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Latest Technologies In Orthodontics-A Review

Authors:
  • Government College of Dentistry, Indore

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The extensive uses of technology in recent years have revolutionized all the fields including medicine and dentistry. The face of orthodontics has changed a lot from Angle's period to the present nanorobotic era in its concepts, biomaterials and technology. The digital technology has been extensively used for diagnosis, treatment planning, 3D printing, appliance systems, digital storage, integration and retrieval of data. The purpose of this article is to provide a review on the latest technologies available in the market and its various applications in Orthodontics.
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International Journal of Medical Science and Current Research (IJMSCR)
Available online at: www.ijmscr.com
Volume3, Issue 4, Page No: 01-11
July-August 2020
International Journal of Medical Science and Current Research | July-August 2020 | Vol 3 | Issue 4
1
ISSN (Print): 2209-2870
ISSN (Online): 2209-2862
(International Print/Online Journal)
SJIF IMPACT FACTOR: 5.565
PUBMED-National Library of
Medicine ID-101739732
Latest Technologies In Orthodontics- A Review
Sandhya Jain M.D.S, Merin Kuriakose B.D.S*
1Professor and Head, 2Post Graduate Student
Department of Orthodontics, Government College of Dentistry, Indore
*Corresponding Author:
Merin Kuriakose*
Room no.11, Government college of Dentistry, Indore,
Sardar Patel Marg, Opposite M.Y Hospital Indore, Madhya Pradesh- 452001, India
Type of Publication: Review Article
Conflicts of Interest: Nil
ABSTRACT
The extensive uses of technology in recent years have revolutionized all the fields including medicine and
dentistry. The face of orthodontics has changed a lot from Angle’s period to the present nanorobotic era in its
concepts, biomaterials and technology. The digital technology has been extensively used for diagnosis,
treatment planning, 3D printing, appliance systems, digital storage, integration and retrieval of data. The
purpose of this article is to provide a review on the latest technologies available in the market and its various
applications in Orthodontics.
Keywords: Advancements, Aligners, Digital imaging, 3D printing, latest technologies, Nanotechnology
INTRODUCTION
The future of orthodontics is digital as any other
field. Evolving technology and integration of digital
solutions in private practice have transformed
diagnosis and treatment planning from a traditional
two-dimensional (2D) approach into an advanced
three-dimensional (3D) technique [1].
The applications of 3D imaging in orthodontics
include pretreatment diagnosis and treatment
planning and post-orthodontic assessment of
dentoskeletal relationships and facial aesthetics.
Three-dimensionally fabricated custom made arch
wires, research and medicolegal purposes are also
among the benefits of using 3D models in
orthodontics [2].
Various digital imaging techniques like CBCT, intra
oral scanners, T scan, 3D facial scanners, 3D
cephalometry, Moire topography,
Stereophotogrammetry, 3D facial morphometry, 4D
facial dynamics, microcomputed tomography, Tuned
aperture computed tomography etc are widely used
nowadays. Various CAD CAM processed appliances
and aligners are also available. 3D printing enables to
achieve various products with high level of precision.
The use of the technology to build dental models,
removable appliances, customized brackets and arch
wires, and occlusal splints has been attempted and
reported in the orthodontic literature [1].
Rapid prototyping (RP) is a technique by which 3D
models are fabricated from computer aided designs
and it is built layer by layer according to the 3D input
[3]. Various Android and IOS apps for management,
diagnosis, communication and professional
interaction are also widely used nowadays.
Nanotechnology has got several applications in
orthodontics and it includes mainly nanocoatings in
archwires, nanoparticles in orthodontic adhesives etc.
Microsensor technology to help monitor removable
appliance wear is also a new invention.
Flowchart1. Shows the various latest techniques in
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Orthodontics.
