Treatment of impacted canines with aligners: An alternative and viable option

: To recover impacted canines without esthetic issues, the aligners can be a resolutive tool allowing by pontics the camouflage of absent canines during orthodontic treatment. Knowledge of biomechanics, correct staging of dental movements, and surgery planification are strategic to achieve a good result

Treatment of ectopic maxillary canines using a palatal implant for anchorage

[No abstract available

Clear aligner treatments in orthoperio patients

Introduction: Orthodontic treatment is a recognized approach to support specific periodontal issues thanks to its capability to manipulate periodontal tissues. This concept is certainly not new, but the use of aligners in certain clinical conditions can be considered as being innovative when a multidisciplinary treatment is necessary. Moreover, aligners enable to plan 3D tooth movements, root placement, staging, and range of dental movements, alongside the improvement of oral hygiene. Thus, aligners can be suitable for the treatment of periodontal issues. In this article, the authors present two clinical cases with different periodontal issues: one with superficial periodontal problems and the other with a deep one. Both cases were successfully treated with aligners, highlighting how this invisible and comfortable tool can simplify the management of complex adult treatments. Conclusion: Digital workflow is the key for success in the aligner technique. The possibility to design a virtual plan of treatment and to transfer it in the real clinical world represents a way to limit errors and to reduce the time of orthodontic therapy

SEM characterization and ageing analysis on two generation of invisible aligners

Abstract Background: The purpose of the in vitro study is to investigate and compare the morphological features and the chemical stability in weight of two different polyurethane-based blends, Smart Track (LD30) and Exceed30 (EX30), used for orthodontic aligners manufacture before and after the oral usage. Methods: Twenty orthodontic aligners were randomly selected: 10 LD30 and 10 EX30, each group was divided in two subgroups, never used and intra-orally aged. By the employment of a Stereomicroscope, a section of 5 × 5 mm was cut from the buccal surface of the incisal region of each aligner. All samples were subjected to Scanning Electron Microscopy and Ageing tests in different solutions to simulate the hostility of the oral environment. The statistical method used was t-test. Results: At SEM images, LD30 appears more homogeneous in texture respect to EX30. However, after clinical usage, both materials show significant structural alterations: findings have been supported by higher magnifications at SEM, by which it is clearly to observe many superficial cracks cross through the polymer structures of LD30U, absent in never used samples. LD30U surface becomes also smoother due to the disappearance of most of the conglomerates, but at the same time also rougher while EX30U shows a greater irregularity and porosity in which large and deep cracks are also highlighted. Although these changes occur persistently, in the aging tests no significant weight loss from both materials has been found, confirming the initial hypothesis of a good chemical stability and safety of both polyurethane mixtures even in conditions of severe hostility. Conclusion: LD30 is the expression of the technological evolution of EX30, this is made evident above all by its morphological architecture, more homogeneous and defined but also by the chemical stability that can be appreciated even in evident critic situations

Periodontal condition in growing subjects with Marfan Syndrome: a case-control study

Background Marfan’s syndrome (MFS) is a systemic disorder of connective tissue caused by mutations in the extracellular matrix protein fibrillin-1. Orofacial characteristics may be useful in identification of the syndrome. Severe periodontitis is sometimes observed in MFS patients, but no in-depth information has been reported in Italian groups of growing subjects with MFS. The aim of this study was to analyze the periodontal condition on a group of growing subjects affected by MFS, in comparison with a typically developed control group. Methods A group of 16 subjects with diagnosed MFS were recruited from the Centre for Rare Diseases for Marfan Syndrome and Related Disorders of Tor Vergata University Hospital. The Marfan Group (MG) was compared with a Control Group (CG) composed by 20 nonsyndromic subjects. The periodontal clinical parameters like Marginal Gingival Thickness (GT), Plaque Index (PI), Bleeding On Probing (BOP) and Modified Periodontal Screening and Recording (PSR) were assessed. Results The mean value of PI in MG was 59%, instead in CG it reached 21%. Analysis showed a significant difference between MG and CG also for the BOP. In MG the mean value of BOP attained 36% and in CG it reached 16%. A statistical significant difference of distribution of PSR index between the two groups was found for all sextant examined. Discussion Patients with Marfan syndrome reveal a higher presence of plaque and consequently a generalized inflammation in the oral cavity when compared with a control group

