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How well do integrated 3D models predict alveolar defects after treatment with clear aligners?
The Angle Orthodontist
|January 25, 2021
Summary
Integrated models using pretreatment cone-beam CT scans cannot accurately diagnose alveolar defects from clear aligner treatment. These models showed low reliability, indicating potential risks to mandibular incisor bone health during complex tooth movements.
Area of Science:
- Dentistry
- Orthodontics
- Radiology
Background:
- Clear aligner therapy is increasingly popular for orthodontic treatment.
- Assessing potential side effects like alveolar bone defects is crucial for patient safety.
Purpose of the Study:
- To evaluate the diagnostic accuracy of integrated models (IMs) built from pretreatment cone-beam computed tomography (pre-CBCT) scans for identifying alveolar bone defects after clear aligner treatment.
Main Methods:
- Integrated models were created using pre-CBCT scans and predicted tooth positions.
- The accuracy of these models in detecting fenestrations and dehiscences was compared against post-treatment CBCT scans.
- Statistical analysis included defect volume comparison, correlation coefficients, sensitivity, specificity, and predictive values.
Main Results:
- Integrated models demonstrated low reliability (<0.80) in diagnosing alveolar defects.
- Sensitivities for fenestrations (0.41) and dehiscences (0.53) were low, with unacceptable positive predictive values.
- Molar distalization and proclination were significantly correlated with increased alveolar defects at the mandibular incisors.
Conclusions:
- Integrated models constructed from pre-CBCT are not accurate for diagnosing alveolar defects post-clear aligner treatment.
- Clinicians should exercise caution with proclination and molar distalization to protect mandibular incisor alveolar bone.