Latest techniques in orthodontics
Flowchart. 1
Flow chart 1: Latest techniques in orthodontics
Imaging
3D printing
Appliances
Nanotechnology
yyyyy
Digital storage
CBCT
Intra oral
scanners
T scan
3D facial
scanners
Stereophotogra
mmetry
Moire
topography
4D facial
dynamics
Prediction
imaging
software
Rapid prototyping
Aligner
fabrication
Surgical and
bruxism splints
Auto
transplantation
templates
Customized
appliances
Indirect bonding
trays
Diagnostics for
impacted teeth
3D printed Jaws
Cranofacial/Cleft
Planning
3Dprinted
Functional
Appliance
CAD CAM
Appliances
Aligners
Robotic
arch wires
Newer
bracket
systems
E Models
Virtual
orthodontic
patients
Software that
integrate data
Android and
IOS apps for di-
agnosis,commu
-nication,
management
and
professional
interaction
Nanocoatings
Nanoparticles
SMPs
Bio
MEMS/NEMS
TAD
Nanomechanical
sensors
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LATEST IMAGING TECHNIQUES
CBCT
CBCT was introduced in dental radiology in 1998
with the NewTom QR-DVT 9,000 (NIM, s.r.l.,
Verona, Italy) [4]. During a CBCT scan, many single
2D snapshot images are captured from predefined
angles as the machine moves through a single iso
centric rotation of the x-ray source/sensor unit.
Advantages of CBCT over 2D imaging techniques
are [5];
3D representation of dental and craniofacial
structures.
Magnification errors or projection artifacts are
avoided.
Management of superimpositions
Interoperability in Digital Imaging and
Communications in Medicine (DICOM)
format
Generated data can be used for diagnosis,
modeling, and manufacturing of appliances.
Radiation exposure magnitude lower than that
of medical CT devices.
Applications of CBCT in orthodontics
3D lateral cephalograms
3D frontal cephalograms
Volumetric 3D skeletal views to visualize
maxillomandibular relationships
Comprehensive view of dentition
Evaluation of root resorption
Evaluation of radiopaque bony lesions
Evaluation of alveolar bone volume for
placement of TADs
Evaluation of TMJ
Assessment of sinuses and airway
3D superimposition
Imaging modality for CLCP patients
Advantages of 2D and 3D lateral cephalograms
retrieved from CBCT images [5];
CBCT projection magnification can be
computationally corrected during primary
reconstruction, helps to create an orthogonal
image.
When a standard of known length is placed in
view, the CBCT lateral cephalogram can be
calibrated to a true 1:1 representation of the
structure being imaged.
Ability to correct head position errors using
the 3-D manipulations.
Alignment of the cranial base between left
and right sides often reveals
maxillomandibular asymmetries that would
be otherwise difficult to detect.
If asymmetry exists between right and left
side, it is possible to generate a lateral
cephalometric view of each side for
independent analysis.
Optimal visualization of soft and hard tissues
is possible.
Advantages of CBCT-generated frontal
cephalograms [5];
Volume operations enable to avoid
superimposition of irrelevant structures.
Head can be repositioned into an ideal
position in all 3 planes of space before
generation of a PA cephalogram.
Digital scanning in orthodontics
3D scanning of the dental arch was first introduced
approximately 30 years ago for use with computer-
aided design and computer-aided manufacturing
(CAD/ CAM) technology in order to provide dental
restorations (Mo¨rmann et al., 1985) [6].
Applications of Digital scanning in orthodontics:
Treatment planning
Indirect bonding tray fabrication
Customized appliance design and
construction
Clear aligner technology
Orthognathic surgery simulation and wafer
construction
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The scoring of surgical outcomes in patients
with Cleft Lip and Palate abnormalities
Advantages of Digital scanning:
Replaces the need for unpleasant impressions
Accurate digital models
Permanent digital storage of the records
Reduces the risk of allergy to any constituents
of impression materials
More acceptable to the patients
Reduces the traditional workflow
Reduce the number of patients’ visits
Maximize the efficiency and cost savings in
the orthodontic office .
Patient information can be easily sent to
laboratories.
Lost or broken appliances can be easily
refabricated using the digital information
from database in the Cloud.
Benchtop scanners
Benchtop scanners (Figure 1) are mainly used for 3D
scanning of plaster models and impressions in the
laboratory. There are various scanners available
commercially.
Some of them are:
3Shape R Series
AGE solutions maestro 3D dental scanner
Dental Wings scan and design systems
Ortho Insight 3D Desktop Scanning System
Figure 1: Benchtop Scanner
Intraoral scanners
The concept of intraoral scanning in dentistry was
first introduced in 1973 (Duret, 1973) [7]. A few
years later, a chair-side scanning device utilising
CAD/CAM technology was available commercially
and manufactured by Sirona Dental Systems
(CEREC) (Brandestini and Moermann, 1989;
Mo¨rmann, 2006[8]. This led to introduction of the
first orthodontic scanning system; OrthoCAD,
developed by Cadent in 1999.