In vitro evaluation of structural factors favouring bacterial adhesion on orthodontic adhesive resins

Bacterial adhesion to the surface of orthodontic materials is an important step in the formation and proliferation of plaque bacteria, which is responsible for enamel demineralization and periodontium pathologies. With the intent of investigating if adhesive resins used for bracket bonding are prone to bacteria colonization, the surface roughness of these materials has been analyzed, combining information with a novel methodology to observe the internal structures of orthodontic composites. Scanning electron microscopy, combined with focus ion bean micromachining and stylus profilometry analyses, were performed to evaluate the compositional factors that can influence specific pivotal properties facilitating the adhesion of bacteria to the surface, such as surface roughness and robustness of three orthodontic adhesive composite resins. To confirm these findings, contact angle measurements and bacteria incubation on resin slide have been performed, evaluating similarities and differences in the final achievement. In particular, the morphological features that determine an increase in the resins surface wettability and influence the bacterial adhesion are the subject of speculation. Finally, the focused ion beam technique has been proposed as a valuable tool to combine information coming from surface roughness with specific the internal structures of the polymers

Le tecnologie CAD-CAM in odontoiatria: il sistema Invisalign: caratteristiche tecniche ed applicazioni cliniche

La tecnologia CAD-CAM (Computer Aided Design - Computer Aided Manufacturing) è presente in diversi settori dell’odontoiatria dalla diagnosi, alla chirurgia implantare, alla protesi sino di recente all’ortodonzia. In campo ortodontico la tecnologia CAD-CAM è alla base del sistema Invisalign, un innovativa tecnica in grado di riallineare i denti mediante una serie di mascherine in polimero trasparente, rimovibili ed invisibili. Gli elementi innovativi ed unici di Invisalign sono il Clincheck e la produzione industriale delle apparecchiature ortodontiche tramite la stereolitografia. Il Clincheck, la fase CAD del processo, è una rappresentazione grafica virtuale tridimensionale del piano di trattamento prescritto dal medico e riproduce le fasi della terapia in base alle quali verranno successivamente realizzate le mascherine. I vantaggi offerti dal Clincheck sono la possibilità di programmare e visualizzare la terapia prima che essa venga attuata. La fase CAM del processo è rappresentata dalla produzione industriale automatizzata delle mascherine basata sulla tecnica stereolitografica; questo è il secondo elemento innovativo di Invisalign. La stereolitografia consente la fabbricazione di una serie di modelli in resina realizzati con un polimero fotopolimerizzabile perfettamente corrispondenti ai modelli virtuali delle arcate visualizzati sul pc attraverso il Clincheck. Il nostro studio ha voluto testare la validità di questa tecnica ortodontica affrontando il trattamento di un paziente con caratteristiche cliniche al limite delle indicazioni presenti in letteratura e fornite dalla stessa Align Technology. I risultati ottenuti, decisamente positivi, ci fanno ritenere Invisalign una tecnica estremamente affidabile, predicibile e che presenta delle potenzialità di sviluppo ancora notevoli. Si può ben sperare che in futuro il campo di applicazione clinica di questa tecnica si amplierà notevolmente permettendo il trattamento di malocclusioni che oggi vengono ancora corrette esclusivamente con ortodonzia fissa.The CAD-CAM (Computer Aided Design - Computer Aided Manufacturing) technology is present in different sectors of dentistry: diagnosis, implantology, prosthodontics and orthodontics. In orthodontics the CAD-CAM technology is the base of the Invisalign system, a new technique to align teeth by a series of individualized, removable, and invisible acrylic splints. The innovative and original elements of Invisalign are the Clincheck and the Stereolithography technology to produce orthodontic appliances. The Clincheck (CAD phase) is a three-dimensional graphic representation of the treatment’s plan prescribed by the orthodontist, which reproduces the single stages of the therapy corresponding to the single aligners that will be produced. The Clincheck’s advantages are the possibility to program, view, and modify the therapy before it is realized. The CAM phase is represented by the industrial production of the aligners based on the Stereolithography technology: this is the second original element of the Invisalign. In fact, the Stereolithography lets the production of a series of the resin plastic models made photoactivated polymer, which correspond to the virtual models of the Clincheck. From these plastic resin models, clear removable appliances (aligners) are made. In this work we want to test the validity of Invisalign by the treatment of a patient with a malocclusion not indicated for this new technique yet. The positive clinical results indicate that the Invisalign is a reliable and predictable technique, which presents still potentiality of development. In the future, the clinical indications of Invisalign will become wider, enabling the treatment of malocclusions that today are corrected only by fixed appliances

