanical planning that will be more fully realized within the next few decades. These technologies combined with 3D printing are already being applied to customized appliance fabrication such as aligners and retainers. The future prospects for custom fabrication of orthodontic brackets of appropriate material properties and smart devices are highly desirable and compelling goals. Within biomedicine, the fundamental understanding of cartilage growth and bone biology is currently being tested in animal models to modify mandibular growth and modulate tooth movement, respectively. Some of these discoveries will ultimately have clinical applications in orthodontics including for growth modification, accelerating orthodontic tooth movement, and enhancing anchorage or retention of teeth. Additional genomic and proteomic information will add to further customization of orthodontic diagnosis and treatments. Over the coming decades, precision orthodontics will continue to benefit from advances in many fields and will require the integration of advances in technology, and biomedical and clinical research to deliver optimal, efficient, safe, and reproducible personalized orthodontic treatment.

Personalized scaffolding technologies for alveolar bone regenerative medicine

“…Additionally, it accommodates with principal stress on tissues, simulating different dynamic states of tissues. This shows a clear advancement in treatment planning in interdisciplinary dental fields …”

“…Furthermore, using 3D printing, skeletal components can be simulated and translated into physical models through the customized fabrication of appliances, which could serve as a surgical splint and/or a stainless‐steel arch wire. During the treatment planning phase, orthodontists and oral surgeons can utilize these appliances to review the relevant anatomical movements and discuss the detailed surgical procedures and anticipated surgical end point . This approach helps to reduce the surgical time and fulfil the aesthetic demands.…”

Hunting for genes that shape human faces: Initial successes and challenges for the future

“…The ability, for example, to predict aspects of facial morphology or facial growth from genetic information could have numerous applications, in the clinic and beyond. The concept of personalized orthodontics, where the therapeutic approach is based in part on a patient's genetic profile, is already shifting from theory to reality . Genetic information may also eventually inform surgical planning to correct craniofacial malformations.…”

“…An improved understanding of the genetic architecture of normal facial variation can not only provide insights into the biological mechanisms that control facial development, but can offer clues to help decipher the causes of anomalies involving the same facial structures. In the long term, our knowledge about the relationship between genotype and facial phenotype may inform personalized treatment planning in fields like orthodontics . There have now been a number of studies attempting to identify genetic variants associated with normal‐range variation in facial morphology.…”

“…In the long term, our knowledge about the relationship between genotype and facial phenotype may inform personalized treatment planning in fields like orthodontics. 5 There have now been a number of studies attempting to identify genetic variants associated with normal-range variation in facial morphology. In this brief review, we discuss the genetic evidence accumulated to date, some recent methodological advances, and some of the major challenges the field is facing.…”