Authors: Dr. Julia Steinmaier (née Funke), Dr. Julia Haubrich, Dr. Werner Schupp
Introduction
Aligner orthodontics has established itself as a permanent orthodontic treatment method over the last two decades. It enables the comfortable and almost invisible correction of misaligned teeth and is also increasingly being used for children. The success of aligner therapy depends largely on patient compliance. While aligners were initially popular with adults in particular, it has been shown that they can also be an effective alternative to fixed appliances for children.
Treatment example
An eight-year-old female patient presented with an anterior crossbite from tooth 12 to 42 and a transversely constricted maxilla. The treatment consisted of repositioning the crossbite, derotation of the first molars and expansion of the maxilla using aligner therapy. Alternative treatment methods would have been an active plate with an anterior spring or a fixed 2×4 mechanism. The advantage of aligners is that their layer thickness in the occlusal area means that additional bites can be dispensed with.
Therapy procedure
First, vertical composite attachments were placed on the first molars and a horizontal attachment was placed on the palatal surface of tooth 12. After an intraoral scan (iTero, Align Technology), the digital model was processed and segmented using OnyxCeph™ software. A virtual target setup was created to accurately plan the tooth movements. The largest movement was planned for tooth 12 (4.4 mm labially), which was divided into eight equal steps of 0.55 mm each.
The eight set-up models were printed using a 3D printer (D 30, Rapid Shape) and the aligners were thermoformed onto them. PET-G thermoforming sheets (Biolon, Dreve) with layer thicknesses of 0.5 mm and 0.75 mm were used. The patient wore the aligners for 22 hours a day and changed them on her own every week. After 16 aligners, an additional fine adjustment was made with six more aligners so that the entire early treatment was completed in 22 weeks.
Conclusion
Die Alignertherapie stellt nicht nur eine ästhetische, sondern auch eine effektive Alternative zu traditionellen kieferorthopädischen Behandlungsmethoden für Kinder dar. Die Kombination aus moderner Computersoftware, intraoralen Scans und digitaler Fertigung ermöglicht eine präzise Planung und Herstellung von Alignern direkt in der Praxis. Während sich die Forschung zur Optimierung von Aligner-Materialien und Softwarelösungen weiterentwickelt, wird die Aligner-Orthodontie zukünftig noch präzisere und individuellere Behandlungsmöglichkeiten bieten.
Source:
Funke, J., Haubrich, J., & Schupp, W. (2020). Aligner orthodontics in children. Dentista, 01, 2020.