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Clinical Performance of Direct-Printed Versus Thermoformed Aligners

2026年6月5日 更新者:Ali Rahman Issa、University of Baghdad

Clinical Performance of In-Office Directly Printed Versus Thermoformed Aligners: A Randomized Clinical Trial

The goal of this study is to evaluate and compare the clinical effectiveness of in-office directly 3D-printed clear aligners versus conventional multilayered thermoformed aligners.

The main question it aims to answer is:

Does the use of in-office direct-printed shape-memory aligners result in superior clinical effectiveness, compared to established multilayer thermoformed aligner systems?

Researchers will compare a Direct-Printed Aligner (DPA) group using Senertek Clear-A V2 resin to a Thermoformed Aligner (TFA) group using Zendura FLX multilayer sheets to see if the additive manufacturing process improves clinical outcomes and patient satisfaction.

Participants will:

  • Undergo initial records including intraoral digital scans, photos, and a panoramic radiograph for treatment planning.
  • Wear their assigned clear aligners (either direct-printed or thermoformed) for at least 22 hours per day, changing them every 7 days.
  • Attend follow-up appointments every 5 weeks.

調査の概要

詳細な説明

This is a prospective, parallel-arm randomized controlled multi-center clinical trial, to assess and compare the clinical effectiveness of in-office 3D-printed clear aligners with multilayered thermoformed aligners.

The subject population for this study will be male and female subjects aged 16-30 years who have fully erupted permanent dentition and mild dental crowding or spacing.

Methodology:

Patients requiring orthodontic treatment are randomly allocated into two groups.

Experimental Group (DPA): Aligners are fabricated using additive manufacturing (direct 3D printing) with Senertek Clear-A V2 shape-memory resin. This process eliminates the intermediate physical model, potentially reducing cumulative manufacturing errors.

Control Group (TFA): Aligners are fabricated by thermoforming multilayered thermoplastic sheets (Zendura FLX) over 3D-printed resin molds.

Assessment:

Digital models (STL files) will be obtained at the start (T0) and at the end of the treatment (T1). These will be compared to the digital treatment plan (Tp) using 3D superimposition and trigonometric analysis. Stable anatomical structures, such as the palatal rugae, will serve as reference points for superimposition. The primary outcome is the "Tracking Accuracy Percentage," which measures how closely the actual clinical tooth movement matches the digitally predicted movement. Secondary outcomes include clinical efficiency, patient-reported pain levels, and Manufacturing complexity, including total fabrication time.

研究の種類

介入

入学 (推定)

34

段階

  • 適用できない

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究場所

      • Baghdad、イラク、10013
        • 募集
        • Z Orchida Clinic
        • コンタクト:
      • Baghdad、イラク、10047
        • 募集
        • Orthodontic department, College of dentistry, university of Baghdad.
        • コンタクト:
    • Bab Al-Muadham
      • Baghdad、Bab Al-Muadham、イラク、10047

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

  • 子
  • 大人

健康ボランティアの受け入れ

はい

説明

Inclusion Criteria:

  1. Adult patient with an age range of 15-30 with fully erupted all permanent dentitions excluding third molars, and a willingness to participate in the trial.
  2. Angle Class I non-extraction cases, presented with mild crowding or spacing (<5 mm) and dental rotation <30° .
  3. Good oral hygiene; no active caries/periodontal disease, no history of trauma or root resorption.

Exclusion Criteria:

  1. Pregnancy, smoking, and systemic conditions affecting bone remodeling.
  2. Subject with poor oral hygiene, using simplified oral hygiene index (OHI-S ≥ 3.1 ) (Greene & Vermillion, 1963).
  3. Patient with malposed lower second molars (need orthodontic alignment).
  4. Allergy to materials used (resins, plastics, solvents).
  5. History of trauma, root resorption, and dilacerated roots.
  6. Previous extraction or history of previous orthodontic treatment.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:処理
  • 割り当て:ランダム化
  • 介入モデル:並列代入
  • マスキング:ダブル

武器と介入

参加者グループ / アーム
介入・治療
実験的:Direct-Printed Aligner
Participants in this group will receive clear aligners manufactured using in-office 3D printing technology. This arm tests the effectiveness of additive manufacturing and the shape-memory properties of the resin in achieving programmed tooth movements.
Participants in this group will receive clear aligner therapy fabricated via direct-printing, utilizing a specialized light-curable resin (Clear-A V2, Senertek, İzmir, Turkey).
アクティブコンパレータ:Thermoformed Aligner
Participants in this group will receive conventional clear aligners manufactured using the vacuum-forming (thermoforming) process. This arm serves as the gold standard to which the experimental 3D-printed aligners are compared.
Participants in this group will treated with clear aligners fabricated via the conventional indirect method, involving the thermoforming of thermoplastic sheets (Zendura FLX, Zendura dental, Fremont, California) over 3D-printed dental molds.