The various intraoral scanners available
commercially are:
The TRIOSH Intraoral scanner marketed by
3Shape
The LythosTM intraoral scanner marketed by
Ormco
The True Definition scanner marketed by 3M
ESPE
iTeroH intraoral scanner marketed by Align
Technology Inc.
PlanScanH marketed by Planmeca (Figure 2)
Figure 2: Intraoral scanner
T- scan
T-scan is a digital occlusal technology that records in
real-time, quantifiable relative occlusal force, and
contact time sequencing. T-scan system is comprised
of a USB handle, a processing unit, the U-shaped HD
sensor of large and small sizes, and color monitor of
the computer screen with T-Scan® software [9].
The T-Scan® III system records and displays for
visual interpretation the occlusal contact sequence,
individual tooth contact force percentages, the
bilateral (right-left) force distribution, and the
percentage of occlusal force present in anterior and
posterior quadrants.
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PARTS OF T-SCAN
Sensor and support
a. large b. small
Handle assembly (Figure 3)
Computer software
Printer
Figure 3: T-scan handle
Applications of T-scan in orthodontics:
Document occlusion prior to treatment and
track changes in the bite over time
Identify lateral interferences
Recognize early and high forces so we can
quickly redistribute them
Verify proper occlusion, both aesthetically
and functionally
Prevent patients from developing
malocclusion later in life
Ensure long-lasting, stable results
3D facial scanners
Facial scanners help to acquire three-dimensional
topography of the facial surface anatomy, automatic
facial landmark recognition, and analysis of the
symmetry and proportions of the face. Practical
applications of facial scanners are quantitative and
qualitative assessment of growth and development,
ethnic variations, gender differences, and isolation of
specific diagnostic traits in selected populations of
patients with craniofacial anomalies [2,10].
Stereophotogrammetry
Stereophotogrammetry is a unique method which
utilizes means of triangulation and camera pairs in
stereo configuration to recover the 3D distance to
features on the facial surface [1]. Burke and Beard
introduced the concept in 1967 [11].
Advantages of 3D photogrammetry:
A near-instantaneous image capture (on the
order of 1.5 milliseconds)
Reduces motion artefacts and makes it
suitable for children, even babies.
Image quality can be immediately reviewed
Software tools are available to view and
manipulate the image
Facilitate landmark identification
It can calculate anthropometric linear,
angular, and volumetric measurements.
Disadvantages of 3D photogrammetry:
Expensive
Limited availability
Shiny, shadowed, or transparent facial
structures are difficult to record
Lack of ability to calculate interactive
landmarks
Moiré topography
It is a totally non-invasive, non-contact and vision-
based imaging system. Moiré topography delivers 3D
information based on the contour fringes and fringe
intervals [2]. The depth of the fringes is obtained by
ray optics and high accuracy is achieved with crude
instrumentation. If a surface has sharp features,
difficulty in recording is encountered. Better results
can be obtained on smoothly contoured faces.
DIGITAL STORAGE
With digital impression techniques, it’s easier to
make digital study models. Digital storage, retrieval
and transport can all be achieved through electronic
systems, thus reducing vast physical storage
requirements, missing and broken models, difficulty
in storing large amount study models and
transportation issues, which may be significant for
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audit and research. The quick online transfer of study
models to laboratories for appliance construction is
extremely useful in eliminating transport costs and
increasing efficiency for several practices [8].
Virtual orthodontic patient
With the utilization of 3D imaging and 4D facial
dynamics, it is possible to make a virtual orthodontic
patient where we can see the bone, flesh and teeth in
three dimensions. The concept of virtual orthodontic
patient will allow considerable data to be collected
and a variety of soft and hard tissue analyses to be
performed. Knowledge about the masticatory system
will increase, and our understanding of tooth
movement biomechanics, orthopedic and
orthognathic corrections will be improved [12].
