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Análise da eficácia e predictibilidade da expansão maxilar utilizando Invisalign® : um estudo retrospetivo
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Abstract(s)
Introdução: A expansão maxilar é essencial no tratamento ortodôntico para o correto alinhamento dentário e corrigir más oclusões transversais. O sistema Invisalign®, tem sido promovido como uma alternativa estética e confortável aos aparelhos tradicionais, utilizando expansão maxilar lenta. No entanto, existem incertezas quanto à eficácia e predictibilidade deste sistema.
Objetivos: Avaliar a eficácia e a predictibilidade da expansão maxilar com o sistema Invisalign®, comparando os movimentos previstos pelo software ClinCheck® com os resultados clínicos reais.
Materiais e Métodos: Este estudo foi conduzido de forma retrospetiva, utilizando modelos 3D criados através de um scanner intraoral iTero® em 127 pacientes que foram submetidos a um tratamento de expansão maxilar com o sistema Invisalign®. Nestes pacientes, foram recolhidos modelos dentários digitais em 2 momentos distintos: antes do tratamento (T0) e após a primeira fase de alinhadores (T1). Os movimentos dentários previstos pelo software ClinCheck® foram comparados com os movimentos reais ocorridos, utilizando medições lineares da largura interdentária no arco dentário superior.
Resultados: A amostra incluiu 85 mulheres e 42 homens. Todas as comparações T0-T1 mostraram diferenças significativas (p < 0,001) em todos os segmentos. As maiores expansões ocorreram nos 1.º pré-molares (2,80 ± 1,87 mm) e 2.º pré-molares (3,16 ± 1,87 mm). A eficácia variou entre 62,86% (caninos) e 76,35% (2.º pré-molares). A predictibilidade foi elevada entre 97,04% e 98,22%. Os homens apresentaram uma eficácia superior e significativa nos 1.º molares (p = 0,04). A idade correlacionou-se negativamente com a eficácia e a predictibilidade, especialmente nos dentes mais posteriores e no sexo masculino.
Conclusão: O Invisalign® demonstrou eficácia na expansão maxilar com elevada predictibilidade (> 97%). Dentes posteriores apresentaram maior eficácia e os caninos a menor (62,86%). A idade e sexo influenciaram significativamente os resultados. Estes achados suportam o uso do sistema, recomendando sempre um planeamento individualizado, considerando as variáveis clínicas identificadas.
Introduction: Maxillary expansion is essential in orthodontic treatment for proper dental alignment and correction of transverse malocclusions. The Invisalign® system has been promoted as an aesthetic and comfortable alternative to traditional appliances, utilizing slow maxillary expansion. However, uncertainties remain regarding the system’seffectiveness and predictability. Objectives: To evaluate the efficacy and predictability of maxillary expansion with the Invisalign® system, comparing movements predicted by ClinCheck® software with actual clinical outcomes. Materials and Methods: This retrospective study was conducted using 3D models created through an iTero® intraoral scanner in 127 patients who underwent maxillary expansion treatment with the Invisalign® system. In these patients, digital dental models were collected at 2 distinct timepoints: before treatment (T0) and after the first series of aligners (T1). Dental movements predicted by ClinCheck® software were compared with actual movements that occurred, using linear measurements of interdental width in the upper dental arch. Results: The sample included 85 women and 42 men. All T0-T1 comparisons showed significant differences (p < 0.001) in all segments. The greatest expansions were observed at the first premolars (2.80 ± 1.87 mm) and second premolars (3.16 ± 1.87 mm). Efficacy ranged between 62.86% (canines) and 76.35% (second premolars). Predictability was high, between 97.04% and 98.22%. Men showed superior and significant efficacy at the first molars (p = 0.04). Age correlated negatively with efficacy and predictability, especially in the most posterior teeth and in males. Conclusion: Invisalign® demonstrated efficacy in maxillary expansion with high predictability (> 97%). Posterior teeth showed greater efficacy and canines the lowest (62.86%). Age and sex significantly influenced the results. These findings support the use of the system, recommending individualized planning considering the identified clinical variables.
Introduction: Maxillary expansion is essential in orthodontic treatment for proper dental alignment and correction of transverse malocclusions. The Invisalign® system has been promoted as an aesthetic and comfortable alternative to traditional appliances, utilizing slow maxillary expansion. However, uncertainties remain regarding the system’seffectiveness and predictability. Objectives: To evaluate the efficacy and predictability of maxillary expansion with the Invisalign® system, comparing movements predicted by ClinCheck® software with actual clinical outcomes. Materials and Methods: This retrospective study was conducted using 3D models created through an iTero® intraoral scanner in 127 patients who underwent maxillary expansion treatment with the Invisalign® system. In these patients, digital dental models were collected at 2 distinct timepoints: before treatment (T0) and after the first series of aligners (T1). Dental movements predicted by ClinCheck® software were compared with actual movements that occurred, using linear measurements of interdental width in the upper dental arch. Results: The sample included 85 women and 42 men. All T0-T1 comparisons showed significant differences (p < 0.001) in all segments. The greatest expansions were observed at the first premolars (2.80 ± 1.87 mm) and second premolars (3.16 ± 1.87 mm). Efficacy ranged between 62.86% (canines) and 76.35% (second premolars). Predictability was high, between 97.04% and 98.22%. Men showed superior and significant efficacy at the first molars (p = 0.04). Age correlated negatively with efficacy and predictability, especially in the most posterior teeth and in males. Conclusion: Invisalign® demonstrated efficacy in maxillary expansion with high predictability (> 97%). Posterior teeth showed greater efficacy and canines the lowest (62.86%). Age and sex significantly influenced the results. These findings support the use of the system, recommending individualized planning considering the identified clinical variables.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Alinhadores Invisalign® Expansão maxilar Predictibilidade Eficácia