Class II Malocclusion in Adult Patients: What Are the Effects of the Intermaxillary Elastics with Clear Aligners? A Retrospective Single Center One-Group Longitudinal Study
Roberto Rongo, Simona Dianišková, Antonio Spiezia, Rosaria Bucci, Ambrosina Michelotti, Vincenzo D'Antò, Roberto Rongo, Simona Dianišková, Antonio Spiezia, Rosaria Bucci, Ambrosina Michelotti, Vincenzo D'Antò
Abstract
Aim: To evaluate the dental effects of the treatment with clear aligners and intermaxillary elastics in adult patients with Class II malocclusion. Material and methods: A sample of 20 Class II patients treated with Invisalign aligners (5 M and 15 F; mean age of 27.6 ± 6.3 years) was included in this single-center one-group longitudinal study. Dental cast and cephalometric records were analyzed before (T0) and after treatment (T1). Data were analyzed with a t-test for paired data (p < 0.05). Results: There was a significant reduction of the Overjet (OVJ= −1.4 ± 0.2; p ≤0.001) and a retroposition of upper incisors (U1-NPo = −1.3 ± 1.7; p < 0.001). Furthermore, distalization of upper molars with an improvement of molar class (U6-PT Vertical = −0.93 ± 0.97; p < 0.001; Molar Relation = −0.75 ± 0.45; p < 0.001) was observed. A good control of the lower and upper incisor inclination was present, highlighted by the non-significant changes in these values (L1-GoGn = −0.12 ± 5.4; p = 0.923; U1-AnsPns = −1.1 ± 8.1; p = 0.551). In the lower arch, an increase in the intermolar diameter (0.6 ± 1.0; p = 0.01) was present. Finally, there were no statistically significant changes in all the skeletal variables (ANPg = 0.005 ± 0.687; p = 0.974; SN/MP = −0.47 ± 1.9; p = 0.298). Conclusions: Treatment with Invisalign aligners shows a reduction of the Overjet, a retroposition of the upper incisors, good control of the lower incisors, and an improvement of the molar relationship.
Keywords: Class II; adults; clear aligners; elastics.
Conflict of interest statement
The authors declare no conflict of interest.
Figures
References
- Shalish M., Cooper-Kazaz R., Ivgi I., Canetti L., Tsur B., Bachar E., Chaushu S. Adult Patients’ Adjustability to Orthodontic Appliances. Part I: A Comparison between Labial, Lingual, and InvisalignTM. Eur. J. Orthod. 2012;34:724–730. doi: 10.1093/ejo/cjr086.
- Rosvall M.D., Fields H.W., Ziuchkovski J., Rosenstiel S.F., Johnston W.M. Attractiveness, Acceptability, and Value of Orthodontic Appliances. Am. J. Orthod. Dentofac. Orthop. 2009;135:276–277. doi: 10.1016/j.ajodo.2008.09.020.
- Walton D.K., Fields H.W., Johnston W.M., Rosenstiel S.F., Firestone A.R., Christensen J.C. Orthodontic Appliance Preferences of Children and Adolescents. Am. J. Orthod. Dentofac. Orthop. 2010;138:698.e1–698.e12. doi: 10.1016/j.ajodo.2010.06.012.
- Azaripour A., Weusmann J., Mahmoodi B., Peppas D., Gerhold-Ay A., Van Noorden C.J.F., Willershausen B. Braces versus Invisalign®: Gingival Parameters and Patients’ Satisfaction during Treatment: A Cross-Sectional Study. BMC Oral Health. 2015;15:69. doi: 10.1186/s12903-015-0060-4.
- Melkos A.B. Advances in Digital Technology and Orthodontics: A Reference to the Invisalign Method. Med. Sci. Monit. Int. Med. J. Exp. Clin. Res. 2005;11:PI39–PI42.
- Bucci R., Rongo R., Levatè C., Michelotti A., Barone S., Razionale A.V., D’Antò V. Thickness of Orthodontic Clear Aligners after Thermoforming and after 10 Days of Intraoral Exposure: A Prospective Clinical Study. Prog. Orthod. 2019;20:36. doi: 10.1186/s40510-019-0289-6.
- Ravera S., Castroflorio T., Garino F., Daher S., Cugliari G., Deregibus A. Maxillary Molar Distalization with Aligners in Adult Patients: A Multicenter Retrospective Study. Prog. Orthod. 2016;17:12. doi: 10.1186/s40510-016-0126-0.
- Simon M., Keilig L., Schwarze J., Jung B.A., Bourauel C. Forces and Moments Generated by Removable Thermoplastic Aligners: Incisor Torque, Premolar Derotation, and Molar Distalization. Am. J. Orthod. Dentofac. Orthop. 2014;145:728–736. doi: 10.1016/j.ajodo.2014.03.015.
- Bin Bahar B.S.K., Alkhalidy S.R., Kaklamanos E.G., Athanasiou A.E. Do Orthodontic Patients Develop More Gingival Recession in Anterior Teeth Compared to Untreated Individuals? A Systematic Review of Controlled Studies. Int. Orthod. 2020;18:1–9. doi: 10.1016/j.ortho.2019.08.025.
- Papageorgiou S.N., Koletsi D., Iliadi A., Peltomaki T., Eliades T. Treatment Outcome with Orthodontic Aligners and Fixed Appliances: A Systematic Review with Meta-Analyses. Eur. J. Orthod. 2020;42:331–343. doi: 10.1093/ejo/cjz094.
