A 3-dimensional comparative assessment of the dentoskeletal effects of clear aligners vs temporary skeletal anchorage device-assisted posterior intrusion in adolescents with anterior open bite: A single-center, retrospective, cohort study.

INTRODUCTION

The dentoskeletal effects of clear aligner treatment (CAT) with Invisalign vs temporary skeletal anchorage device-anchored Sydney intrusion spring (SIS) were compared in consecutively treated growing patients with anterior open bite using cone-beam computed tomography scans.

METHODS

Fifteen adolescents treated exclusively with Invisalign, and 14 with SIS (first-phase treatment) were assessed retrospectively. Rigid-wise, voxel-based registration of pretreatment and posttreatment cone-beam computed tomography scans were performed using the anterior cranial base, maxillary plane, and mandibular body as reference regions. Treatment outcomes were compared between groups using median regression modeling.

RESULTS

Molar intrusion and incisor extrusion (millimeters), as well as buccolingual inclination changes (°), were not expressed as prescribed in the ClinChecks for Invisalign. Both treatment modalities resulted in similar improvement of anterior open bite; however, via different mechanics. Compared with CAT, SIS demonstrated significantly greater intrusion of the maxillary first molars when measured from the mesiobuccal (16: 2.09 mm [95% confidence interval {CI}, 1.05-3.12]; 26: 2.98 mm [95% CI, 2.00-3.96]) and palatal cusps (16: 2.08 mm [95% CI, 1.15-3.01], 26: 2.83 mm [95% CI, 1.92-3.74]) and less extrusion of the maxillary incisors (12: -1.30 mm [95% CI, -2.13 to -0.47], 11: -1.30 mm [95% CI, -2.40 to -0.20], 21: -0.92 mm [95% CI, -1.73 to -0.12], 22: -0.85 mm [95% CI, -1.71 to -0.00]). There was weak evidence of association with less extrusion of the mandibular incisors using SIS. Maxillary and mandibular incisors tipped lingually in both groups with no statistical difference across groups.

CONCLUSIONS

SIS demonstrated greater maxillary molar intrusion, whereas CAT was associated with incisor extrusion.