• 대한치과교정학회지
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• 제48권5호
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• pp.326-332
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• 2018

Objective: This study was performed to compare the perception of pain between patients treated with passive self-ligating fixed appliances and those treated with Invisalign aligners. Methods: This prospective study conducted in Saudi Arabia used an estimated sample of 64 patients from a private dental clinic. After obtaining written informed consent, the patients were divided into two groups; one group (n = 32) was treated using passive self-ligating fixed appliances and the other group (n = 32) using $Invisalign^{(R)}$ aligners. Immediately after fitting the appliances, the patients' perception of pain was evaluated through a close-ended and coded self-administrated questionnaire by using a visual analog scale (VAS). Their responses were recorded at 4 hours, 24 hours, day 3, and day 7. Mann-Whitney U-test, Kruskal-Wallis test, and Pearson's chi-square test were performed for statistical analysis. Results: A lower percentage of patients treated with Invisalign aligners reported pain than did patients treated with passive self-ligating fixed appliances, and these differences were statistically significant (p = 0.001). Similarly, the mean VAS score for the Invisalign group was significantly lower than that for the passive self-ligating fixed appliance group at different intervals during the first week of treatment. The intensity of pain with both appliances peaked at 24 hours (mean VAS score, 3.87) and was lowest (mean VAS score, 1.62) on day 7. Conclusions: During the first week of orthodontic treatment, patients treated with Invisalign aligners reported lower pain than did those treated with passive self-ligating fixed appliances.

• 대한치과교정학회지
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• 제49권3호
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• pp.140-149
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• 2019

We are currently living in an era where the use of computer-aided design/computer-aided manufacturing has allowed individualized orthodontic treatments, but has also incorporated enhanced digitalized technology that does not permit improvisation. The purpose of this systematic review was to analyze publications that assessed the accuracy and efficiency of the $Invisalign^{(R)}$ system. A systematic review was performed using a search strategy to identify articles that referenced $Invisalign^{(R)}$, which were published between August 2007 and August 2017, and listed in the following databases: MEDLINE, Embase, Cochrane Library, Web of Knowledge, Google Scholar, and LILACS. Additionally, a manual search of clinical trials was performed in scientific journals and other databases. To rate the methodological quality of the articles, a grading system described by the Swedish Council on Technology Assessment in Health Care was used, in combination with the Cochrane tool for risk of bias assessment. We selected 20 articles that met the inclusion criteria and excluded 5 due to excess biases. The level of evidence was high. Although it is possible to treat malocclusions with plastic systems, the results are not as accurate as those achieved by treatment with fixed appliances.

• 대한치과교정학회지
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• 제51권4호
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• pp.293-300
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• 2021

In this report, we demonstrate the effectiveness of the Invisalign^® system in the treatment of severe gingival recession and bone dehiscence through torque, translation, and intrusion movements in a young woman. Cone-beam computed tomography was used to assess bone parameters and check the teeth during treatment. The root of the mandibular right central incisor, which was buccally positioned and exhibited bone dehiscence of 9.4 mm, was moved toward the center of the alveolar process by using the Invisalign^® system and SmartForce^® features. The patient was monitored by a periodontist throughout the orthodontic treatment period. Her gingival recession reduced, while the bone dehiscence reduced from 9.40 mm to 3.14 mm. Thus, movement of the root into the alveolus promoted bone neoformation and treated the gingival recession. The findings from this case suggest that orthodontic treatment using the Invisalign^® system, along with periodontal monitoring, can aid in the treatment of gingival recession and alveolar defects.

• 대한치과교정학회지
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• 제52권4호
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• pp.268-277
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• 2022

Objective: Poor experience with Invisalign treatment affects patient compliance and, thus, treatment outcome. Knowing the potential discomfort level in advance can help orthodontists better prepare the patient to overcome the difficult stage. This study aimed to construct artificial neural networks (ANNs) to predict patient experience in the early stages of Invisalign treatment. Methods: In total, 196 patients were enrolled. Data collection included questionnaires on pain, anxiety, and quality of life (QoL). A four-layer fully connected multilayer perception with three backpropagations was constructed to predict patient experience of the treatment. The input data comprised 17 clinical features. The partial derivative method was used to calculate the relative contributions of each input in the ANNs. Results: The predictive success rates for pain, anxiety, and QoL were 87.7%, 93.4%, and 92.4%, respectively. ANNs for predicting pain, anxiety, and QoL yielded areas under the curve of 0.963, 0.992, and 0.982, respectively. The number of teeth with lingual attachments was the most important factor affecting the outcome of negative experience, followed by the number of lingual buttons and upper incisors with attachments. Conclusions: The constructed ANNs in this preliminary study show good accuracy in predicting patient experience (i.e., pain, anxiety, and QoL) of Invisalign treatment. Artificial intelligence system developed for predicting patient comfort has potential for clinical application to enhance patient compliance.