- Janson G., Sathler R., Fernandes T.M.F., Branco N.C.C., de Freitas M.R. Correction of Class II Malocclusion with Class II Elastics: A Systematic Review. Am. J. Orthod. Dentofac. Orthop. 2013;143:383–392. doi: 10.1016/j.ajodo.2012.10.015.
- Dianiskova S., Rongo R., Buono R., Franchi L., Michelotti A., D’Antò V. Treatment of Mild Class II Malocclusion in Growing Patients with Clear Aligners versus Fixed Multibracket Therapy: A Retrospective Study. Orthod. Craniofac. Res. 2021;25:96–102. doi: 10.1111/ocr.12500.
- You Z.H., Fishman L.S., Rosenblum R.E., Subtelny J.D. Dentoalveolar changes related to mandibular forward growth in untreated Class II persons. Am. J. Orthod. Dentofacial. Orthop. 2001;120:598–607. doi: 10.1067/mod.2001.119801.
- Sfondrini M., Cacciafesta V., Sfondrini G. Upper Molar Distalization: A Critical Analysis: Upper Molar Distalization. Orthod. Craniofac. Res. 2002;5:114–126. doi: 10.1034/j.1600-0544.2002.01155.x.
- Fontana M., Cozzani M., Mutinelli S., Spena R., Caprioglio A. Maxillary Molar Distalization Therapy in Adult Patients: A Multicentre Study. Orthod. Craniofac. Res. 2015;18:221–231. doi: 10.1111/ocr.12098.
- Caruso S., Nota A., Ehsani S., Maddalone E., Ojima K., Tecco S. Impact of Molar Teeth Distalization with Clear Aligners on Occlusal Vertical Dimension: A Retrospective Study. BMC Oral Health. 2019;19:182. doi: 10.1186/s12903-019-0880-8.
- Rossini G., Parrini S., Castroflorio T., Deregibus A., Debernardi C.L. Efficacy of Clear Aligners in Controlling Orthodontic Tooth Movement: A Systematic Review. Angle Orthod. 2015;85:881–889. doi: 10.2319/061614-436.1.
- Aras I., Pasaoglu A. Class II Subdivision Treatment with the Forsus Fatigue Resistant Device vs Intermaxillary Elastics. Angle Orthod. 2017;87:371–376. doi: 10.2319/070216-518.1.
- Pancherz H. The Mechanism of Class II Correction in Herbst Appliance Treatment. Am. J. Orthod. 1982;82:104–113. doi: 10.1016/0002-9416(82)90489-4.
- Gerszewski C., Topolski F., Correr G.M., Gomes R.A.P., Morais N.D., Moro A. Dentoalveolar Evaluation of Lower Incisors by CBCT after Treatment with Herbst Appliance. Braz. Dent. J. 2018;29:562–568. doi: 10.1590/0103-6440201802382.
- Kinzinger G., Frye L., Diedrich P. Class II Treatment in Adults: Comparing Camouflage Orthodontics, Dentofacial Orthopedics and Orthognathic Surgery—A Cephalometric Study to Evaluate Various Therapeutic Effects. J. Orofac. Orthop. Fortschr. Kieferorthopädie. 2009;70:63–91. doi: 10.1007/s00056-009-0821-2.
- Bucci R., Rongo R., Bucci P., Valletta R., Michelotti A., D’Antò V. Effects of surgical mandibular advancement on the upper airways of adult class II patients: A systematic review with meta-analysis. J. Oral Rehabil. 2021;48:210–232. doi: 10.1111/joor.13140.
- Martina S., Rongo R., Bucci R., Razionale A.V., Valletta R., D’Antò V. In vitro cytotoxicity of different thermoplastic materials for clear aligners. Angle Orthod. 2019;89:942–945. doi: 10.2319/091718-674.1.
- Tamburrino F., D’Antò V., Bucci R., Alessandri-Bonetti G., Barone S., Razionale A.V. Mechanical Properties of Thermoplastic Polymers for Aligner Manufacturing: In Vitro Study. Dent. J. 2020;8:47. doi: 10.3390/dj8020047.
- D’Antò V., Bucci R., De Simone V., Huanca Ghislanzoni L., Michelotti A., Rongo R. Evaluation of Tooth Movement Accuracy with Aligners: A Prospective Study. Materials. 2022;15:2646. doi: 10.3390/ma15072646.
- Martina S., Amato A., Faccioni P., Iandolo A., Amato M., Rongo R. The perception of COVID-19 among Italian dental patients: An orthodontic point of view. Prog. Orthod. 2021;22:11. doi: 10.1186/s40510-021-00355-7.
- Madariaga A.C.P., Bucci R., Rongo R., Simeon V., D’Antò V., Valletta R. Impact of Fixed Orthodontic Appliance and Clear Aligners on the Periodontal Health: A Prospective Clinical Study. Dent. J. 2020;8:4. doi: 10.3390/dj8010004.
- Patterson B.D., Foley P.F., Ueno H., Mason S.A., Schneider P.P., Kim K.B. Class II maloc-clusion correction with Invisalign: Is it possible? Am. J. Orthod. Dentofacial. Orthop. 2021;159:e41–e48. doi: 10.1016/j.ajodo.2020.08.016.
Source: PubMed