UNLOCK THE FULL POTENTIAL OF CLEAR ALIGNERS WITH CBCT AND FACIAL SCAN INTEGRATION

Clear aligner treatment (CAT) has transformed orthodontics with its 3D simulation capabilities, offering a new way to align teeth. In today's tech-driven world, dental technology plays a crucial role in treating orthodontic patients. While clear aligners have revolutionized the industry, there is always room for improvement.

Root Movements

One of the major challenges in clear aligner treatment is controlling root movements, particularly root torquing and expansion. Traditional CAT planning, which relies solely on crown data from intraoral scans, often fails to accurately reflect the final occlusion due to the lack of detailed information about the underlying root morphologies.

The integration of Cone Beam Computed Tomography (CBCT) into the clear aligner workflow addresses this limitation. CBCT provides comprehensive, three-dimensional data on the entire tooth structure, including the root position and anatomy. This detailed information is crucial when planning arch expansion or tooth torquing, as it allows planners to assess the biological limitations and available bone support to facilitate the desired tooth movements safely, avoiding potential complications such as bone fenestration.

The thickness of the alveolar bone defines the boundaries of the orthodontic movement and challenging these limits may cause undesirable collateral effects for the periodontal tissues. The most critical orthodontic movement includes dental arch expansion and incisor buccal-lingual movements. Such mechanics can decentralize teeth from the alveolar bone envelope, causing bone dehiscence and fenestrations and gingival recession, depending on the initial morphology of alveolar bone as well as on the amount of tooth movement. Due to the high

definition and sensitivity, helical and Cone-Beam CT images can show bone dehiscence and fenestrations.

By aligning the CBCT data with the intraoral scans, clinicians can now visualize a

dimensionally accurate representation of each tooth and its root position relative to the alveolar ridge. This enhanced visualization enables more realistic treatment simulations and improves the predictability of the final occlusal outcome.

In parallel, the importance of facial analysis has grown, as clinicians recognize the need to consider the patient's overall esthetic harmony when designing the optimal tooth movements. The integration of 3D facial scanning, such as RAYFace Scan, has enabled a more holistic approach to treatment planning, allowing clinicians to visualize the anticipated changes to the patient's facial appearance throughout the clear aligner treatment.

By using 3D facial scanning technology, this visual simulation helps manage patient expectations and ensures that the final result aligns with the patient's desired esthetic. This increased transparency and shared understanding between clinician and patient can lead to higher patient satisfaction and treatment acceptance, ultimately contributing to the success of clear aligner therapy.

The NEW Trio iDesign 2.0 software takes this integration a step further by seamlessly combining both CBCT and facial scan data into a comprehensive digital treatment planning for TrioClear™ progressive clear aligners. With this software, the clinician can first capture a CBCT scan of the patient's dentition, providing a detailed, three-dimensional view of the entire tooth structure, including the root morphology and surrounding alveolar bone.

Next, the clinician can perform a 3D facial scan of the patient using RAYFace Scan, capturing the unique contours and soft tissue features of the patient's face. During the virtual treatment planning process, Trio iDesign 2.0 software then integrates the CBCT and facial scan data. It overlays the planned tooth positions from the clear aligner treatment onto the patient's facial scan, providing a realistic preview of the anticipated esthetic outcome. This allows the clinician to visualize the patient's dentition in the context of their overall facial anatomy and proportions.

In summary, the combination of CBCT and facial scanning within the Trio iDesign 2.0 software represents a significant advancement in clear aligner treatment planning. By considering both the functional and esthetic aspects of the patient's dentofacial complex, clinicians can now deliver personalized care that addresses the unique needs and desires of each individual, elevating the overall quality of clear aligner therapy.

References

• Journal of Clinical Orthodontics. (2020). Integrating CBCT and Virtual Models for Root Movement with Clear Aligners.

• Journal of Clinical Orthodontics. (2015). Accuracy of 3D Facial Models Obtained from CBCT Volume Wrapping

• ScienceDirect (2021). A cone-beam computed tomographic study evaluating the efficacy of incisor movement with clear aligners: Assessment of

• incisor pure tipping, controlled tipping, translation, and torque

• Dental Press J Orthod. (2010). Alveolar bone morphology under the perspective of the computed tomography: Defining the biological limits of tooth movement.