Le tecnologie CAD-CAM in odontoiatria: il sistema Invisalign: caratteristiche tecniche ed applicazioni cliniche

La tecnologia CAD-CAM (Computer Aided Design - Computer Aided Manufacturing) è presente in diversi settori dell’odontoiatria dalla diagnosi, alla chirurgia implantare, alla protesi sino di recente all’ortodonzia. In campo ortodontico la tecnologia CAD-CAM è alla base del sistema Invisalign, un innovativa tecnica in grado di riallineare i denti mediante una serie di mascherine in polimero trasparente, rimovibili ed invisibili. Gli elementi innovativi ed unici di Invisalign sono il Clincheck e la produzione industriale delle apparecchiature ortodontiche tramite la stereolitografia. Il Clincheck, la fase CAD del processo, è una rappresentazione grafica virtuale tridimensionale del piano di trattamento prescritto dal medico e riproduce le fasi della terapia in base alle quali verranno successivamente realizzate le mascherine. I vantaggi offerti dal Clincheck sono la possibilità di programmare e visualizzare la terapia prima che essa venga attuata. La fase CAM del processo è rappresentata dalla produzione industriale automatizzata delle mascherine basata sulla tecnica stereolitografica; questo è il secondo elemento innovativo di Invisalign. La stereolitografia consente la fabbricazione di una serie di modelli in resina realizzati con un polimero fotopolimerizzabile perfettamente corrispondenti ai modelli virtuali delle arcate visualizzati sul pc attraverso il Clincheck. Il nostro studio ha voluto testare la validità di questa tecnica ortodontica affrontando il trattamento di un paziente con caratteristiche cliniche al limite delle indicazioni presenti in letteratura e fornite dalla stessa Align Technology. I risultati ottenuti, decisamente positivi, ci fanno ritenere Invisalign una tecnica estremamente affidabile, predicibile e che presenta delle potenzialità di sviluppo ancora notevoli. Si può ben sperare che in futuro il campo di applicazione clinica di questa tecnica si amplierà notevolmente permettendo il trattamento di malocclusioni che oggi vengono ancora corrette esclusivamente con ortodonzia fissa.The CAD-CAM (Computer Aided Design - Computer Aided Manufacturing) technology is present in different sectors of dentistry: diagnosis, implantology, prosthodontics and orthodontics. In orthodontics the CAD-CAM technology is the base of the Invisalign system, a new technique to align teeth by a series of individualized, removable, and invisible acrylic splints. The innovative and original elements of Invisalign are the Clincheck and the Stereolithography technology to produce orthodontic appliances. The Clincheck (CAD phase) is a three-dimensional graphic representation of the treatment’s plan prescribed by the orthodontist, which reproduces the single stages of the therapy corresponding to the single aligners that will be produced. The Clincheck’s advantages are the possibility to program, view, and modify the therapy before it is realized. The CAM phase is represented by the industrial production of the aligners based on the Stereolithography technology: this is the second original element of the Invisalign. In fact, the Stereolithography lets the production of a series of the resin plastic models made photoactivated polymer, which correspond to the virtual models of the Clincheck. From these plastic resin models, clear removable appliances (aligners) are made. In this work we want to test the validity of Invisalign by the treatment of a patient with a malocclusion not indicated for this new technique yet. The positive clinical results indicate that the Invisalign is a reliable and predictable technique, which presents still potentiality of development. In the future, the clinical indications of Invisalign will become wider, enabling the treatment of malocclusions that today are corrected only by fixed appliances