Orthodontics and New Technologies: 2nd Edition

A special issue of Dentistry Journal (ISSN 2304-6767).

Deadline for manuscript submissions: 31 December 2025 | Viewed by 12643

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Guest Editor
Department of Human Sciences, Innovation and Territory, School of Dental Hygiene, Postgraduate School of Orthodontics, University of Insubria, 22100 Como, Italy
Interests: oral health prevention; orthodontics;dentistry
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Special Issue Information

Dear Colleagues,

Nowadays, orthodontics is rapidly changing, and more and more patients ask for a consultation to improve their smile and aesthetics. Such an increase is paired with an incredible technological evolution that makes the orthodontic treatments really close to the needs of the patients. There are numerous new technologies in the orthodontic field:

  • Clear aligners;
  • Intra oral scanners;
  • Digital planning of the treatment;
  • Orthodontic accelerators;
  • Telemedicine;
  • New innovative materials.

The synergy between orthodontics and new technologies meets the desires of the patients, but also helps clinicians to share and improve their knowledge and clinical satisfaction in order to deliver the best outcome.

This Special Issue aims to investigate the current available state of the art in orthodontics and new dental technologies, both from researchers and clinicians’ points of view.

Prof. Dr. Luca Levrini
Guest Editor

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Keywords

  • 3D printing
  • application/apps
  • clear aligner appliances
  • dental materials
  • digital dentistry
  • digital healthacare
  • intra oral scanner
  • new materials
  • orthodontic treatment
  • telemedicine
  • tooth movement techniques

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Related Special Issue

Published Papers (11 papers)

