Planned overbite reduction challenging in patients with extractions following treatment with Invisalign aligner appliances

A study was done to determine whether achieved outcome regarding overjet and overbite matched the predicted outcome following treatment with Invisalign (Align Technology, San Jose, Calif) aligner appliances.

Data including pretreatment, predicted and achieved overjet, and overbite measurements provided by Align’s digital treatment facility, ClinCheck Pro, were evaluated. Descriptive statistics, Mann-Whitney U-test, and Wilcoxon rank-sum intraclass correlation (ICC) test results were calculated.

Results

From an initial sample of 600, 355 adult patients satisfied the inclusion and exclusion criteria. ICC scores for data input were excellent. Median (interquartile range [IQR]) age was 30.14 (23.33, 39.92) years and most (n = 259; 72.95%) were women. Almost one-third (n = 101; 28.45%) had undergone extraction as part of their treatment. More aligners were prescribed in the initial digital treatment plan for patients (median, 44; IQR: 35, 51.5; minimum, 17; maximum, 92) undergoing extractions as part of their orthodontic treatment than those who were not (median, 24; IQR: 18.25, 32; minimum, 13; maximum, 85) (P < .0001). Planned changes in overjet differed significantly from achieved outcomes (P < .001). Planned increases in overbite resulted in up to more than twice (222.72%) as much increase than predicted. Planned reduction of overbite achieved 8.69% of its predicted reduction in extraction cases.

Achieved overjet and overbite measurements differed significantly from the predicted outcomes at the end of an initial sequence of aligners. Planned increases in overbite resulted in greater overbite correction than predicted, particularly in extraction cases. Planned overbite reduction was challenging, especially in patients with extractions.

Reference:

Maurice J. Meade, Tony Weir; Predicted and achieved overjet and overbite measurements with the Invisalign appliance: a retrospective study. Angle Orthod 2023; doi: https://doi.org/10.2319/030923-161.1

Keywords:

Planned, overbite, reduction, challenging, patients, extractions, Maurice J. Meade, Tony Weir, Angle Orthodontist