The combined use of computer-guided, minimally invasive, flapless corticotomy and clear aligners as a novel approach to moderate crowding: a case report
The aim of this case report was to describe an innovative orthodontic treatment
method that combined surgical and orthodontic techniques. The novel method
was used to achieve a positive result in a case of moderate crowding by
employing a computer-guided piezocision procedure followed by the use of clear
aligners. A 23-year-old woman had a malocclusion with moderate crowding. Her
periodontal indices, oral health-related quality of life (OHRQoL), and treatment
time were evaluated. The treatment included interproximal corticotomy cuts
extending through the entire thickness of the cortical layer, without a fullthickness
flap reflection. This was achieved with a three-dimensionally printed
surgical guide using computer-aided design and computer-aided manufacturing.
Orthodontic force was applied to the teeth immediately after surgery by using
clear appliances for better control of tooth movement. The total treatment time
was 8 months. The periodontal indices improved after crowding correction, but
the oral health impact profile showed a slight deterioration of OHRQoL during
the 3 days following surgery. At the 2-year retention follow-up, the stability of
treatment was excellent. The reduction in surgical time and patient discomfort,
increased periodontal safety and patient acceptability, and accurate control of
orthodontic movement without the risk of losing anchorage may encourage the
use of this combined technique in appropriate cases