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Research

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12 pages, 235 KiB  
Article
Mandibular Kinematics on an Orthodontic Population Assessed with an Optical Jaw Tracking System: A Comparative Study
by Joana Silva, Ariana Azevedo, Eugénio Martins, Alberto Canabez, Domingo Martin and Conchita Martin
Dent. J. 2025, 13(5), 184; https://doi.org/10.3390/dj13050184 - 23 Apr 2025
Viewed by 333
Abstract
Objective: To evaluate mandibular kinematics in an orthodontic population using the Modjaw® optical jaw tracking system. Materials and methods: A total of 154 orthodontic patients underwent mandibular kinematic analysis using the Modjaw® system. ANB values determined skeletal classification, while [...] Read more.
Objective: To evaluate mandibular kinematics in an orthodontic population using the Modjaw® optical jaw tracking system. Materials and methods: A total of 154 orthodontic patients underwent mandibular kinematic analysis using the Modjaw® system. ANB values determined skeletal classification, while dental classification was assessed on digital casts. The Modjaw® records were taken as instructed by the manufacturer, and data collected from the readings included the discrepancy between centric occlusion and maximum intercuspation, maximum opening, Bennett angles, and sagittal condylar guidance. The presence or absence of temporomandibular disorders was determined by the DC-TMD questionnaires. Non-parametric tests and Spearman correlations were applied for the statistical analysis. Results: Significant differences in mandibular kinematics were observed between skeletal classes, particularly in CO-MI discrepancies, Bennett angles, and maximum opening (p < 0.05). TMD symptoms were associated with higher absolute CO-MI discrepancies but did not significantly alter other kinematic parameters. Weak correlations were found between sagittal condylar guidance and anterior guidance variables. Conclusions: Mandibular kinematics differ by skeletal classification, with Class III patients demonstrating distinct patterns. While TMD symptoms impact CO-MI discrepancies, overall mandibular dynamics remain consistent. Full article
(This article belongs to the Special Issue Orthodontics and New Technologies: 2nd Edition)
13 pages, 1782 KiB  
Article
Breaking Barriers in Orthodontics: An Experimental Study on How Stabilization Discs Improve Mini-Implant Outcomes
by Tinela Panaite, Cristian Liviu Romanec, Mihnea Iacob, Carina Balcos, Carmen Savin, Nicolae Daniel Olteanu, Raluca-Maria Vieriu, Chehab Alice and Irina Nicoleta Zetu
Dent. J. 2025, 13(3), 109; https://doi.org/10.3390/dj13030109 - 28 Feb 2025
Viewed by 468
Abstract
Background/Objectives: The stabilization disc (SD) for orthodontic mini-implants is a novel device designed to enhance anchorage stability and minimize the risk of mini-implant mobility. The disc features a flat structure with four prongs and is crafted from biocompatible materials such as titanium or [...] Read more.
Background/Objectives: The stabilization disc (SD) for orthodontic mini-implants is a novel device designed to enhance anchorage stability and minimize the risk of mini-implant mobility. The disc features a flat structure with four prongs and is crafted from biocompatible materials such as titanium or stainless steel. It provides additional support to mini-implants by improving force distribution and reducing stress concentration around the insertion site. This study aims to evaluate the biomechanical performance of mini-implants with an SD compared to without-SD mini-implants, with a specific focus on their ability to maintain anchorage under orthodontic loading conditions. Methods: A finite element analysis (FEA) model was created for a commercially available mini-implant (2.0 mm in diameter and 12 mm in length). The mandible’s anatomical structure was reconstructed in 3D from computed tomography (CT) scans using SpaceClaim software 2023.1. To simulate real-world orthodontic conditions, forces of 10 N were applied at an angle of 30°. This retrospective study explores the role of SDs in enhancing mini-implant stability by reducing displacement and optimizing stress distribution. The evaluation included analyzing von Mises stress, cortical bone deformation, and mini-implant movement under simulated orthodontic loading. Results: The results demonstrate that the SD significantly reduces maximum total displacements by over 41% and redistributes von Mises stresses more evenly across the mini-implant and surrounding bone. Cortical bone stress and deformation were reduced in cases utilizing the SD, indicating enhanced implant stability and durability. Conclusions: The stabilization disc enhances mini-implant stability by improving stress distribution and reducing deformation without requiring permanent implant modifications. Its adaptability makes it a valuable solution for managing variable bone density and high orthodontic forces, offering a promising advancement in orthodontic anchorage. Full article
(This article belongs to the Special Issue Orthodontics and New Technologies: 2nd Edition)
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11 pages, 496 KiB  
Article
The Effect of MRI Exposure on the Shear Bond Strength and Adhesive Remnant Index of Different Bracket Types
by Luka Šimunović, Jakov Stojanović, Katarina Tečić, Dijana Zadravec and Senka Meštrović
Dent. J. 2025, 13(3), 108; https://doi.org/10.3390/dj13030108 - 28 Feb 2025
Viewed by 508
Abstract
Background/Objectives: Magnetic resonance imaging (MRI) is widely used in diagnostics, but its effects on orthodontic materials remain a concern. This study aimed to evaluate the impact of MRI exposure at 1.5 T and 3 T on the shear bond strength (SBS) and [...] Read more.