• 치위생과학회지
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• 제23권4호
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• pp.245-254
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• 2023

Background: This study aimed to determine the skeletal and dental effects in pediatric and adolescent Korean patients with Class II Division 1 malocclusion treated using the Invisalign Mandibular Advancement (MA^®) appliance. Methods: The study included patients aged 6 to 18 years who received orthodontic treatment with the MA^® appliance for Class II Division 1 malocclusion at the Department of Pediatric Dentistry, Wonkwnag University Daejeon Dental Hospital, between July 1, 2018, and December 31, 2021. The treatment group consisted of 20 patients, 10 boys and 10 girls. The control participants were also 10 boys and 10 girls. Lateral cephalometric radiographs were taken before and after treatment, and 41 measurements of skeletal and dental changes were measured and analyzed using the V-Ceph^TM 8.0 (Osstem Implant). All analyses were performed using SPSS software (IBM SPSS for Windows, ver 26.0; IBM Corp.), and statistical significance was tested using paired and independent samples t-tests for within-group and between-group comparisons, respectively. Results: The patients in the treatment group showed significant decreases in ANB (A point, Nasion, B point), maxillary protrusion, maxillary anterior incisor labial inclination, and maxillary protrusion after treatment. However, when compared with the growth changes observed in the control group, only ANB and maxillary protrusion decreased, with no significant differences in SNA, SNB, and mandibular length. Conclusion: Collectively, the results of this study confirm that the use of MA^® appliance in pediatric and adolescent Korean patients with Class II Division 1 malocclusion results in a reduction of anteroposterior skeletal and dental disharmony.

• 대한치과교정학회지
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• 제54권3호
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• pp.142-152
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• 2024

Objective: This retrospective cohort study aimed to assess and compare the accuracy of 3 different Invisalign^® treatment regimens in terms of variations of aligner change frequency and type of aligner material in achieving maxillary dental buccal expansion. Methods: Altogether, 120 adult patients whose treatment involved maxillary dental expansion with Invisalign^® were included. The patients were divided into 3 groups, with each group comprising 40 patients as follows: SmartTrack^® 1-week changes (ST1), SmartTrack^® 2-week changes (ST2), and EX30^® 2-week changes (EX2). The groups were assessed by comparing actual changes achieved with those prescribed by ClinCheck^®. The rates of clinically significant inaccuracies (CSI) observed for buccal expansion (≥ 0.5 mm) and buccolingual inclination (≥ 2°) during expansion were then determined. Results: In terms of expansion, the ST1 group demonstrated the highest CSI rate at all tooth levels, whereas the ST2 group had the lowest rate of CSI and the lowest mean inaccuracy for each tooth level. In terms of buccolingual inclination, the ST1 group had the highest CSI rate across all tooth levels, whereas the EX2 group had the lowest CSI rate at all tooth levels except for the canine level where the ST2 group had the lowest CSI rate. A tendency toward overexpression of buccal crown inclination, and underexpression of buccal expansion was observed at all tooth levels. Conclusions: Two-week aligner change regimens offer improved accuracy compared with 1-week aligner changes. SmartTrack^® 2-week changes were the most accurate for buccal expansion, whereas EX30^® 2-week changes were the most accurate for buccolingual inclination.

• 대한치과의사협회지
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• 제54권7호
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• pp.563-574
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• 2016

A clear overlay appliance is a type of a removable appliance made from transparent thermoplastic plastic film that covers the entire dentition to move the teeth. It is one of the most favored orthodontic methods opted for by adult patients; this treatment is esthetic, does not cause discomfort and allows oral hygiene to be easily managed when compared to other conventional fixed treatment methods. However, the use of clear overlay appliances, such as invisalign or clear aligner, is associated with various clinical challenges. In particular, the appliances require longer treatment periods compared to fixed treatment, and due to the structural characteristics of the appliances, it is difficult to make proper posterior occlusion and certain type of tooth movement, including extrusion, rotation and tip. Thus, the clear overlay appliances are regarded as supplementary appliances by most orthodontists and have been used for simple orthodontic treatments, such as partial anterior alignments or orthodontic relapse cases. Owing to the remarkable advancement in the field of 3D digital technology over a period of 15 years, the accuracy and convenience of modern clear overlay appliances have continuously improved. Moreover, orthodontic outcomes have also been greatly improved by the introduction of new materials and successful application of various biomechanical methods from conventional orthodontic treatments in the design of clear overlay appliances. This study investigates the clinical limitations that should be considered during the application of clear overlay appliances and also examines the efforts and methods used to overcome these challenges.

