Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

The Use of Clear Aligners in Multi-segmental Maxillary Surgery: A Case Control Study in Cleft Lip and Palate and Skeletal Class III Patients

Maria Costanza Meazzini
,
Leonardo Paolo Demonte
* ORCID logo ,
Noah Cohen
,
Valeria Marinella Augusta Battista
,
Dimitri Rabbiosi
,
Luca Autelitano
Version 1 : Received: 3 February 2024 / Approved: 19 February 2024 / Online: 19 February 2024 (15:37:34 CET)

A peer-reviewed article of this Preprint also exists.

Meazzini, M.C.; Demonte, L.P.; Cohen, N.; Battista, V.M.A.; Rabbiosi, D.; Autelitano, L. The Use of Clear Aligners in Multi-Segmental Maxillary Surgery: A Case–Control Study in Cleft Lip and Palate and Skeletal Class III Patients. J. Clin. Med. 2024, 13, 1329. Meazzini, M.C.; Demonte, L.P.; Cohen, N.; Battista, V.M.A.; Rabbiosi, D.; Autelitano, L. The Use of Clear Aligners in Multi-Segmental Maxillary Surgery: A Case–Control Study in Cleft Lip and Palate and Skeletal Class III Patients. J. Clin. Med. 2024, 13, 1329.

Abstract

Introduction: maxillary hypoplasia and mandibular asymmetry may be corrected with orthognathic surgery at the completion of growth. Many patients require segmental Le Fort I osteotomies to obtain the most stable results. Unfortunately, if Invisalign is chosen for pre-surgical preparation, ClinCheck © software does not allow for prediction when these complex surgeries are planned. The objective of this paper was to show the potential of aligners beyond its software in most complex cases like multiple-piece maxillary osteotomies in cleft and non-cleft patients. Method: Thirteen patients who underwent pre-surgical treatment with clear aligners-Invisalign (study group) were matched in terms of diagnosis, surgical procedure, and orthodontic complexity with thirteen patients treated using fixed appliances (control group). A technique based on simple superimposition was devised to enhance the software for creating a suitable occlusion for segmental pre-surgical treatments. Virtual curves following the lower arch were employed to guide the correct pre-surgical positions of the upper teeth. The amount of impressions required in both groups to achieve satisfactory pre-surgical alignment of the segmented arches was compared. Results: one or no refinement phase were needed in the Invisalign group to reach an acceptable pre-surgical occlusion while the amount of pre-surgical impressions taken in order to reach adequate coordination with fixed appliance treatment was slightly higher. The average overall treatment duration did not show a statistically significant variation between the groups. Conclusions: it appears that clear aligner could serve as an effective treatment for individuals with skeletal discrepancies, including cleft and craniofacial anomalies, necessitating segmental Le Fort I osteotomies when aided by the suggested superimposition approach during digital pre-surgical movement simulations. More sophisticated softwares will certainly be implemented in the future.

Keywords

Invisalign; orthognathic surgery; cleft; skeletal class III; craniofacial; segmental Le Fort I osteotomy; occlusogram

Subject

Medicine and Pharmacology, Dentistry and Oral Surgery

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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