OrthoCAD™ Technology
OrthoCAD™ software was developed by CADENT,
Inc. (Computer Aided DENTistry, Fairview, NJ,
USA) to helps the orthodontist to view, manipulate,
measure and analyze 3D digital study models very
easily and quickly [12]. Alginate impressions of the
upper and lower dentitions, along with a bite
registration are needed for the devolopment of 3D
digital study models, which may be then downloaded
manually or automatically from the worldwide
website using OrthoCAD Downloader. The software
has several diagnostic tools such as: measurement
analyses (e.g. Bolton analysis); midline analysis and
overbite and overjet analyses.
OrthoCAD™ software features a program called
‘Occlusogram’ which permit the orthodontist to
visually assess the inter-occlusal contacts. OrthoCAD
Virtual Set-up and OrthoCAD™ Bracket Placement
System are two other interesting features of the
software.
Prediction imaging software
Outcomes of orthognathic surgery can be predicted
by using various available prediction software
programs, alone or in combination with video
images.
At present, several software systems are available
which allow clinicians to manipulate digital hard and
soft tissue profile tracings and subsequently morph
the pretreatment image to produce a treatment
simulation [13].
Quick Ceph was the first commercially available
software for orthognathic surgery prediction. It
permits a wide range of functions based on a 28-point
digitization. When orthodontic and surgical
movements are simulated, horizontal and vertical
changes are recorded by the computer. An adjustment
in the soft tissue occurs automatically according to
predetermined ratios. Its latest version (Quick
Ceph2000) incorporated many advantages, including
capture and storage of high resolution images,
treatment simulations, growth forecasts,
compatibility with any operating system and digital
image enhancement of tracing accuracy [14].
The dentofacial planner developed by Dentofacial
Software Inc. (Toronto, Canada) is able to perform a
variety of cephalometric analyses including Steiner,
Downs, McNamara, Ricketts, Grummons, Harvold,
Legan, and Jarabak. It is also able to perform CO
CR conversions, to estimate facial growth, simulate
any combination of orthognathic surgery procedures
including one piece or segmental maxillary surgery,
mandibular advancement or setback, total or anterior
mandibular sub apical surgery and chin surgery
[15,16].
Vistadent (GAC International, Birmingham, AL)
developed by GAC TechnoCenter is another
orthognathic surgical program that uses VTO
(Ricketts) for treatment simulations. It is compatible
with all digital X-ray systems and digital cameras.
Orthodontic treatment planner (OTP) (Pacific Coast
Software, Inc., Wayzata, MN) is a surgical prediction
program distributed by orthovision technologies
[13].
Orthognathic prediction analysis (OPAL) is software
that enables simulation of surgical jaw movements
and dental decompensation and illustrates these
changes in terms of quantitative values [17].
Dolphin imaging software (Dolphin Imaging and
Management Solutions, Chatsworth, CA) is a popular
software orthognathic surgical program, presently
commercially available. The software indirectly
digitizes dental, skeletal and soft tissue landmarks of
the scanned cephalogram, using a mouse-controlled
cursor. The software links up the points to give a
trace image, which can be manually manipulated for
improved fit. The user can then select the analysis of
choice [18].
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Three-dimensional prediction methods are also
available nowadays, such as surface scan/cone-beam
CT, three-dimensional computerized tomography
(3DCT), 3D magnetic resonance imaging (3DMRI).
3D PRINTING
Additive manufacturing or 3D printing was founded
in 1990 by Wilfried Vancraen, CEO and Director of
Materialise NV, the first Rapid Prototyping sector
company in the Benelux region [19]. 3D printing
technology helps to “print” 3D objects, prototypes,
and production parts from a virtual model.
Rapid prototyping
Rapid prototyping (RP) is the fabrication of a three-
dimensional (3D) model from a computer aided
design (CAD), traditionally built layer by layer
consistent with the 3D input [20]. The first
commercial process of RP was presented at the
Autofact show in Detroit (US) in November 1987 by
a company called 3D systems, Inc [21].The main idea
of this method is named as “layered manufacturing”
or “solid free form fabrication” in which a solid 3D
CAD model of an object is developed first and then it
is decomposed into the cross-sectional layers and
then numerical files in the form of virtual trajectories.
It guides the material additive processes for
physically rapid buildup of those layers in an
automated fabrication machine to form the object
called the prototype [22].
