Journal of Aligner Orthodontics, 02/2024

This article examines the innovative Stop and Go concept in aligner treatment planning, an important aspect of the Functional and Cosmetic Excellence Aligner System (Forestadent, Pforzheim, Germany). This approach sets a predetermined control point during treatment at which to reassess the patient’s progress as a reference for fabricating the following phase of aligners. It offers several benefits, namely the need for fewer aligners, shorter treatment time, improved tracking and more predictable finishing, and is also environmentally friendly. Guidelines for planning the Stop and Go phase during treatment are based on intra-treatment analysis of the evolution of the planned treatment design. In cases where it is necessary to modify the original treatment plan, change the aligner material, improve tracking, modify attachments and place or remove occlusal stops, Stop and Go is highly advantageous. Its use is suggested by the treatment planner based on the complexity and type of correction required; if necessary, however, the orthodontist has the freedom to decide the optimal time at which to introduce the Stop and Go phase based on treatment progress. In conclusion, Stop and Go is an important concept in both moderate and complex cases, for improved efficiency and treatment outcomes. Keywords: aligners, Functional and Cosmetic Excellence Aligner System, occlusion, predictability, tracking

Clear aligner treatment is a widely used and extremely popular treatment modality. The types of attachments that should be used and their optimal size, shape and location are the subject of debate among clinicians and in the literature. Different companies have different concepts of attachments. The present authors raise the question of whether so many attachments are truly necessary in all scenarios, outlining two cases that were treated without any attachments at all and seeking to explore the factors that led to their success. Keywords: aligner sequence, attachments, simulation

Background: An orthodontic traction technique with a miniscrew- anchored cantilever spring was introduced for use in conjunction with clear aligners to perform traction of an impacted maxillary third molar that had caused severe root resorption of the adjacent second molar. Case description: A 21-year-old woman with mild malocclusion sought multidisciplinary treatment for bilateral maxillary second molars, one of which was suffering from severe decay, while the other was subject to root resorption caused by the adjacent third molar, as shown on panoramic radiographs and CBCT images. The second molars were removed, and the impacted maxillary right third molar underwent orthodontic traction with the aid of a miniscrew-anchored cantilever spring. After 31 months of orthodontic treatment, both the maxillary and mandibular dentition had been aligned successfully and the patient was satisfied with the treatment outcome. Practical implications: A miniscrew-anchored cantilever spring can not only work effectively for orthodontic traction of impacted third molars to substitute second molars with severe root resorption individually, but also cooperate well with clear aligners. Keywords: cantilever spring, Class II treatment, clear aligners, impacted teeth, miniscrew

Objective: This study aims to determine how the individual operator's level of clinical experience influences the quality of treatment delivered with the Invisalign system (Align Technology, San Jose, CA, USA) under identical conditions. Quality was assessed using the Peer Assessment Rating Index and Little Irregularity Index. Treatment duration, the number of regular/emergency appointments and the total number of aligner sets required were also defined. Methods: The initial and final models of 81 adult patients selected according to strict criteria and who underwent Invisalign Full (now Invisalign Comprehensive) treatment were 3D printed, scanned with a CS 3600 intraoral scanner (Carestream, Rochester, NY, USA) and entered into CS Model+ measuring software (Carestream) to evaluate the Peer Assessment Rating Index and Little Irregularity Index semiautomatically. Based on when their treatment began, patients were grouped into periods T0, T1 and T2 with treatment delivered by three different orthodontists, all of whom had a different level of clinical experience. All data were analysed statistically. Results: The treatment results of the different operators and for the different periods did not vary significantly. There were also no significant differences in treatment duration, or the number of regular/emergency appointments and total aligner sets. Conclusion: In the case of highly standardised structures (clinic) and processes (treatment protocols), orthodontists with comparable postgraduate training can provide the same treatment quality (treatment results) despite having different levels of clinical experience. Keywords: aligner, expertise, Invisalign, Irregularity Index, Peer Assessment Rating Index, treatment quality

The following amendments are made to the published article: J Aligner Orthod 2023;7(2): 99–111; First published 3 July 2023