Abstract
Objective:The aim of the present study is to propose a 3-dimensional evaluation of lower intrusion obtained with lingual orthodontics considering not only the crowns but also dental roots.Methods:9 adult patients underwent fixed lingual orthodontic treatment with i-TTя lingual brackets system for the correction of crowding in the lower arch associated with a deep overbite. Initial records, consisting of photos, CBCTs and intraoral scans were collected. Threshold segmentation of the CBCT was performed to generate a three-dimensional virtual model of each the teeth of the lower arch, superimposed with the crown of the same teeth obtained by intraoral scan models to generate a complete set of digital composite lower arch The same procedure was performed to monitor one key step of the i-TTЯ technique consisting in lower incisors intrusion (T2). T1-T2 three-dimensional superimposition and color displacement maps were generated to measure and evaluate the movements obtained at the lower arch.Results:The root displacement of the incisors during their intrusion in the early stage was totally “bone-safe” in the 88.9% (8 of 9) of the cases observed. No significant extrusion of the premolars used as anchorage unit was measured.Conclusion:This method has proved to be an accurate and reliable approach to dynamically visualize the 3-dimensional positions of the teeth, including their roots, with no additional radiation for in-progress treatment monitoring. The 3-dimensional evaluation showed that the employed lingual appliance allowed to obtain significant lower incisors intrusion with negligible undesired extrusion of premolars employed as anchorage teeth.
Highlights
In Orthodontics different appliances are used to move teeth from a malocclusion to a functional and stable occlusion with the teeth in their proper relationships as well as in harmony with the maxillofacial hard and soft tissues
The aim of the present study is to propose a 3-dimensional evaluation of lower intrusion obtained with lingual orthodontics considering the crowns and dental roots
9 adult patients underwent fixed lingual orthodontic treatment with i-TTя lingual brackets system for the correction of crowding in the lower arch associated with a deep overbite
Summary
In Orthodontics different appliances are used to move teeth from a malocclusion to a functional and stable occlusion with the teeth in their proper relationships as well as in harmony with the maxillofacial hard and soft tissues. The six fundamental keys that describe teeth locations in three-dimensional (3D) space defined by Andrews [1 - 4] were suggested for successful orthodontic treatment outcomes. One of the most frequent problem to solve in our orthodontic treatment is to find a proper mechanics for lower incisors intrusion in adult patients, considering the risk of unwanted side effects, such as buccal tipping of incisors associated to distal and/or buccal tipping of the anchorage units, usually represented by the posterior teeth, resulting in possible periodontal problems [9]. Lingual fixed appliances have been described as effective for reaching lower incisors intrusion minimizing side effects [10 - 16]
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