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Reliability of torque expression by the Invisalign® appliance: A retrospective study Cover

Reliability of torque expression by the Invisalign® appliance: A retrospective study

Open Access
|Jul 2021

Figures & Tables

Table I.

Criteria for sample selection.

Inclusion criteria:
Non-growing patients
Complete permanent dentition
Orthodontic treatment with Invisalign (SmartTrack)
All subjects finished the initial aligner wear as determined by ClinCheck
Two-week aligner wear protocol
Simple Class I malocclusion comprising spacing (< 4 mm) to crowding (< 6 mm)
Non – extraction treatment
No interproximal reduction
No intermaxillary elastics
No orthognathic surgery
No restorative treatment to incisors and distal most molars during orthodontic treatment
All the subjects included in this study met the criteria of compliance
Exclusion criteria:
Periodontally compromised patients
Medications which alter bone metabolism (e.g.: Bisphosphonates, PG inhibitors)
Patients treated with Power Ridges
Figure 1.

Generation of long axis of the tooth.

Figure 2.

Generation of reference plane.

Figure 3.

Measurement of torque.

Figure 4.

Best-fit superimposition (global and fine).

Figure 5.

The best fit superimposition with a common transverse reference plane for both pretreatment and predicted post-treatment STL files.

Figure 6.

Measurement of interincisal angle.

Table II.

Calculation of torque, interincisal angle (IIA) differential and mean accuracy.

Predicted change in torque = torque at T1 – torque at T0
Achieved change in torque = torque at R – torque at T0
Torque differential = predicted change in torque – achieved change in torque
Predicted change in IIA = IIA at T1 – IIA at T0
Achieved change in IIA = IIA at R – IIA at T0
IIA differential = predicted change in IIA – achieved change in IIA
Mean accuracy for torque or IIA = 100 – (predicted change-achieved change/predicted change) X 100
Table III.

Descriptive statistics and paired student t-test values for torque, IIA differential.

GroupNPredicted change (Mean ± SD) (°)Achieved change (Mean ± SD) (°)
(Mean ± SD) (°)
Differential (predicted change – achieved change) (°)tP-value
Median (°)95% CI
Lower (°)Upper (°)
Labial CTUC568.16 ± 7.781.73 ± 5.226.43 ± 7.095.944.508.366.78<0.001*
UL515.99 ± 6.260.93 ± 4.495.06 ± 7.323.942.967.164.94<0.001*
LI1127.77 ± 5.115.03 ± 5.942.75 ± 5.702.401.653.845.10<0.001*
Lingual/Palatal CTUC244.49 ± 3.385.22 ± 4.01-0.73 ± 3.31-0.71-2.160.70-1.08>0.05
UL294.90 ± 4.284.54 ± 4.380.36 ± 4.410.81-1.362.080.44>0.05
LI484.73 ± 5.395.40 ± 5.50-0.67 ± 6.06-0.45-2.491.15-0.77>0.05
Labial CT – IIA6113.80 ± 10.694.80 ± 8.749.00 ± 10.737.506.2011.86.55<0.001*
Lingual/Palatal CT– IIA199.79 ± 11.7013.20 ± 9.44-3.40 ± 7.90-2.45-7.390.59-1.88>0.05

1* Statistically significant. Positive values of differential indicate under-expression and negative values indicate over-expression of intended change in torque, IIA.

Figure 7.

Box-whisker plot showing the distribution of torque and IIA differential.

Figure 8.

Mean accuracy of the torque expression and interincisal angle change resulting from prescribed torque.

Table IV.

Liner regression analysis.

GroupUnstandardised coefficientsStandardised coefficients
ConstantB(R 2 )
Labial CTUC-2.270.490.53
UL-1.210.360.25
LI-2.210.930.64
Lingual/Palatal CTUC1.180.900.58
UL1.330.660.41
LI1.760.770.57
Labial CT – IIA-3.080.570.49
Lingual/Palatal CT – IIA6.390.700.74

1 Independent variable: Predicted change (in torque, IIA), Dependent variable: Achieved change (in torque, IIA), Constant: Y-intercept of linear regression graph, B: Slope of regression line; Regression equation: Achieved change = Constant + (Predicted change X B).

DOI: https://doi.org/10.21307/aoj-2021-001 | Journal eISSN: 2207-7480 | Journal ISSN: 2207-7472
Language: English
Page range: 3 - 13
Published on: Jul 13, 2021
Published by: Australian Society of Orthodontists Inc.
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year

© 2021 Raj Gaddam, Elissa Freer, Brett Kerr, Tony Weir, published by Australian Society of Orthodontists Inc.
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.