Background/Objectives: Magnetic resonance imaging (MRI) is widely used in diagnostics, but its effects on orthodontic materials remain a concern. This study aimed to evaluate the impact of MRI exposure at 1.5 T and 3 T on the shear bond strength (SBS) and adhesive remnant index (ARI) of different orthodontic bracket types (metal, self-ligating, and ceramic). Methods: A total of 90 extracted human premolars were divided into three groups (control, 1.5 T, and 3 T MRI exposure). The three bracket types were bonded using Transbond XT adhesive and subjected to standardized polymerization. MRI scans were conducted using 1.5 T and 3 T machines with clinically relevant sequences. SBS was measured using a universal testing machine, and the ARI was assessed under a stereomicroscope. Statistical analysis was performed using Kruskal–Wallis and chi-square tests. Results: MRI exposure influenced SBS and the ARI differently across bracket types. Firstly, 3 T MRI exposure significantly reduced SBS in self-ligating (p = 0.017) and ceramic brackets (p = 0.014) compared to the control, whereas metal brackets showed no significant changes. ARI scores varied across MRI conditions, with metal and self-ligating brackets showing increased adhesive retention at higher field strengths. No significant differences were observed in ARI scores for ceramic brackets across MRI conditions. Conclusions: The clinical importance of understanding these results is that both patients and clinicians must be aware of inevitable changes that occur in SBS during MRI, since exposure to high-field MRI, particularly 3 T, may alter bond strength and adhesive failure characteristics. Full article
(This article belongs to the Special Issue Orthodontics and New Technologies: 2nd Edition)
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15 pages, 2443 KiB  
Article
Summed Tissue Resistance of Periodontal Ligaments and Alveolar Bone in Orthodontic Distal Retraction of Maxillary Canines: Mathematical Simulation of Clinical Data and Interpretation of Results
by Olimpia Bunta, Vlad Muresan, Dana Festila and Mihaela Baciut
Dent. J. 2025, 13(2), 55; https://doi.org/10.3390/dj13020055 - 27 Jan 2025
Viewed by 975
Abstract
Background: The mechanical properties of either alveolar bone or periodontal ligaments under orthodontic loading, as well as orthodontic tooth movement, have been studied in recent years using computational approaches. In previous studies, we developed a theoretical mathematical approach that uses a weighting [...] Read more.
Background: The mechanical properties of either alveolar bone or periodontal ligaments under orthodontic loading, as well as orthodontic tooth movement, have been studied in recent years using computational approaches. In previous studies, we developed a theoretical mathematical approach that uses a weighting coefficient of the summed resistance of periodontal structures, namely the bone and periodontal ligaments, in relation to apex movement, the center of rotation, orthodontic force loading, and time in order to quantify the biological response to orthodontic biomechanics. Methods: We analyzed the distal retraction of three maxillary canines and integrated the clinical data obtained in the previously developed mathematical programs. Results: The values of the (σ) weighting coefficient of the tissue resistance were interpreted in the context of the clinical data obtained: the smaller the value of (σ), the higher the actual tissue resistance, with a greater difference between the crown and root movement; also, the higher the value of (σ), the lower the actual tissue resistance, with a small difference between the crown and apex movement. Conclusions: The clinical interpretation of the results allows us to set a premise for the refinement of the mathematical programs so that we can use them in assessing the orthodontic biomechanics of larger patient groups over longer periods of time and create premises of treatment protocol simplification and adjustment. Full article
(This article belongs to the Special Issue Orthodontics and New Technologies: 2nd Edition)
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11 pages, 4618 KiB  
Article
Accuracy of One-Piece vs. Segmented Three-Dimensional Printed Transfer Trays for Indirect Bracket Placement
by Bayan Alyammahi, Amar Hassan Khamis and Ahmed Ghoneima
Dent. J. 2024, 12(11), 352; https://doi.org/10.3390/dj12110352 - 31 Oct 2024
Viewed by 1317
Abstract
Objective: To assess the accuracy of three-dimensional (3D) printed one-piece vs. multiple segmented transfer trays for indirect bonding techniques in moderate and severe crowding cases. Methods: Eighty digital maxillary dental models were produced by an extraoral scanner. 3D-printed one-piece and segmented trays were [...] Read more.
Objective: To assess the accuracy of three-dimensional (3D) printed one-piece vs. multiple segmented transfer trays for indirect bonding techniques in moderate and severe crowding cases. Methods: Eighty digital maxillary dental models were produced by an extraoral scanner. 3D-printed one-piece and segmented trays were virtually designed utilizing Maestro 3D Ortho Studio® v4 and printed using a NextDent printer. The sample was classified into two groups: Group 1 (moderate crowding) included 40 digital models with a space deficiency of 6–7 mm, and Group 2 (severe crowding) included 40 digital models with a space deficiency of 10 mm. Ortho classic brackets were then placed into the 3D printed models with the aid of the transfer trays, and the models with the final bracket positioning were scanned using iTero scanner. Four measurements were selected on each tooth to perform the analysis. Mann–Whitney and Kruskal–Wallis tests were used for comparisons. A p-value of ≤ 0.05 was considered statistically significant. Results: In the moderate crowding group, statistically significant differences were detected between the one-piece, segmented, and control groups for three measurements (p < 0.001), while the rest of the measurements showed no significant differences (p > 0.05). In the severe crowding group, no significant differences were detected for any of the measurements. Conclusions: One-piece and segmented 3D-printed transfer trays are considered accurate tools for indirect bonding in moderate and severe malocclusion cases. The severity of crowding did not affect the accuracy of bracket transfer in indirect bonding. Full article
