Massive intrusion of maxillary second molar for prosthodontic purposes through miniscrew-supported biomechanics and fixed partial appliances: A case report.

This clinical case demonstrates how the use of a hybrid approach consisting of aligners, orthodontic miniscrews and partial fixed appliances can be an effective and efficient solution for recovering adequate vertical space for satisfactory implant-prosthetic rehabilitation. Specifically, massive intrusion of an upper second molar (tooth 1.7) was achieved orthodontically with direct TADs support to allow otherwise unpredictable movements and achieve maximum anchorage control for subsequent implant rehabilitation of the fourth quadrant.

Class II subdivision with skeletal transverse maxillary deficit treated by single-sitting bone-borne appliance.

This case report describes orthodontic treatment including both skeletal maxillary expansion and unilateral distalization by means of a single bone-borne appliance followed by clear aligner therapy in a young adult patient. A surgical guide was digitally designed and three-dimensionally printed to facilitate the placement of four miniscrews in the palatal vault. The miniscrews were fitted and the bone-borne appliance was delivered in a single clinical appointment. The postexpansion photographic records and models demonstrate the opening of the palatal median suture, the pure skeletal expansion, and the resolution of the left crossbite after 40 activations. Specifically, left molar Class I was obtained in about 5 months without any loss of anterior anchorage, and the subsequent aligner phase achieved all of the objectives established in the treatment plan. This case report shows clearly how careful digital planning of miniscrew insertion and the delivery of a pure bone-borne appliance in a single sitting enabled good clinical outcomes to be achieved in an acceptable timeframe, without side effects, even in a young adult patient.

Clear aligner hybrid approach: A case report.

INTRODUCTION: This case demonstrates that hybrid application of clear aligners can be a rational and efficient approach for treating malocclusions, as compared with a clear aligner therapy alone option in which the magnitude of some movements would require a higher number of aligners and likely further refinement. TREATMENT PLAN AND PROGRESS: After a first successful orthopedic phase face mask + rapid maxillary expansion (FM + RME), a diagnostic digital setup of the second orthodontic treatment phase was performed, opting for an esthetic approach to make the treatment as fast and efficient as possible. After positioning lingual tubes on both arches, digital models were obtained and lingual archwires, passing through the previously positioned tubes, were simulated digitally. Then, a virtual setup comprising 10 steps for both arches was planned. Aligners enveloped fixed partial lingual appliances, improving patient comfort and efficiency of overall treatment. Aligners were changed every 7 days and the second phase of treatment was finished in 10 weeks with good occlusion and alignment in both arches. The entire treatment of the Class III patient was completed in 13 months of active therapy. CONCLUSION: Combining clear aligner therapy and fixed lingual appliance is an esthetic means of treating malocclusions in a shorter treatment time with low costs and high efficiency.

Class II subdivision correction with clear aligners using intermaxilary elastics.

BACKGROUND: To describe an esthetic orthodontic treatment using aligners in an adult patient with class II subdivision associated with crowding and dental crossbite. An 18-year-old hyperdivergent male patient with skeletal class II from mandibular retrusion presented for an orthodontic treatment. Occlusally, the patient presents class II subdivision, crossbite at tooth 4.4, an upper midline deviated towards the left with respect to the lower and facial midlines, and slight crowding in both arches. The patient refused conventional fixed multibracket treatment in favor of aligners. Pre- and post-treatment records as well as 1-year follow-up records are presented. FINDINGS: Treatment objectives were achieved in 12 months, and the patient was satisfied with the functional and esthetic outcomes, which were stable at 1 year. CONCLUSION: Combining aligners with appropriate auxiliaries is an efficacious means of resolving orthodontic issues such as class II, dental crossbite, and crowding in a time-frame comparable to that of conventional fixed orthodontics. Furthermore, this system is associated with optimal oral hygiene and excellent esthetics.

Class III malocclusion and bilateral cross-bite in an adult patient treated with miniscrew-assisted rapid palatal expander and aligners.

This case report describes the use of a miniscrew-assisted rapid palatal expander and aligners to correct bilateral cross-bite and crowding in an adult patient with a Class III skeletal pattern. A digitally designed surgical guide was three-dimensionally printed and used to accurately insert four miniscrews into the palate; these were employed to anchor a novel miniscrew-assisted rapid palatal expander appliance without any dental anchorage. Cone-beam computed tomograms before and after miniscrew-assisted rapid palatal expander treatment demonstrated the orthopedic expansion of the maxilla without dental tipping. The patient was then fitted with aligners to correct crowding and malocclusion. This case report demonstrates the successful treatment of an adult patient with a narrow maxilla and bilateral cross-bite using a nonsurgical, conservative treatment.

Stiffness comparison of mushroom and straight SS and TMA lingual archwires.

BACKGROUND: The aim of this study is to investigate the relative stiffness of straight and mushroom lingual archwires of different diameters, cross sections and alloys, plotting their load/deflection graphs and using a modified three-point bending test. METHODS: Fujita's mushroom archwires and straight lingual archwires of different diameters, cross sections and alloys were derived by a virtual set-up of an equal malocclusion and were cut at their straight distal portion. These distal portions were tested using a modified three-point bending test by an Instron 4467 dynamometer and the forces, were exerted at 1-mm deflection and were compared on each resulting load/deflection curve by means of ANOVA (p < 0.05). RESULTS: All upper lingual mushroom wires exerted significantly lower forces than the straight wire. Lower mushroom archwires were stiffer than their upper counterparts, which were longer and featured inset bends. In the lower arch, similar levels of forces were recorded for the two types of wire. Load-deflection curves were higher for the straight wires, and stiffness increased proportionally with their diameter. CONCLUSIONS: The stiffness of an archwire is a function of its diameter, length and the alloy it is made from. In lower lingual wires, there is little difference in stiffness between mushroom and straight wires, but in upper wires, the straight version is considerably stiffer. The greater bearing effect exhibited by the straight wire in the working and finishing phases makes it less susceptible to bowing effect and therefore preferable for sliding mechanics during en masse retraction, particularly in the upper arch.