Types of Rapid Prototyping:
1. Stereolithography
2. Fused deposition modeling
3. Selective laser melting and selective laser
sintering
4. Inkjet printing
5. Electron beam melting (EBM)
6. Digital Light Processing (DLP)
7. Laminated object manufacturing (LOM)
LATEST UPDATES IN APPLIANCES USED IN
ORTHODONTICS
Align® Technology
Align® Technology, Inc. developed the Invisalign
appliance for orthodontic tooth movement in the
USA in 1998. It is a process in which thin, clear,
overlay sequential appliances are used to straighten
teeth into a perfect occlusion [12].
The process begins with the orthodontist making an
initial diagnosis and treatment plan. Then the
diagnosis and treatment plan along with patient’s
radiographs, impressions and an occlusal bite
registration are sent to Align® Technology. Using the
acquired data, models are converted into 3D data
through ‘destructive scanning’ machines. A 3D
model is developed from the 3D data. The treatment
is divided into a series of stages that go from the
present condition to the desired final result. The
orthodontist will approve the simulation of the stages,
following which a series of dental models are
constructed from photosensitive thermoplastic. These
are used to fabricate the finished product: a series of
clear Invisalign aligners. The patient is instructed to
wear each aligner for about 12 weeks, and then to
move forward to the subsequent stage.
Drawbacks of Align technology:
Orthopedic changes are not possible with this
system
Continued eruption of teeth or significant arch
changes during growth does not happen
during Invisalign treatment.
Any change in tooth morphology during the
treatment phase by means of restorations or
composite build-ups can prevent the use of
subsequent aligners.
Root positioning at the end of the treatment is
not taken into account.
Newer Bracket System
Brackets are the vehicle through which orthodontic
force is transmitted to the teeth. Conventional metal
brackets are always superior in its performance but in
aesthetic point of view they are inferior. Because of
increasing aesthetic concern among people, brackets
are being made from tooth colored materials like
ceramic and plastics.
Ceramic brackets
Polycrystalline and single-crystal alumina brackets
are commercially available.
Advantages of ceramic brackets:
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Excellent aesthetics
Minimal water absorptivity
Better mechanical properties
Biocompatibility
Drawbacks of ceramic brackets:
Bracket wing fracture when tying the ligature
Fracture from archwire forces
Tooth wear during treatment
Enamel fracture at debonding
Plastic Brackets
Plastic brackets are made up of polycarbonate and are
aesthetically appealing for the patients.
Drawbacks of plastic brackets
Problems with torque capacity
Excessive creep deformation
Decreased hardness and wear resistance
Intraoral softening
Fracture
Discolouration
Self-ligating brackets
Self-ligating brackets are bracket systems that have a
mechanical device built into the bracket to close the
edgewise slot. The cap inbuilt in the bracket holds the
arch wire in the bracket slot and replaces the
steel/elastomeric ligature. With the self-ligating
brackets, the moveable fourth wall of the bracket is
used to convert the slot into a tube [23].
The philosophy behind this system is to deliver light
forces on a low-friction basis, thus insuring more
physiologic tooth movement and at balanced oral
interplay [23].
There are two types of self-ligating bracket systems,
active and passive. They refer to the mode by which
they interact with the arch wire. The active self-
ligating brackets has a spring clip that encroaches on
the bracket slot from the labial/buccal aspect and
presses against the arch wire. It provides an active
seating force on the arch wire. Examples are In-
Ovation (GAC International, Bohemia, NY, USA),
SPEED (Strite Industries, Cambridge, Ontario,
Canada), and Time brackets (Adenta,
Gilching/Munich, Germany).
The passive type self-ligating brackets use a rigid
door or latch to entrap the archwire providing more
room for the arch wire and the clip does not press
against the archwire. Examples are Damon
(Ormco/”A”Company), SmartClip™ (3M Unitek,
USA), and Oyster ESL (Gestenco International,
Gothenburg, Sweden)[23].
Benefits of self-ligating brackets:
Reduced friction between arch wire and
bracket
Reduced clinical forces
Reduced treatment time
Faster alignment
Faster space closure
Different arch dimensions
Better alignment and occlusal outcomes
Less patient pain
More hygienic.