(This article belongs to the Special Issue Orthodontics and New Technologies: 2nd Edition)
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12 pages, 1645 KiB  
Article
Multibraided Fixed Retainers with Different Diameters after Magnetic Resonance Imaging (MRI): In Vitro Study Investigating Temperature Changes and Bonding Efficacy
by Maria Francesca Sfondrini, Maurizio Pascadopoli, Paola Gandini, Lorenzo Preda, Domenico Sfondrini, Karin Bertino, Cinzia Rizzi and Andrea Scribante
Dent. J. 2024, 12(8), 255; https://doi.org/10.3390/dj12080255 - 13 Aug 2024
Viewed by 1909
Abstract
Objectives: Orthodontists are often asked to remove fixed retainers before patients undergo magnetic resonance imaging (MRI). The present in vitro study was designed to analyze the heating and bonding efficacy of stainless steel multibraided fixed retainers after 1.5- and 3-tesla (T) MRI. Materials [...] Read more.
Objectives: Orthodontists are often asked to remove fixed retainers before patients undergo magnetic resonance imaging (MRI). The present in vitro study was designed to analyze the heating and bonding efficacy of stainless steel multibraided fixed retainers after 1.5- and 3-tesla (T) MRI. Materials and methods: A total of 180 human mandibular incisors were used to create 45 specimens of four teeth each, divided into nine groups. Handmade multibraided fixed retainers of three different sizes, defined by the diameter of the initial wire used (0.008″, 0.010″ and 0.012″), were tested. Three groups underwent MRI at 1.5 T, another three groups underwent MRI at 3 T and the last three groups did not undergo MRI. Temperature was assessed before and after MRI. Shear bond strength (SBS) and adhesive remnant index (ARI) were assessed after MRI for all groups. Data were statistically analyzed (p < 0.05). Results: After 1.5 T exposure, no significant temperature increase from T0 to T1 was observed in any of the groups (p > 0.05). Regarding the 3 T groups, a significant difference from T0 to T1 was found for all the groups (p < 0.05). Temperature changes were not clinically relevant, as they were less than 1 °C for all groups except for group 3 (ΔT0–T1: 1.18 ± 0.3 °C) and group 6 (ΔT0–T1: 1.12 ± 0.37 °C). Furthermore, there were no significant differences between the temperature variations associated with different wire diameters (p > 0.05). Conclusions: No significant changes in SBS or ARI were found (p > 0.05). Clinical significance: Since overheating was irrelevant and adhesion values did not change, the tested devices were concluded to be safe for MRI examinations at 1.5 T and 3 T. Full article
(This article belongs to the Special Issue Orthodontics and New Technologies: 2nd Edition)
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14 pages, 251 KiB  
Article
Assessment of Food Masticatory Capability with Clear Aligners
by Luca Levrini, Nicola Giannotta, Rodolfo Francesco Mastrapasqua, Davide Farronato, Vittorio Maurino, Alessandro Deppieri, Federico Tasquier and Stefano Saran
Dent. J. 2024, 12(7), 217; https://doi.org/10.3390/dj12070217 - 15 Jul 2024
Cited by 2 | Viewed by 1426
Abstract
Nowadays, aligners represent a possible therapeutical approach that combines both esthetic and function in order to address dental malocclusion. However, they require a significant level of compliance from the patient. According to the manufacturer, at least 22 h of wearing a day is [...] Read more.
Nowadays, aligners represent a possible therapeutical approach that combines both esthetic and function in order to address dental malocclusion. However, they require a significant level of compliance from the patient. According to the manufacturer, at least 22 h of wearing a day is demanded to reach the optimal therapeutical level; hence, aligners can only be removed during meals. Patients’ compliance might increase and the duration of the treatment might decrease if they were allowed to eat with aligners on. The idea of patients keeping the aligners on during meals has been contemplated, not only to favor patients’ compliance but also treatment effectiveness. This study aims to assess the degree of chewing difficulty that aligners cause when eating certain kinds of food and the quantity of residue left. Material and Methods: A questionnaire titled “Questionnaire for the Assessment of Masticatory Function with Aligners” was administered using Google Forms to 240 patients in treatment with clear aligners. The survey was validated through the reliability test using the test–retest method. This method had a higher correlation coefficient of 0.9 across all items (with a cutoff of 0.8) with statistical significance, and an excellent internal correlation coefficient (α > 0.9). The statistical analysis performed consisted of descriptive analysis, frequencies, percentages, Pearson’s correlation test and Friedman’s test. Results: Pearson’s test showed a statistically significant correlation between all items except between meat or clams and yogurt or ice cream and with mozzarella or soft cheese regarding food chewing difficulties. Pearson’s test showed a statistically significant correlation between all items regarding food residues. A total of 69.2% of the cohort reported some movements of aligners during mastication. In total, 88.3% of them affirmed not to have perceived deformations or breakage of aligners during chewing. Furthermore, 79.2% of them declared that they would continue to eat if eating with aligners was proven to speed up treatment. Conclusions: Wearing clear aligners while chewing foods such as yogurt, ice cream, soft cheese, bread, rice, etc., can be possible and can help shorten the duration of orthodontic treatment, benefiting both the patient and the orthodontist. However, further research using qualitative methods is needed to understand the barriers and facilitators to chewing food with aligners. Full article
(This article belongs to the Special Issue Orthodontics and New Technologies: 2nd Edition)

