An Evaluation of Using Detailing Instruments on the Final Clear Aligner for the Alignment in the Aesthetic Zone-A Randomised Clinical Trial.

Abstract

Objective: The aim of this study is to evaluate the clinical efficiency of detailing instruments on the need for refinement in a group of young adults treated with clear aligners.

Materials and methods: The study sample included 74 intraoral scans from patients who were treated in an academic setting with in-house clear aligners and needed refinement. After the first set of aligners was used, an intraoral scan was taken (T1). These scans were used as a control sample (n = 37). At the same appointment, the final aligner was activated using detailing instruments for the expression of rotation, torque and inclination according to the needs of the case. Second scans were taken 10 days later (T2) and treated as a study sample (n = 37). The two scans were then imported to Nemocast software and digital setups were performed for ideal finishing. The primary outcome variable was the number of refinement aligners.

Results: Of the 222 teeth in total, 52.2% received activations for rotation (78.4%); inclination (6.9%) and torque (14.7%). Reduction in the number of aligners (T1-T2) was 1.62 ± 1.53 in the study sample; 1.93 ± 1.64 in subgroup A; 2.40 ± 1.71 in subgroup B (p = 0.000; p = 0.002; p = 0.007, respectively). Intergroup comparisons revealed that the difference between groups was not significant.

Conclusion: This study is a pioneer to investigate the effects of detailing instruments in clear aligner practice. This intervention created a clinically small but statistically significant decrease in the number of refinement aligners when used on the final aligner only. Applications in earlier stages can have more prominent effects on the expression of movements, which might be the subject for future investigations.