Three-dimensional digital planning of class III decompensation with clear aligners: Hard and soft tissue augmentation with concomitant corticotomy to stretch the limits of safe orthodontic treatment

Brugnami, Federico; Meuli, Simonetta; Caiazzo, Alfonso; Marrocco, Sergio; Scopelliti, Domenico

doi:10.1016/j.jobcr.2021.02.011

Cited by 7 publications

(8 citation statements)

References 26 publications

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“…4,27 In recent years, various attempts, such as regenerative corticology 28 and anterior segmental subapical osteotomy, have been reported for incisor axis correction. [29][30][31][32] In addition, rotational maxillary setback in 2-jaw surgery has been used to decompensate the inclination of the maxillary incisors by surgery. 5,30 Also, Le Fort I osteotomy is a typical surgical movement for the correction of incisor proclination.…”

Section: Discussionmentioning

confidence: 99%

“…[29][30][31][32] In addition, rotational maxillary setback in 2-jaw surgery has been used to decompensate the inclination of the maxillary incisors by surgery. 5,30 Also, Le Fort I osteotomy is a typical surgical movement for the correction of incisor proclination. 6 The U1-SN angle and the U1-NA measurements were conventionally used to represent the inclination of maxillary anterior teeth, and according to past practice, they were planned to reach the ethnic norm after decompensation.…”

Section: Discussionmentioning

confidence: 99%

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The Efficiency of Segmental Le Fort I Surgery in Clear Aligner Therapy of Skeletal Class III Deformity: A Pilot Study

Xiao,

Wu,

Yeweng

2024

Journal of Craniofacial Surgery

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Introduction: The purpose of this study was to investigate the efficiency of segmental Le Fort I osteotomy in clear aligner therapy of skeletal Class III deformities and to explore whether Le Fort I segmental osteotomy was effective for maxillary incisor axis correction and reduced the duration of perioperative orthodontics. Materials and Methods: Patients who had skeletal Class III deformities (ANB<0) treated with extraction of the maxillary first premolars, segmental Le Fort I osteotomy, and clear aligners therapy were included in this retrospective study. We measured the amount of tooth extraction space that was closed by surgery and recorded the preoperative orthodontic and total treatment duration. Lateral cephalograms were analyzed to measure changes of maxillary incisor inclination before treatment (T0), 1 week before surgery (T1), 1 week after surgery (T2), and after total orthodontic treatment (T3). Statistical analyses were performed, and the P value was set at 0.05. Results: The sample was composed of 15 patients aged 19 to 30 (M=22.9) years. The average preoperative orthodontic treatment duration was 16.2±5.22 mo, with 33.5 pairs of clear aligners. The gap at the extraction site decreased from 5.42±1.57 mm to 0.80±0.62 mm on average after surgery. U1-SN and U1-NA(deg) increased sparingly with preoperative decompensation, decreased in quantity after surgery, and then slightly increased with postoperative compensation (T2<T3<T0<T1; △U1-SN, △U1-NA: T1-T2, P<0.05; T0-T1 and T2-T3, P >0.05). Conclusions: Le Fort I segmental osteotomy assisted decompensation of the upper anterior teeth and reduced the duration of preoperative orthodontics with clear aligners.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Efficiency of Segmental Le Fort I Surgery in Clear Aligner Therapy of Skeletal Class III Deformity: A Pilot Study

Xiao,

Wu,

Yeweng

2024

Journal of Craniofacial Surgery

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“…The first-generation aligner systems have introduced hybrid systems (elastics, mini-screws, corticotomies, etc.) to support complex movements scarcely achievable with a pure system [ 9 , 10 , 13 , 16 , 17 , 18 , 19 , 20 , 21 ], but little is known about other systems in both pure and hybrid forms [ 6 , 11 , 12 , 36 ]. Thus, the attempt to find data relating to MMSC through the reciprocal movement of mesialization of other molars present and the distalization of latero-posterior teeth, brings out an important fact: this movement has not yet been described with any CA system [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

“…Correction of deep bites, rotations, arch expansions and movements that require root control are more likely to be unsatisfactory [ 6 , 7 , 8 ]. For this reason, in extractive cases, hybrid systems that offset the insufficient biomechanical performance at the pure tooth–aligner interface are preferable [ 9 , 10 , 11 , 12 ]. Orthodontic forces are attenuated by wearing CAs that disallow them from exerting sufficiently constant strength and elasticity without creep and stress relaxation [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

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

Putrino,

Marinelli,

Zaami

2023

JPM

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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.

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“…The digital workflow allows for a 3D scan of the dental arches and the design of tooth movements. It is possible to choose which teeth to move individually, as if using a segmented orthodontic system, or to move all the teeth simultaneously, as if using a straight wire or functional orthodontic system [ 27 , 28 , 29 , 30 , 31 , 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Treatment of Class III Malocclusion and Anterior Crossbite with Aligners: A Case Report

et al. 2022

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The article describes the orthodontically treated case of a 25-year-old patient with skeletal and dental class III malocclusion, anterior crossbite, which caused functional and aesthetic problems, occlusal trauma, and incisor wear. Treatment with transparent aligners was proposed to meet the patient’s needs, using the sequential distalization protocol. While sequential distalization is well documented for class II malocclusion treatment in maxillary arch teeth, further investigations are necessary for class III malocclusions. In fact, lower teeth movements are more complex due to mandibular bone density and the presence of the third molars, which are often extracted to perform distalization. In addition, the use of intermaxillary elastics helps control the proclination of the anterior teeth as a reaction to distalizing forces. At the end of the treatment, the patient reached molar and canine class I and positive overjet and overbite. The inclination of lower incisors and the interincisal angle have improved, resulting in aesthetic and functional enhancement.

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Three-dimensional digital planning of class III decompensation with clear aligners: Hard and soft tissue augmentation with concomitant corticotomy to stretch the limits of safe orthodontic treatment

Cited by 7 publications

References 26 publications

The Efficiency of Segmental Le Fort I Surgery in Clear Aligner Therapy of Skeletal Class III Deformity: A Pilot Study

The Efficiency of Segmental Le Fort I Surgery in Clear Aligner Therapy of Skeletal Class III Deformity: A Pilot Study

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

Treatment of Class III Malocclusion and Anterior Crossbite with Aligners: A Case Report

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