Review

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27 pages, 1179 KiB  
Review
Treatment Options for Unilateral Agenesis of the Maxillary Lateral Incisor Combined with Contralateral Microdontic or Peg-Shaped Lateral Incisor: A Systematic Review
by Federica Bitonto, Alessio Verdecchia, Massimiliano Lombardo, Erica Lipani, Claudia Dettori and Enrico Spinas
Dent. J. 2025, 13(4), 169; https://doi.org/10.3390/dj13040169 - 17 Apr 2025
Viewed by 677
Abstract
Background: Managing unilateral maxillary lateral incisor agenesis (UMLIA) with an associated microdontic or peg-shaped contralateral incisor (Mi or Peg MLI) presents clinical and esthetic challenges. Deciding between orthodontic space opening (OSO) or closure (OSC) and whether to restore or extract the Mi or [...] Read more.
Background: Managing unilateral maxillary lateral incisor agenesis (UMLIA) with an associated microdontic or peg-shaped contralateral incisor (Mi or Peg MLI) presents clinical and esthetic challenges. Deciding between orthodontic space opening (OSO) or closure (OSC) and whether to restore or extract the Mi or Peg MLI are critical factors for achieving optimal treatment outcomes. Methods: A systematic review was conducted using a dual strategy across Scopus, Web of Science, Embase, PubMed, and Cochrane Central Register of Controlled Trials databases. The Cochrane RoB2 tool was used for randomized controlled trials (RCTs), the ACROBAT-NRSI tool for non-randomized studies, and the JBI Manual for case reports. High-quality case reports were included when the literature was limited. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) tool evaluated the certainty of evidence, considering bias, inconsistency, indirectness, imprecision and other considerations. Results: Thirty-five studies met the inclusion criteria, assessing treatment modalities, esthetic outcomes, periodontal health, and occlusal and temporomandibular joint (TMJ) function. Both OSO and OSC demonstrated similar occlusal and TMJ outcomes, while slight differences in esthetic and periodontal results were noted between the two approaches. Direct composite and indirect ceramic restorations showed comparable effectiveness for reshaping the Mi or Peg MLI. Extraction combined with OSC contributed to improved smile symmetry. Conclusions: A personalized, multidisciplinary approach is essential for treating UMLIA with an Mi or Peg MLI. Both OSO and OSC are viable options, and the choice should be tailored to the patient’s specific clinical scenario, with attention to achieving the best esthetic and periodontal outcomes. Further research is needed to refine treatment protocols and support clinical decision-making. Full article
(This article belongs to the Special Issue Orthodontics and New Technologies: 2nd Edition)
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13 pages, 2904 KiB  
Review
Three-Dimensional Surgical Guides in Orthodontics: The Present and the Future
by Silvia Izabella Pop, Eugen Bud, Kinga Mária Jánosi, Anamaria Bud and Bernadette Kerekes-Máthé
Dent. J. 2025, 13(2), 74; https://doi.org/10.3390/dj13020074 - 8 Feb 2025
Viewed by 1242
Abstract
Surgical guides are integral tools in orthodontics, enhancing the precision and predictability of mini-implant placement. These guides facilitate accurate positioning, reduce risks to surrounding anatomical structures, and ensure proper angulation and depth during procedures. The aim of the present paper is to present [...] Read more.
Surgical guides are integral tools in orthodontics, enhancing the precision and predictability of mini-implant placement. These guides facilitate accurate positioning, reduce risks to surrounding anatomical structures, and ensure proper angulation and depth during procedures. The aim of the present paper is to present a detailed review of the surgical guides used in orthodontics, focusing on their classification, mechanical properties, biocompatibility, and future developments. The advantages, disadvantages, clinical steps, and implications are also described based on the data in recent scientific literature. Future developments may incorporate artificial intelligence and augmented reality, further optimizing treatment planning and patient outcomes, thus solidifying the role of surgical guides in efficient orthodontic care. Full article
(This article belongs to the Special Issue Orthodontics and New Technologies: 2nd Edition)
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Other

