Malocclusion, Angle Class I
Conditions
Keywords
Clear aligners, Fixed orthodontic appliance, 3D Printing, In-House Aligners, Orthodontic Treatmen Duration, ABO Objective Grading System
Brief summary
Clear aligner therapy has become increasingly popular as an esthetic alternative to conventional braces in orthodontic treatment. While clear aligners are traditionally manufactured by commercial laboratories using a thermoforming technique, recent advances in 3D printing technology now allow clinicians to produce aligners directly in their own clinic, either by printing the aligner itself (direct method) or by printing a model and then thermoforming the aligner over it (indirect method)." "This study compares three approaches to orthodontic treatment in patients with mild to moderate dental crowding who do not require tooth extraction: clear aligners produced directly in-house using 3D printing with a shape-memory resin, clear aligners produced indirectly in-house using a 3D-printed model and thermoforming, and conventional fixed orthodontic treatment with metal brackets and wires." "A total of 36 patients aged 12 to 30 years were randomly assigned to one of these three treatment groups, and 33 patients completed the study. Treatment quality was evaluated using the American Board of Orthodontics Objective Grading System (ABO-OGS), an objective scoring method based on dental models obtained at the end of treatment. The total duration of treatment, from the start of active treatment to its completion, was also compared among the three groups." "The findings of this study may help clinicians and patients better understand the advantages and limitations of in-house clear aligner production compared to conventional fixed appliances, particularly regarding treatment efficiency and duration.
Interventions
DEVICEDirect In-House Clear Aligners
Clear aligners fabricated directly by the clinician using a stereolithography (SLA) 3D printer (Asiga MAX UV) with a shape-memory resin (Tera Harz TC-85, Graphy Inc., Seoul, Korea). The shell of the aligner was designed digitally using Direct Aligner Designer software and printed directly, without the need for a physical model. Printed aligners were post-processed by centrifugation to remove excess resin, followed by UV light curing.
DEVICEIndirect In-House Clear Aligners
Clear aligners fabricated indirectly by the clinician via 3D-printed dental models (Asiga MAX UV printer) followed by thermoforming using CA Pro+ sheets (0.75 x 120 mm, SCHEU-DENTAL GmbH, Iserlohn, Germany) with a pressure-forming machine (MINISTAR S). The thermoformed aligners were trimmed from the printed model after shaping.
Conventional fixed orthodontic treatment using metal brackets (AO, Mini Master Roth 018, ) bonded to the upper and lower dental arches with stainless steel archwires.
Sponsors
TC Erciyes University
The Scientific and Technological Research Council of Turkey
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Intervention model description
Participants were randomly assigned to one of three parallel groups: direct in-house clear aligners, indirect in-house clear aligners, or fixed orthodontic treatment.
Eligibility
Sex/Gender
ALL
Age
12 Years to 30 Years
Healthy volunteers
No
Inclusion criteria
* Presence of permanent dentition (no primary teeth remaining) * Non-extraction orthodontic treatment plan * Age between 12 and 30 years * Mild to moderate dental crowding (0-6 mm) * Skeletal Class I classification (ANB: 2±2°) * Normal vertical growth direction (Sn-GoGn: 32±6°) * No congenital tooth agenesis (excluding third molars) * No atypical tooth shapes * No extracted permanent teeth * No dental caries * Good oral hygiene * Healthy periodontal tissues
Exclusion criteria
* Presence of craniofacial anomalies * Systemic disease or condition * Previous fixed orthodontic treatment * History of allergy to dental materials * History of xerostomia
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Treatment Quality Assessed by the American Board of Orthodontics Objective Grading System (ABO-OGS) | From the date of treatment initiation (attachment placement or bracket bonding) until the date of treatment completion (final day of aligner use or bracket debonding), assessed up to 13 months | Post-treatment dental models were evaluated using the ABO Objective Grading System, which scores eight criteria: tooth alignment, marginal ridge height, buccolingual inclination, overjet, occlusal contacts, occlusal relationships, interproximal contacts, and root angulation. Lower total scores indicate better treatment quality. Scores were classified as successful (\<20), borderline (20-30), or unsuccessful (\>30). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total Treatment Duration | From the date of treatment initiation (attachment placement or bracket bonding) until the date of treatment completion (final day of aligner use or bracket debonding), assessed up to 13 months | The total duration of treatment was calculated as the time interval between treatment initiation (aligner delivery or bracket bonding) and treatment completion (final day of aligner use or bracket debonding) |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORAhmet Yağcı, Prof. Dr.
Erciyes University, Faculty of Dentistry, Department of Orthodontics
STUDY_DIRECTORMusa Göksu, DDS
Erciyes University, Faculty of Dentistry, Department of Orthodontics
Outcome results
None listed