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Scanning electron microscopy analysis of aligner fitting on anchorage attachments

Rasterelektronenmikroskopische Untersuchung der Paßgenauigkeit von Alignern an Verankerungsattachments

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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Abstract

Purpose

The aims of the study were (1) to evaluate the fitting of three different aligners (Invisalign [Align Technology, Santa Clara, CA, USA], CA Clear Aligner [Scheu-Dental, Iserlohn, Germany] and F22 [Sweden&Martina, Due Carrare, Italy]) on anchorage attachments using scanning electron microscopy (SEM), and (2) to analyze the influence of 2 different types of resin used to build attachments on aligner fitting.

Methods

Using STL files of a patient, six resin casts were obtained and rectangular attachments were bonded on them. Conventional bulk-fill resin was used to build upper attachments while a flowable resin was used to build the lower ones. Passive aligners were adapted on each cast and then sectioned buccolingually. Microphotographs of the obtained sections were performed using a SEM and then micrometric measurements of aligner fitting on anchorage attachments were recorded.

Results

Analyzing the overall fitting of upper arch aligners, Invisalign provided a significantly better fitting with respect to F22 (P = 0.009); differences were not significant when comparing Invisalign with CA Clear Aligner, and CA Clear Aligner with F22. Analyzing the overall fitting of lower arch aligners, F22 provided a significantly better fitting with respect to CA Clear Aligner (P = 0.008) and Invisalign (P = 0.011). The analysis showed a significantly better fitting on upper attachments, built using conventional bulk-fill resin (P = 0.034).

Conclusions

Invisalign, CA Clear Aligner and F22 have comparable performance in terms of fitting on anchorage attachments. Conventional bulk-fill resin provides the best fitting on anchorage attachments.

Zusammenfassung

Ziel

Ziele der vorliegenden Studie waren (1) die Paßgenauigkeit von drei unterschiedlichen Alignern (Invisalign [Align Technology, Santa Clara, CA, USA], CA Clear Aligner [Scheu-Dental, Iserlohn, Germany] and F22 [Sweden&Martina, Due Carrare, Italy]) an Verankerungsattachments rasterelektronenmikroskopisch zu untersuchen (REM) und (2) den Einfluss von zwei unterschiedlichen Kompositmaterialien zum Attachmentaufbau auf die Alignerpassform zu prüfen.

Methode

Aus STL Datensätzen eines Patienten wurden sechs Modelle gedruckt und mit rechteckigen Attachments versehen. Für die Attachments im Oberkiefer wurde konventionelles Bulk-Fill Komposit verwendet, für Attachments im Unterkiefer fließfähiges Komposit. Für jedes Modell wurden passive Aligner erstellt und in bukkolingualer Richtung durchtrennt. Mikrophotographien der gewonnenen Schnitte wurden rasterelektronenmikroskopisch untersucht. Die Passform der Aligner an den Attachments wurde metrisch bestimmt.

Ergebnisse

Analysiert man die Passgenauigkeit der Aligner im Oberkiefer, zeigten Aligner von Invisalign signifikant bessere Ergebnisse als F22 Aligner (P = 0,009). Unterschiede zwischen Invisalign und CA Clear Aligner bzw. CA Clear Aligner und F22 waren statistisch nicht signifikant. Betrachtet man die Passgenauigkeit der Aligner im Unterkiefer, schnitten F22 Aligner signifikant besser als CA Clear Aligner (P = 0,008) und Invisalign ab (P = 0,011). Attachments im Oberkiefer aus konventionellem Bulk-Fill Komposit waren den Attachments im Unterkiefer signifikant überlegen (P = 0,034).

Schlussfolgerungen

Invisalign, CA Clear Aligner und F22 zeigten vergleichbare Ergebnisse in Hinblick auf die Passgenauigkeit von Alignern an Verankerungsattachments. Generell war die Passform der Aligner an Attachments aus konventionellem Bulk-Fill Komposit besser als an Attachments aus fließfähigem Komposit.

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Authors and Affiliations

  1. Department of Orthodontics, Dental School, University of Turin, Via Nizza 230, 10126, Turin, Italy

    Edoardo Mantovani, Gabriele Rossini, Andrea Deregibus & Tommaso Castroflorio

  2. Department of Mammalian Genetics Unit, Harwell Campus, Oxfordshire, UK

    Enrico Castroflorio

  3. Department of Mechanics and Aerospace Engineering, Politecnico of Turin, Turin, Italy

    Gabriele Rossini

  4. Turin, Italy

    Francesco Garino

  5. Department of Medical Sciences, University of Turin, Turin, Italy

    Giovanni Cugliari

Authors
  1. Edoardo Mantovani
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  2. Enrico Castroflorio
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  3. Gabriele Rossini
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  4. Francesco Garino
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  5. Giovanni Cugliari
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  6. Andrea Deregibus
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  7. Tommaso Castroflorio
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Correspondence to Edoardo Mantovani.

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Conflict of interest

E. Mantovani, E. Castroflorio, G. Rossini, F. Garino, G. Cugliari, A. Deregibus and T. Castroflorio declare that they have no competing interests.

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Mantovani, E., Castroflorio, E., Rossini, G. et al. Scanning electron microscopy analysis of aligner fitting on anchorage attachments. J Orofac Orthop 80, 79–87 (2019). https://doi.org/10.1007/s00056-018-00167-1

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  • DOI: https://doi.org/10.1007/s00056-018-00167-1

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