The Power of Customized Clear Aligners in Closing Molar Edentulous Spaces: Clinical and Medico-Legal Considerations in a Scoping Review and Case Report

Abstract

Successful closure of edentulous spaces with clear aligners (CAs) is influenced by many factors. CAs are tailored orthodontic devices whose predictability may have relevant medico-legal implications. This study presents a scoping review about missing molar space closure (MMSC) with CAs and a clinical case. This study aims to highlight the feasibility of molar space closure by mesialization with CAs without hybrid supports. Following PRISMA Sc-review guidelines, English-written randomized/non-randomized/observational clinical studies on PubMed, Scopus, Cochrane and Lilacs were searched. An 18-year-old patient, with upper and lower edentulous spaces due to the loss of two first molars, was rehabilitated with CAs (Sorridi®, Sorridi srl, Latina, Italy) without hybrid supports and attachments. The therapy was carried out over 10 months. Currently, there are no studies documenting MMSC by mesialization with only CAs. Existing articles document the closure of premolar or incisor spaces. The upper and lower left second molars replaced the missing first molars, and erupting third molars replaced adjacent teeth. The biomechanical effects in space closure with CAs related to extraction cases appear as priorities of clinical/medico-legal interest. Our case turns attention to this movement of CAs without attachments/hybrid supports, indicating that even such a complex treatment can be comfortable for patients and safely predictable for specialists.

New Perspectives in Third Molar Auto-Transplantation: Literature Review and a Case Report of Clinical, Financial and Forensic Implications

“…With regard to orthodontic splinting, in the selected literature, there does not seem to be a single orientation with respect to the type of method to be used nor with respect to the time of application on the third molars. Therefore, we maintained the methods and duration of application used for the other types of auto-transplanted teeth [ 10 , 13 , 42 , 43 , 44 , 45 , 46 ]. Still, the bone response visible on radiographs confirms the safety of auto-transplantation, for example, in the successful emergency treatment of complications of an oro-antral fistula [ 32 , 47 ].…”

Predictability of Dental Distalization with Clear Aligners: A Systematic Review

“…From a biomechanical point of view, CAs produce an orthodontic force that moves the teeth thanks to the reversible deformation of the aligner and a certain level of elasticity [105]. The use of transparent aligners to close an extraction site can cause a pronounced inclination of the adjacent teeth, such as the canines, in the case of extraction of the first premolar, and the posterior teeth, towards the extraction space [75,106]. It has been observed that a certain level of computer planning on the transparent masks can prevent unwanted rollovers towards the extraction space during the closure of the space [75,107].…”