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11 pages, 1706 KiB  
Case Report
The Treatment of Gingival Recessions in the Lower Anterior Region Associated with the Use/Absence of Lingual-Fixed Orthodontics Retainers: Three Case Reports Using the Laterally Closed Tunnel Technique and Parallel Incision Methods
by Alexandra Tavares Dias, Jessica Figueiredo Lopes, Juliana Campos Hasse Fernandes and Gustavo Vicentis Oliveira Fernandes
Dent. J. 2025, 13(3), 93; https://doi.org/10.3390/dj13030093 - 21 Feb 2025
Cited by 1 | Viewed by 943
Abstract
Background: The prevalence of gingival recessions (GRs) in the global population is 78%. A long-term study showed a 47% increase in the prevalence of GRs five years post-orthodontic treatment, particularly in the lower anterior region. It can be caused and/or exacerbated after [...] Read more.
Background: The prevalence of gingival recessions (GRs) in the global population is 78%. A long-term study showed a 47% increase in the prevalence of GRs five years post-orthodontic treatment, particularly in the lower anterior region. It can be caused and/or exacerbated after orthodontic treatment, where the retainer placed can induce tooth movement or when it fails to maintain a passive position upon bonding. Thus, the goal of this case report was to present treatments for gingival recessions, with the approaches of the laterally closed tunnel technique and parallel incision methods, after orthodontic treatment in patients using non-passive lingual retainers. Methods: This case report adhered to the CARE guidelines. Three healthy patients were referred due to GR defects in the lower anterior region (RT1 and RT2). All patients had GR associated with deficient lingual-fixed orthodontics retainers. The same experienced periodontist (ATD) developed the surgeries and aimed to achieve root coverage using the connective tissue graft associated with a coronally advanced flap (CAF) and modify the recipient area’s gingival phenotype. Results: In all cases, a new orthodontic treatment was not possible due to anatomical or patient-related factors. Outcomes after six months, three years, and five years are presented, encompassing clinical and esthetic evaluations. Conclusions: GRs must always be addressed by orthodontic therapy or lingual-fixed orthodontic retainers. In cases where dental elements are positioned outside the bone envelope, orthodontic treatment may be considered before root coverage surgery. Therefore, surgical intervention should be undertaken for the keratinized tissue and volume gain, independently of the tooth position. Modifying the phenotype in these situations is vital for the long-term maintenance of periodontal health. Full article
(This article belongs to the Special Issue Orthodontics and New Technologies: 2nd Edition)
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15 pages, 1327 KiB  
Systematic Review
Home Biofilm Management in Orthodontic Aligners: A Systematic Review
by Alessia Pardo, Annarita Signoriello, Alessandro Zangani, Elena Messina, Selene Gheza, Paolo Faccioni, Massimo Albanese and Giorgio Lombardo
Dent. J. 2024, 12(10), 335; https://doi.org/10.3390/dj12100335 - 21 Oct 2024
Cited by 3 | Viewed by 1970
Abstract
Background. Transparent aligners are recently introduced orthodontic devices considered promising for the improvement of oral health conditions, in terms of faster treatment times and enhanced comfort, especially if compared with traditional fixed orthodontic therapy. This systematic review aimed to evaluate at-home protocols for [...] Read more.
Background. Transparent aligners are recently introduced orthodontic devices considered promising for the improvement of oral health conditions, in terms of faster treatment times and enhanced comfort, especially if compared with traditional fixed orthodontic therapy. This systematic review aimed to evaluate at-home protocols for proper oral hygiene and aligners cleaning during orthodontic treatment. Methods. A search was conducted using the following four databases: PubMed, Cochrane Library, Web of Science, and Scopus. The systematic review (registered as CRD 42024562215) followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and included prospective studies, randomized controlled trials (RCTs), controlled clinical trials, and in vivo and ex vivo studies; they had to assess treatment with invisible orthodontics compared to treatment with fixed orthodontics, home oral hygiene, or aligner disinfection protocols. The evidence in the studies was evaluated for risk of bias using the RoB-2 (for RCTs and randomized crossover studies) and ROBINS-I tools (for observational studies). Results. Eleven studies were included in this systematic review: four RCTs, four crossover studies, and three cross-sectional observational studies. Seven studies considered patients undergoing orthodontic treatment, whereas four examined orthodontic aligners. The cleaning protocols of the aligners were evaluated based on the analysis of residual biofilm on the thermoplastic surfaces. Studies included were characterized by a low level of certainty, thus further evidence is needed. Conclusions. The most effective protocols entailed a combination of mechanical and chemical agents, suggesting that it is fundamental for patients undergoing aligner treatment to focus on individually tailored home oral hygiene protocols. Full article
(This article belongs to the Special Issue Orthodontics and New Technologies: 2nd Edition)
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