Abstract
AimThe aim of the present study was to compare the accuracy of the actual space obtained through interproximal enamel reduction (IPR) compared to the amount of IPR planned through the digital setup during clear aligner treatment (CAT).Materials and methodsA total of 10 clinicians were randomly recruited using the Doctor Locator by Align Technology (California). For each clinician, four consecutive patients treated with CAT and manual stripping were selected for a total of 40 subjects and 80 dental arches. For each patient, the amount of planned IPR and the amount of actual IPR performed were recorded. Each arch was considered individually. For each arch, the mesio-distal tooth measurements were obtained from second to second premolars.ResultsNo systematic measurement errors were identified. In 25 cases, stripping was planned and performed in both arches; in 4 cases only in the upper arch and in the remaining 7 cases only in the lower arch. The difference between planned IPR and performed IPR was on average 0.55 mm (SD, 0.67; P = 0.022) in the upper arch and 0.82 mm (SD, 0.84; P = 0.026) in the lower arch. The accuracy of IPR in the upper arch was estimated to be 44.95% for the upper arch and 37.02% for the lower arch.ConclusionOverall, this study showed that the amount of enamel removed in vivo did not correspond with the amount of IPR planned. In most cases, the performed IPR amount was lower than planned. When considering the actual amount in millimeter, these differences may not be considered clinically relevant.
Highlights
Over the last 20 years, different technological improvements have revolutionized orthodontic treatment planning and execution
Overall, this study showed that the amount of enamel removed in vivo did not correspond with the amount of interproximal enamel reduction (IPR) planned
The success of clear aligner treatment (CAT) as an alternative orthodontic treatment is based on many potential advantages such as esthetics, increased patient comfort, improved oral hygiene control, and periodontal health compared to fixed appliances [2, 3]
Summary
Over the last 20 years, different technological improvements have revolutionized orthodontic treatment planning and execution. Extra-oral scanners have allowed the generation of digital models that can replace clay models for both treatment planning and appliance construction. When associated with increasing patient demands for esthetic and customized approaches, these innovations have allowed the development of different clear aligner systems as alternatives. The success of clear aligner treatment (CAT) as an alternative orthodontic treatment is based on many potential advantages such as esthetics, increased patient comfort, improved oral hygiene control, and periodontal health compared to fixed appliances [2, 3]. Several related features help the achievement of successful clear aligner treatment outcomes. Some are related to the patient’s physiology such as bone density [7], tooth crown and root shape [6]. Others depend on operator factors such as treatment planning, monitoring, and the accuracy in performing interproximal enamel reduction (IPR) [8]
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