Comparison of labio-palatal incisor movement between two wear protocols: a retrospective cohort study

To investigate the accuracy of the Invisalign appliance in achieving predicted angular tooth movement of the maxillary central incisors, to locate the center of rotation in a labio-palatal direction, and to investigate any difference between 1-weekly and 2-weekly wear protocols.

This study involved a retrospective sample of two groups of 46 Class I adult subjects treated non-extraction with different protocols of 1-weekly and 2-weekly wear. The pretreatment, predicted outcome and achieved outcome digital models were superimposed and measured using metrology software. Angular and center-of-rotation measurements in the sagittal plane for the maxillary right central incisor were analyzed.

There was a statistically significant difference between predicted and achieved angular measurements (P < .005) for labial tooth movements regardless of wear protocol. For palatal movements, no statistically significant difference was observed (P > .05). A small amount of overexpression was observed in some cases. Regarding crown and root control, uncontrolled tipping was the most predictable. No statistically significant difference was found between predicted and achieved center of rotation, but the confidence interval was wide. No statistically significant difference (P > .05) was found between the two wear protocols for the parameters measured.

For maxillary central incisors, labial angular movements were not as accurate as palatal movements. Overcorrection could be recommended with careful clinical monitoring due to the possibility of overexpression. Control of root movements may be unpredictable, and further research is required to draw stronger conclusions. For the parameters measured in this clinical sample, there was no difference between the two wear protocols.