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Angular tooth movement tracking accuracy
時間枠:The expected duration of subject participation from enrollment to the end of treatment is 6-12 months.
Digital models (Initial (T0), planned (Tp), and final (T1)) will be compared using trigonometry. Angular measurements of vestibulo-lingual tipping, mesio-distal tipping, and rotation, will be performed on the three digital casts that had been previously superimposed.
The expected duration of subject participation from enrollment to the end of treatment is 6-12 months.
Linear tooth movement tracking accuracy
時間枠:The expected duration of subject participation from enrollment to the end of treatment is 6-12 months.
Evaluation of the tracking accuracy of linear tooth movements (in millimeters) by superimposing three-dimensional digital dental models across three therapeutic stages: Initial (T0), Planned (Tp), and Final (T1). Trigonometric spatial analysis will be executed on the superimposed digital casts to quantify the absolute positional discrepancy between the virtually planned tooth position and the actual clinically achieved position.
The expected duration of subject participation from enrollment to the end of treatment is 6-12 months.

二次結果の測定

結果測定
メジャーの説明
時間枠
Clinical efficiency
時間枠:The expected duration of subject participation from enrollment to the end of treatment is 6-12 months.
The additional treatment time necessitated by refinements will be calculated and compared statistically between the study groups.
The expected duration of subject participation from enrollment to the end of treatment is 6-12 months.
Evaluate degree of conversion
時間枠:The expected duration of subject participation from enrollment to the end of treatment is 6-12 months.
The relative concentration of unreacted aliphatic carbon double bonds will be evaluated by measuring the peak areas of the aliphatic C=C stretching vibrations (at 1634 cm -1 and 1620 cm-1) and the stable internal standard (N-H bending absorption at 1523 cm-1) via the tangent baseline technique. These distinct spectral values will be mathematically aggregated using the standard normalized ratio equation: DC (%)=[1-(R cured/R monomer)]×100. Unit of Measure, percentage (%) of converted double bonds.
The expected duration of subject participation from enrollment to the end of treatment is 6-12 months.
Shape memory property
時間枠:3 months
The percentage of shape recovery over time and the total deformation angles exhibited by both the direct-printed resin (Senertek Clear-A V2) and the thermoformed aligner sheets.Quantitative measurements will be recorded using a standardized thermo-mechanical bending test layout under controlled temperature intervals.
3 months
Color stability assessment
時間枠:The expected duration of subject participation from enrollment to the end of treatment is 6-12 months.
Optical transmittance will be measured across the visible light spectrum to evaluate and compare the transparency degradation and color stability of direct-printed versus thermoformed aligners before and after in vivo aging.
The expected duration of subject participation from enrollment to the end of treatment is 6-12 months.
Manufacturing complexity and fabrication time
時間枠:The expected duration of subject participation from enrollment to the end of treatment is 6-12 months.
For each workflow, the total production time, hands-on labor, and material expenses will be recorded and analyzed.
The expected duration of subject participation from enrollment to the end of treatment is 6-12 months.
Patient-Reported Treatment Discomfort
時間枠:The expected duration of subject participation from enrollment to the end of treatment is 6-12 months.
Patient-reported pain or discomfort evaluated on a standard horizontal Visual Analogue Scale (VAS) ranging from 0 (no pain) to 100 (severe pain). Unit of Measure, millimeters (mm) on a 100 mm scale.
The expected duration of subject participation from enrollment to the end of treatment is 6-12 months.

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

捜査官

  • スタディディレクター:Noor Muhammed Garma, Assistant Professor、University of Baghdad, College of Dentistry, Department of Orthodontic.

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (推定)

2026年6月1日

一次修了 (推定)

2027年9月1日

研究の完了 (推定)

2027年10月1日

試験登録日

最初に提出

2026年5月23日

QC基準を満たした最初の提出物

2026年6月5日

最初の投稿 (実際)

2026年6月9日

学習記録の更新

投稿された最後の更新 (実際)

2026年6月9日

QC基準を満たした最後の更新が送信されました

2026年6月5日

最終確認日

2026年6月1日

詳しくは

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個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

いいえ

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米国FDA規制医薬品の研究

いいえ

米国FDA規制機器製品の研究

いいえ

米国で製造され、米国から輸出された製品。

はい

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