Less associated subjective discomfort
Promotion of periodontal health
Superior torque expression
APPS USED IN ORTHODONTICS
Software application abbreviated as Apps are also
developed in orthodontics. Various IOS and Android
applications are developed for diagnosis, treatment
planning, communication and interaction with
patients. The applications range from clinician’s apps
for practice management, apps for patients like
diagnostic apps, patient reminder apps, progress
trackers, public awareness information, and
orthodontic educational apps like peer reviewed
journals, model analysis apps etc [24].
Table 1: shows various examples of Apps used in
Orthodontics.
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Table 1: Examples of various Apps used in
orthodontics
NANOTECHNOLOGY IN ORTHODONTICS
The term “Nano” means “dwarf” in Greek. A
nanometer is one billionth of a meter or 109[19].
Nanotechnology has got several applications in
medicine, dentistry as well as in orthodontics.
Various applications of nanotechnology in
orthodontics include [25];
Nanocoatings in archwires Nanoparticles
acts as dry lubricants and helps to minimize
the frictional forces between the orthodontic
wire and brackets. Inorganic fullerene-like
nanoparticles of tungsten sulflide (IF-WS2),
have been used as self- lubricating coatings
for orthodontic stainless steel wires.
Nanoparticle in Orthodontic adhesive-
Polymer nanocomposites contain silica nano
fillers that are 0.005 0.01 microns in size.
Due to the reduced dimension of the particles
and a wide size distribution, an increased
filler load can be achieved that reduces
polymerization shrinkage and also increases
mechanical properties such as tensile and
compressive strength and resistance to
fracture.
Nanoparticle delivery from elastomeric
ligature- Elastomeric ligatures deliver
nanoparticles that can be anticariogenic
(fluoride), antiinflammatory and antibiotic
drug molecules embedded in the elastomeric
matrix.
Shape memory polymers in orthodontics-
Shape memory nanocomposite polymers can
produce esthetic orthodontic wires that have
the property of shape memory also. The SMP
materials are clear, colourable, and stain
resistant, providing the patient a more
aesthetically appealing appliance during
treatment
Control of oral Biofilms during orthodontic
treatment- Metal nanoparticles in the size
range of 1-10 nm have biocidal activity
against bacteria. So combining dental
materials with NPs or coating surfaces with
NPs helps to prevent microbial adhesion, with
the aim of reducing biofilm formation. Resin
composites containing silver ion-implanted
fillers that release silver ions have been found
to have antibacterial effects on oral
streptococci [26]. Nitrogen doped Titanium
dioxide (TiO2 ), Silver (Ag), Gold (Au) ,
Clinicians Apps
Patients Apps
Educational Apps
Orthodontic
update
(provides access to
the publications)
Bracemate
(provides
emergency
informations to
follow if there is
any problem,
patient can pick
colours of the
modules they
wanted for their
teeth)
Glossary of
orthodontic terms
(dictionary app for
students to clear
concepts of all the
terms used in
orthodontics)
Doctor smile
orthodontics (for
giving patient
education and
motivation)
Brace reminder
(notification
reminder for
tightening)
AJODO(Abstracts
of articles can be
read)
Dolphin
MyOrthodontist
(helps to connect
with the patients,
appointments,
account balances,
media for patient
education can be
managed)
My orthodontist
(provides
information about
orthodontist,
FAQs, office
hours, directions)
Oneceph (for
cephalometric
analysis)
Dental monitoring
(Allows remote
monitoring of a
patient, educate the
patient to take good
picture of the
teeth.)
Orthodontic guide
(provides
information about
orthodontic
speciality and
treatment options)
iModel Analysis
(for study model
analysis)
REM
orthodontics
(for shopping of
orthodontic
matierals)
Trayminder
aligner
tracker(helps the
patient to track
aligner wear time
on each day, get a
reminder to switch
to the next aligner,
takes teeth selfies
to document
progress.)
Interceptive
orthodontics
(provides step by
step guide to early
intervention in
cases of ectopic
eruption of
maxillary canines
and molars)
Merin Kuriakose et al International Journal of Medical Science and Current Research (IJMSCR)
Volume 3, Issue 4; July-August 2020; Page No.01-11
© 2020 IJMSCR. All Rights Reserved
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Silica (SiO2 ) Copper (Cu/CuO) and ZnO
nanoparticles are used as antimicrobial
agents.
