Predictability of Root Movements Using Virtual Root Setup in a Patient With Periodontal Disease Treated With Clear Aligners

Stefano Martina,Marco Martini,Monica Bordegoni,Armando Viviano Razionale

doi:10.2174/1874210602115010605

Stefano Martina, Marco Martini + Show 2 more

Open Access

https://doi.org/10.2174/1874210602115010605

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Abstract

Aims: The aim of the study was to show a case with a midline diastema in a patient with high periodontal risks and gingival recessions treated with clear aligners. The objective was to predict and quantify root movements using a dedicated software that extrapolates data from the Cone Beam Computed Tomography (CBCT). Case Presentation: A 31-year-old female with a mandibular midline diastema asked for an aesthetic treatment. She had vertical bone loss on the lower central incisors, so a CBCT was necessary in order to plan the root movements. The purpose of the treatment was to avoid an uncontrolled tipping of the incisors and, therefore, a vestibular movement of the roots, which could cause serious periodontal problems. Conclusion: At the end of the treatment, the complete closure of the diastema and the radiographic healing of the vertical bone loss between mandibular central incisors were achieved. The superimpositions with the virtual setup demonstrated predictability of root movements of 76%.

Highlights

Nowadays, the majority of adult patients require orthodontic treatments, especially aesthetic treatments [1]
This paper suggests a method to close midline diastema in a patient with high periodontal risks and gingival recessions, and to predict and quantify root movements using clear aligners
This study shows that in this patient the aligners were able to give a torque movement to the lower incisors with an average predictability of 76%, higher than the values reported in the literature

Summary

Introduction

The majority of adult patients require orthodontic treatments, especially aesthetic treatments [1]. The displacement of the center of resistance towards the root apex causes a torque increase, which further aggravates the destruction of periodontal tissues [2]. In this regard, in periodontal compromised patients, it would be very important to predict the movements of the roots, which is not possible using the standard software for the clear aligners treatment setup, which allow to visualize only the movements of the dental crowns. The mandibular diastema is not a normal growth characteristic. It occurs less frequently than a maxillary diastema, but it is often more dramatic. A midline diastema may compromise smile attractiveness and dentofacial harmony [5], but not all diastemas can be treated the same in terms of modality or timing [6]

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