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Publication
Alinhadores transparentes e aparelhos expansores tradicionais em pacientes em dentição mista : uma revisão narrativa
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Advisor(s)
Abstract(s)
A expansão maxilar em pacientes em dentição mista representa uma etapa crucial da ortodontia intercetiva, permitindo a correção precoce de discrepâncias transversais e
contribuindo para o desenvolvimento harmonioso do complexo dento-facial.
Os alinhadores transparentes, como o Invisalign® First, surgem como uma alternativa estética, confortável e higiénica para o tratamento de discrepâncias leves a
moderadas. A sua produção com tecnologia CAD-CAM permite um planeamento digital preciso e personalizado, oferecendo boa previsibilidade nos movimentos dentários dentoalveolares. Por outro lado, os expansores tradicionais, como os aparelhos do tipo Haas, Hyrax e McNamara continuam a ser preferidos em casos de deficiência esquelética
severa, dada a sua comprovada capacidade de promover efeitos ortopédicos significativos quando aplicados precocemente. Para casos mais ligeiros de expansão lenta de maxila, os mais utilizados são o Quad-helix, Leaf e a placa de Hawley com parafuso de expansão.
O sistema Invisalign® Palatal Expander (IPE), lançado em 2024, propõe-se como uma solução inovadora removível para expansão dento-alveolar, com vantagens em
termos de conforto e higiene, embora ainda careça de robustez científica para ser comparado diretamente com outras técnicas consolidadas.
Conclui-se que a escolha do dispositivo expansor deve ser individualizada, considerando o grau de severidade da discrepância, a colaboração do paciente e as
características clínicas do caso. A atuação precoce e bem orientada permite não só resultados funcionais e estéticos mais favoráveis, como também uma redução da
complexidade de tratamentos futuros.
Deste modo, foi realizada uma revisão narrativa comparando a expansão maxilar com recurso a aparelhos de expansão tradicionais, o uso de alinhadores transparentes e o
recente sistema IPE, com descrição das suas implicações, vantagens e limitações. Foi realizada uma pesquisa eletrónica nas bases de dados PubMed, Medline,
Scopus, Cochrane Library, Web of Science, Embase, Science Direct e Google Scholar, com a inclusão de artigos deste 2014.
Maxillary expansion in patients in mixed dentition represents a crucial stage in interceptive orthodontics, allowing for the early correction of transverse discrepancies and contributing to the harmonious development of the dentofacial complex. Clear aligners, such as Invisalign® First, have emerged as an aesthetic, comfortable, and hygienic alternative for treating mild to moderate discrepancies. Their fabrication using CAD-CAM technology enables precise and personalized digital planning, offering good predictability for dentoalveolar tooth movements. Conversely, traditional expanders, including Haas, Hyrax and McNamara appliances, remain the preferred choice for severe skeletal deficiencies, given their proven ability to produce significant orthopedic effects when applied at an early stage. For milder cases of slow maxillary expansion, the most commonly used appliances are the Quad-helix, Leaf and the Hawley plate with expansion screw. The Invisalign® Palatal Expander (IPE) system, launched in 2024, presents itself as an innovative removable solution for dentoalveolar expansion, with benefits in terms of comfort and hygiene, although it still lacks sufficient scientific evidence to be directly compared with more established techniques. It is concluded that the selection of the expansion appliance should be individualized, taking into account the severity of the discrepancy, patient compliance, and the clinical characteristics of the case. Early and well-guided intervention not only provides more favourable functional and aesthetic outcomes but also reduces the complexity of future treatments. Accordingly, a narrative review was conducted comparing maxillary expansion using traditional expansion appliances, clear aligners, and the IPE recent system. Their implications, advantages, and limitations were described. An electronic search was carried out across the databases PubMed, Medline, Scopus, Cochrane Library, Web of Science, Embase, Science Direct, and Google Scholar, including articles published since 2014.
Maxillary expansion in patients in mixed dentition represents a crucial stage in interceptive orthodontics, allowing for the early correction of transverse discrepancies and contributing to the harmonious development of the dentofacial complex. Clear aligners, such as Invisalign® First, have emerged as an aesthetic, comfortable, and hygienic alternative for treating mild to moderate discrepancies. Their fabrication using CAD-CAM technology enables precise and personalized digital planning, offering good predictability for dentoalveolar tooth movements. Conversely, traditional expanders, including Haas, Hyrax and McNamara appliances, remain the preferred choice for severe skeletal deficiencies, given their proven ability to produce significant orthopedic effects when applied at an early stage. For milder cases of slow maxillary expansion, the most commonly used appliances are the Quad-helix, Leaf and the Hawley plate with expansion screw. The Invisalign® Palatal Expander (IPE) system, launched in 2024, presents itself as an innovative removable solution for dentoalveolar expansion, with benefits in terms of comfort and hygiene, although it still lacks sufficient scientific evidence to be directly compared with more established techniques. It is concluded that the selection of the expansion appliance should be individualized, taking into account the severity of the discrepancy, patient compliance, and the clinical characteristics of the case. Early and well-guided intervention not only provides more favourable functional and aesthetic outcomes but also reduces the complexity of future treatments. Accordingly, a narrative review was conducted comparing maxillary expansion using traditional expansion appliances, clear aligners, and the IPE recent system. Their implications, advantages, and limitations were described. An electronic search was carried out across the databases PubMed, Medline, Scopus, Cochrane Library, Web of Science, Embase, Science Direct, and Google Scholar, including articles published since 2014.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Tratamento ortodôntico Alinhadores Dentição mista Expansão