Quality in orthodontics: The role of customized appliances.

Orthodontics as well as dentistry are undergoing a technological revolution with advances in medical imaging, 3D printing and customization of appliances and devices. Digital orthodontics can be defined as the process of manufacturing customized appliances based on a target setup which incorporates tooth positioning in six-degrees-of-freedom. Three-dimensional medical imaging provides better diagnostic tools and allows for fabrication of orthodontic appliances based on the coordinates system of the occlusal plane within the facial anatomy.

Incorrect measurements and misleading conclusions in the article "Comparison of the efficacy of tooth alignment among lingual and labial brackets: an in vitro study".

Background/objective: To reproduce the methods and results of the study by Alobeid et al. (2018) in which the efficacy of tooth alignment using conventional labial and lingual orthodontic bracket systems was assessed.

Materials/methods: We used the identical experimental protocol and tested (i) regular twin bracket (GAC-Twin [Dentsply]) and lingual twin bracket systems (Incognito [3M]), (ii) together with NiTi 0.

Evaluating the treatment effectiveness and efficiency of Carriere Distalizer: a cephalometric and study model comparison of Class II appliances.

Background: The purpose of this study was to evaluate the treatment effectiveness of Carriere Distalizer in comparison to Class II intermaxillary elastics and Forsus.

Methods: Three groups of patients treated with Class II intermaxillary elastics (n = 18), Carriere Distalizer (n = 18), and Forsus appliance (n = 18) were collected from three private orthodontic practices. Inclusion criteria were as follows: (1) 10-14 years old of start age with permanent dentition, (2) no history of previous orthodontic treatment, (3) complete pre- and post-treatment records, (4) dental Class II division 1 (end-to-end or more), (5) no pre-treatment transverse discrepancy, (6) non-extraction treatment plan, and (7) Class I post-treatment occlusal relationship.

Memotain: A CAD/CAM nickel-titanium lingual retainer.

Approximately 1/2 of maxillary and 1/5 of mandibular multi-stranded lingual retainers fail during retention in some form, either bond failure or wire breakage. Memotain is a new CAD/CAM fabricated lingual retainer wire made of custom-cut nickel-titanium, as an alternative to multi-stranded lingual retainers. It offers numerous perceived advantages to the traditional multi-stranded stainless steel wire, including precision fit, avoidance of interferences, corrosion resistance and even the potential for minor tooth movement as an active lingual retainer.

A contemporary review of white spot lesions in orthodontics.

Unlabelled: White spot lesions (WSL) associated with fixed orthodontic appliances are a common adverse effect of orthodontic treatment and represent a significant challenge to achieving esthetic excellence. The purpose of this article is to review the current evidence regarding diagnosis, risk assessment, prevention, intratreatment management, and postorthodontic treatment of WSL, and to provide clinical recommendations useful for both the orthodontist and the general dentist. Caries risk assessment should be incorporated into initial evaluations of orthodontic patients, and risk-specific prevention and management protocols can help to eliminate or minimize this clinical problem.

A novel biomechanical model assessing continuous orthodontic archwire activation.

Introduction: The biomechanics of a continuous archwire inserted into multiple orthodontic brackets is poorly understood. The purpose of this research was to apply the birth-death technique to simulate the insertion of an orthodontic wire and the consequent transfer of forces to the dentition in an anatomically accurate model.

Methods: A digital model containing the maxillary dentition, periodontal ligament, and surrounding bone was constructed from computerized tomography data.

Imaging software accuracy for 3-dimensional analysis of the upper airway.

Introduction: The aim of this study was to compare the precision and accuracy of 6 imaging software programs for measuring upper airway volumes in cone-beam computed tomography data.

Methods: The sample consisted of 33 growing patients and an oropharynx acrylic phantom, scanned with an i-CAT scanner (Imaging Sciences International, Hatfield, Pa). The known oropharynx acrylic phantom volume was used as the gold standard.

Accuracy in tooth positioning with a fully customized lingual orthodontic appliance.

Introduction: To understand orthodontic tooth movement, a method of quantification of tooth position discrepancies in 3 dimensions is needed. Brackets and wires now can be fabricated by CAD/CAM technology on a setup made at the beginning of treatment, so that treatment should produce a reasonably precise duplicate of the setup. The extent of discrepancies between the planned and actual tooth movements can be quantified by registration of the setup and final models.

Clinical application of 3D imaging for assessment of treatment outcomes.

This paper outlines the clinical application of CBCT for assessment of treatment outcomes, and discusses current work to superimpose digital dental models and 3D photographs. Superimposition of CBCTs on stable structures of reference now allow assessment of 3D dental, skeletal and soft tissue changes for both growing and non-growing patients. Additionally, we describe clinical findings from CBCT superimpositions in assessment of surgery and skeletal anchorage treatment.

REGISTRATION OF ORTHODONTIC DIGITAL MODELS.

Current methods to assess outcomes and change in orthodontics are comparison of photographs, cephalometric measurements and superimpositions, and comparisons/measurements on dental casts. Digital models are a relatively new records modality in orthodontics. They offer numerous advantages in terms of storage space, spatial registration and superimposition.

Pharyngeal airway volume and shape from cone-beam computed tomography: relationship to facial morphology.

Introduction: The aim of this study was to assess the differences in airway shape and volume among subjects with various facial patterns.

Methods: Cone-beam computed tomography records of 62 nongrowing patients were used to evaluate the pharyngeal airway volume (superior and inferior compartments) and shape. This was done by using 3-dimensional virtual surface models to calculate airway volumes instead of estimates based on linear measurements.

Accuracy and landmark error calculation using cone-beam computed tomography-generated cephalograms.

Objective: To evaluate systematic differences in landmark position between cone-beam computed tomography (CBCT)-generated cephalograms and conventional digital cephalograms and to estimate how much variability should be taken into account when both modalities are used within the same longitudinal study.

Materials And Methods: Landmarks on homologous cone-beam computed tomographic-generated cephalograms and conventional digital cephalograms of 46 patients were digitized, registered, and compared via the Hotelling T(2) test.

Results: There were no systematic differences between modalities in the position of most landmarks.

Working with DICOM craniofacial images.

The increasing use of cone-beam computed tomography (CBCT) requires changes in our diagnosis and treatment planning methods as well as additional training. The standard for digital computed tomography images is called digital imaging and communications in medicine (DICOM). In this article we discuss the following concepts: visualization of CBCT images in orthodontics, measurement in CBCT images, creation of 2-dimensional radiographs from DICOM files, segmentation engines and multimodal images, registration and superimposition of 3-dimensional (3D) images, special applications for quantitative analysis, and 3D surgical prediction.