• 한국정보과학회:학술대회논문집
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• 한국정보과학회 2012년도 한국컴퓨터종합학술대회논문집 Vol.39 No.1(C)
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• pp.350-352
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• 2012

최근 의료 분야 소프트웨어가 발전함에 따라 3차원 가상 모델을 이용한 의료 소프트웨어의 개발도 꾸준히 증가하는 추세이다. 치열 교정 분야는 이러한 3차원 가상 모델을 적용할 수 있는 분야 중 하나이다. 치열교정 분야에서는 3차원 가상 모델을 이용하여 부정 교합 환자의 치료 초기부터 끝까지 여러 단계의 치아이동 과정을 제공한다. 치아 이동의 각 단계별로 Stereolithographic Model이 만들어지는데, 이는 투명하고 얇은 Overlay 장치를 제작하는 기초가 된다. 투명한 재질의 Overlay 장치는 심미적이고 사용이 간편하여 많은 환자들이 선호하고 있다. Overlay 장치를 제작하는 시스템을 구축한 회사로는 Invisalign System이 가장 대표적이다. Invisalign System은 미국에 본사를 둔 회사로 한국에 지사를 두고 적극적인 마케팅을 통해 3D 치열 교정 분야의 국내시장을 거의 독점하고 있다. 독점적이다 보니 비용이 다른 교정 치료보다 2배 가까이 들고 있지만, 현재 한국에서는 개발이 적극적으로 이루어지지 않는 실정이다. 이에 본 논문에서는 환자 치아의 정확하고 과학적인 진단자료를 얻어 높은 치료비용에 대한 개선과 치료 전 과정에 대한 시뮬레이션 및 Stereolithographic Model을 미리 환자에게 제공하여 만족도를 높일 수 있는 3D치열 교정 시스템을 제안한다.

• 대한치과교정학회지
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• 제33권1호
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• pp.21-29
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• 2003

최근 컴퓨터 소프트웨어의 발전으로 환자의 모형을 scanning하여 3차원 가상 모델을 만드는 것이 가능하게 되었다. 이러한 모델은 컴퓨터로 처리되어 치료 시작부터 끝까지 여러 단계의 치아 이동이 이루어지고, 치아 이동의 각 단계별로 stereolithographic model이 만들어 지는데, 이는 일련의 투명하고 얇은 overlay 장치를 제작하는 기초가 된다. 계획된 치아 이동의 단계에 따라 치아를 움직이기 위해서는 환자가 장치를 항상 사용해야 하며, 중정도의 crowding과 공간 폐쇄는 이 장치로 치료가 용이하다는 것이 입증되었다. 지금까지 이 장치를 경험해 본 결과, 고정성 교정장치에 비해 환자가 불편을 덜 느끼고 심미성과 구강 청결이 좋아 환자의 협조도가 뛰어 났다. 이 장치는 완전히 맹출된 영구치열 환자에서 부정교합에 대한 또 하나의 유용한 접근법이라 할 수 있다.

• 대한치과교정학회지
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• 제53권4호
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• pp.264-275
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• 2023

Objective: To investigate the effects of maxillary orthodontic expansion on the alveolar bone tissue in adult patients treated with aligners by using cone-beam computed tomography. Methods: Thirty patients (22 females and 8 males; mean age: 36.3 years) were treated with Invisalign^® aligners. Cone-beam computed tomography and digital models were obtained before (T0) and after (T1) upper arch expansion. The bone thicknesses in the cervical, middle, and apical areas of the incisors, canines, premolar, and first molars were buccally and palatally measured, totaling 96 areas and 2,880 measurements. The buccolingual inclinations and transverse measurements of the teeth were obtained from digital models to correlate them with the bone changes. The statistical tests used were Student's t-test, analysis of variance, and Pearson's correlation tests (p < 0.05). Results: From the 96 areas evaluated, 84 revealed an increase or stability in the alveolar bone thickness and twelve displayed significant bone loss. Bone changes did not correlate with the tooth inclination and transverse measurements. Conclusions: Within the limitation of the present study, mild levels of upper arch expansion obtained with Invisalign^® aligners in adult patients did not result in any clinically significant loss of alveolar bone thickness.