Abstract
Statement of problem
One of the major challenges in restorative dentistry is to provide optimal esthetics
in a minimally invasive way. The optimization of dental esthetics and function is
directly related to the position and alignment of the anterior teeth, but whether
prerestorative clear aligner therapy will enhance esthetics and minimize restorative
needs is unclear.
Purpose
The purpose of this clinical study was to evaluate the effect of prerestorative maxillary
and mandibular second premolar to second premolar clear aligner therapy in minimizing
the need for restorative treatment.
Material and methods
Fifty adult patients treated with clear aligners (Invisalign Go; Align Technology)
were included in this study. Previously generated 3-dimensional orthodontic simulations
and clinical photographs in the ClinCheck/6.0 software program were used. Three restorative
treatment plans for each participant were generated for initial (no aligners), Express
(after using 7 aligners), and Lite Packages (after using 20 aligners) by 2 blinded
restorative dentistry instructors. The maxillary and mandibular teeth in the smile-line
(to the second premolars) were included. Assessment criteria were the estimated number
of restorations, restoration surfaces and preparations and incisal edge inclusion,
and the need for gingival leveling. The Friedman test and Cochran Q test were used
for statistical analyses (α=.05).
Results
A strong positive correlation was found between the 2 instructors (P<.001). Estimated number of restorations (10 [3 to 16]a) decreased significantly for Express (6 [0 to 14]b) and Lite Packages (4 [0 to 8]c) (P<.001). The estimated number of restoration surfaces (28.5 [9 to 48]a) decreased significantly for Express (15 [0 to 42]b) and Lite Packages (9.5 [0 to 24]c) (P<.001). While the estimated number of teeth to be prepared for recontouring (7 [0
to 16]a) was significantly less for Express (3 [0 to 10]b) and Lite Packages (0 [0 to 4]c) (P<.001), the incisal edge inclusion (10 [3 to 16]a) was significantly less for Express (6 [0 to 14]b) and Lite Packages (4 [0 to 8]c) (P<.001). The need for gingival leveling (26 [52%]a) decreased significantly for Express (20 [40%]a) and Lite Packages (7 [14%]b) (P<.001).
Conclusions
Prerestorative short-term clear aligner therapy might conserve tooth structure and
reduce the number of restorations. The application of the Invisalign Lite Package
was more effective than the Invisalign Express Package for second premolar to second
premolar alignment.
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Article info
Publication history
Published online: May 11, 2023
Publication stage
In Press Corrected ProofFootnotes
Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Identification
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© 2023 by the Editorial Council for The Journal of Prosthetic Dentistry.
