Abstract
BackgroundIn adult patients, treatment of skeletal crossbite requires combined treatment by fixed or removable appliances and orthognathic surgery. In cases of dentoalveolar crossbite, expansion can be achieved with fixed multibrackets and removable transparent aligners. Various researchers have already assessed the Invisalign system’s predictability for arch expansion. However, most of this research was conducted using older appliances, making it necessary to assess the characteristics of the updated system SmartTrack.Material and methodsA sample of 114 patients with transverse malocclusion were treated with SmartTrack. The predictability of the system’s software (Clincheck) was assessed by comparing planned measurements (width of canines, premolars and molars rotations and inclinations) with the real measurements achieved at the end of the first treatment phase. Measurements were imported to Clincheck software to create three data sets; T1: initial measurements at start of treatment; T2: Clincheck predicted measurements at end of first treatment phase; T3: measurements taken at start of the second treatment phase.ResultsWidths underwent significant advances as a result of treatment. For all widths, virtual planning obtained prognoses of greater expansion than actually achieved: a mean of 0.63 mm more expansion at the canine level (p<0.001), 0.77 mm at first premolar (p<0.001), 0.81 at second premolar (p<0.001), 0.69 mm at first molar (p<0.001), and 0.25 mm at second molar (p = 0.183). All the treatment plan’s estimations, with the exception of the second molar, were significantly higher than the actual outcomes.ConclusionsAligners are an effective tool for producing arch expansion, being more effective in premolar area and less effective in canine and second molar area. Predictability was reasonable for expansion movement. Overcorrection should be considered at the virtual planning stage in order to obtain the expected outcomes.
Highlights
In the transverse plane, occlusion is considered correct when the palatal cusps in the upper posterior regions occlude into the fossae of the lower posterior teeth
A sample of 114 patients with transverse malocclusion were treated with SmartTrack
Aligners are an effective tool for producing arch expansion, being more effective in premolar area and less effective in canine and second molar area
Summary
Occlusion is considered correct when the palatal cusps in the upper posterior regions occlude into the fossae of the lower posterior teeth. When the vestibular cusps in upper posterior regions occlude into the fossae of the lower posterior teeth, this produces the malocclusion known as posterior crossbite. This type of malocclusion may be of skeletal origin, whereby the dentoalveolar processes are correctly positioned in relation to the bone base but the base presents either maxillary skeletal hypoplasia or mandibular skeletal hyperplasia (or both). When the malocclusion is of dental origin, the bone base will present a correct transversal proportion but irregular dentoalveolar processes. Most of this research was conducted using older appliances, making it necessary to assess the characteristics of the updated system SmartTrack
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