Smart brackets with nanomechanical sensors-
Nanomechanical sensors can be fabricated
and be incorporated into the base of
orthodontic brackets which will provide the
information about the force level applied by
the bracket on the tooth. Nano chip
encapsulated into small low profile
contemporary bracket systems can be used.
Temporary anchorage devices with
nanocoatings- Biocompatible coatings like
Titanium nanotubes can enhance initial
osseointegration and can serve as an
interfacial layer between the newly formed
bone and the TAD.
Microsensor technology
Microsensor technology to help monitor removable
appliance wear is also a new invention. It is
comprised of a miniature microprocessor with size
smaller than a coin which is embedded into the
removable appliance. It is wirelessly connected to a
software which will calculate the real time wear of
the appliance by the patient. It will help to assess the
patient’s compliance towards the treatment.
Examples for few microsensors monitoring
removable appliance wear are TheraMon-
microsensor [27] (Handelsagentur Gschladt,
Hargelsberg, Austria) and Smart retainer
environmental microsensor [28] (Atlanta, Ga).
CONCLUSION
The past few decades have witnessed the great leap
of orthodontics into digital technology. The digital
era has helped orthodontists to work efficiently and
save manpower a lot. Every day newer technologies
are being discovered and are helping the clinician for
better understanding of patient’s problems, diagnosis,
treatment planning and execution of the plan for
more precise results.
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ResearchGate has not been able to resolve any citations for this publication.
Full-text available
Article
Objective: Balanced occlusal force distribution is a critical factor for restorative, prosthetic or orthodontic treatment. It has been postulated that orthodontic treatment may lead to occlusal discrepancies in the arch due to changing the occlusal relationships. This study was conducted to compare the occlusal force parameters between natural dentition patients and a post-orthodontic treatment group. Method and materials: Fifty Thai subjects were divided into non-orthodontic and post-orthodontic groups comprised of 25 subjects each (mean age 24.8 years). The T-Scan® III computerized occlusal analysis system was used to record a multi-bite closure for each subject. The initial occlusal contact location, the bilateral percentage force distribution, the percentage force in the anterior and posterior quadrants, and the individual tooth force percentages were calculated for both groups. The Student's Paired t-Test compared the in-group differences, while a one-way ANOVA analyzed the differences between the two groups. Results: The initial tooth contacts in both groups were found on the second molars and central incisors. Maximum force was most frequently observed on the left second molar tooth (15.9% non-orthodontic; 25.4% post-orthodontic). The bilateral right-to-left side force distribution (51.36% right-48.96% left) was not statistically different for all subjects, nor was it statistically different between the non-orthodontic (48.67% right-51.36% left) and the post-orthodontic groups (48.96% right-51.05% left). Statistically significant differences were found between the quadrants in both the groups (22.46% anterior-77.57% posterior in non-orthodontic subjects; 10.58% anterior-89.42% posterior in post-orthodontic subjects) (p < 0.01). Conclusion: A significant occlusal force discrepancy was found in the post-orthodontic subjects, with higher force percentages observed posteriorly and much less percentage force anteriorly, when compared to the natural dentition subjects. T-Scan® III digital occlusal analysis may be recommended for orthodontic case finishing, to make visible to the Clinician the severity of the orthodontically created occlusal force imbalance, such that it can be minimized during orthodontic case finishing.
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The popularity and availability of virtual technology in orthodontics for the replacement of hard-copy records with electronic records is growing rapidly, with a move towards a 'digital' patient for diagnosis, treatment planning, monitoring of treatment progress and outcome. As part of this ongoing development, three-dimensional digital models of the dental arches have the potential to replace traditional plaster models and their associated limitations for treatment planning, appliance construction and simulated treatment outcomes. This article provides the reader with a summary of the currently available benchtop model scanners and intraoral scanners. It is likely that this technology will become increasingly common-place within the orthodontic profession over the next decade.
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Objective: To assess the effect of wear-time recording on subjective and objective wear time. Materials and methods: This study retrospectively examined a group of 18 patients and a control group of 14 patients at four appointments over 168 days. The patients were treated with removable appliances with embedded TheraMon-microsensors to be worn for 15 hours per day. The study group was not told about the microsensor until the first appointment after fitting of the appliance. At each appointment patients were asked about their subjective wear time and afterward were told about the objective wear time. The existence of the microsensor was revealed to the control group when the appliance was fitted. Objective wear time was also announced at every appointment. Results: Mean wear times did not significantly differ between groups at any appointment or regarding overall wear time. Highly significant differences between subjective and objective wear time were found when patients did not know that their wear time had been monitored. Conclusion: Mean wear times assessed in this study concur with data of previous studies. Patients tend to overestimate their wear times but become more realistic once they know wear time is being monitored. Objective measurement of wear time allows a more realistic view of compliance by patient and orthodontist. Knowing that wear time is recorded does not necessarily increase the amount of time removable appliances are worn by the patient.
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Over the past decade the growing number of adult patients seeking for orthodontic treatment made orthognathic surgery popular. Surgical and orthodontic techniques have developed to the point where combined orthodontic and surgical treatment is now feasible to manage dentofacial deformity problems very satisfactorily. The prediction of orthognathic treatment outcome is an important part of orthognathic planning and the process of patient' inform consent. The predicted results must be presented to the patients prior to treatment in order to assess the treatment's feasibility, optimize case management and increase patient understanding and acceptance of the recommended treatment. Cephalometrics is a routine part of the diagnosis and treatment planning process and also allows the clinician to evaluate changes following orthognathic surgery. Traditionally cephalometry has been employed manually; nowadays computerized cephalometric systems are very popular. Cephalometric prediction in orthognathic surgery can be done manually or by computers, using several currently available software programs, alone or in combination with video images. Both manual and computerized cephalometric prediction methods are two-dimensional and cannot fully describe three-dimensional phenomena. Today, three-dimensional prediction methods are available, such as three-dimensional computerized tomography (3DCT), 3D magnetic resonance imaging (3DMRI) and surface scan/cone-beam CT. The aim of this article is to present and discuss the different methods of cephalometric prediction of the orthognathic surgery outcome.
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Book
When we embarked on this project, we appreciated that a wide range of disciplines would be involved in developing acquisition systems and software analysis packages for a host of applications for medical, medically allied, entertainment, and military/security groups. In fact, three-dimensional imaging potentially is of interest to all and certainly has the potential to have an impact on everyone in daily life. We took a clear initiative to build a text that is not only informative, illustrative, and applied, but also provides the latest in state-of-the-art technology. The book is set out in three sections – (1) diagnostic and assessment methods, (2) applications, physiological development, and surgical procedures, and (3) movement and facial dynamics – to cover clinical interest in the craniofacial complex not only for dentists, specialists, and specialties related to dentistry, but also for other professions that deal with the craniofacial complex, such as speech therapists and psychologists. We have chosen a group of authors world-renowned in their field, and their topics cover a wide range of applications representing different levels of sophistication, experience, and knowledge. The chapters are well illustrated to facilitate knowledge and skills transfer. Each chapter is well referenced to enable interested readers to facilitate their understanding and build a foundation of knowledge. Certain chapters direct readers to utilize open-sourced, readily available software, commercially available packages, and also the mathematical theory behind problem-solving. This book addresses a gap in the applications of three-dimensional imaging in dentistry and allied health professionals. We hope that we have derived a blend of topics that will be of interest to the novice as well as to experts in different disciplines.
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To test the accuracy and reproducibility of a 3-dimensional (3D) stereophotogrammetric imaging system for measuring the facial soft tissues of healthy subjects. Three-dimensional soft tissue facial landmarks were obtained from the faces of 10 adult subjects, by use of a 3D stereophotogrammetric imaging system (Vectra; Canfield Scientific, Fairfield, NJ). Sixteen linear measurements were computed. Systematic and random errors between operators, calibration steps, and acquisitions were calculated. No systematic errors were found for all performed tests (P > .05, paired t test). The method was repeatable, and random errors were always lower than 1 mm, except for the distance from cheilion to cheilion. Repeated sets of acquisition showed random errors up to 0.91 mm, without systematic biases. The 3D stereophotogrammetric imaging system can assess the coordinates of facial landmarks with good precision and reproducibility. The method is fast and can obtain facial measurements with few errors.