Award Date

May 2025

Degree Type

Thesis

Degree Name

Master of Science (MS)

Department

Dental Medicine

First Committee Member

James Mah

Second Committee Member

Charles Hill

Third Committee Member

Brian Chrzan

Fourth Committee Member

Brendan O'Toole

Number of Pages

68

Abstract

Introduction: Clear aligner therapy (CAT) is an alternative option for clinicians to use for orthodontic treatment as opposed to fixed appliances. Many patients prefer clear aligner therapy due to its esthetic looks, removability, ease of oral hygiene, and comfort. Clear aligner companies boast to clinicians that it can be used more efficiently and effectively than fixed appliances in many orthodontic cases. Although these claims have been made, there is a lack of evidence to prove that clear aligner therapy is more efficient or effective. This research will focus on torque control. This project is designed around a new, pre-manufactured attachment named CADMUS. The research will help improve the design, test its capabilities, and retrieve evidence showing that clear aligner therapy can be used efficiently and effectively in torque control. This pre-manufactured novel attachment is designed to provide the clinician with the option of fixed appliance using its patented slot design while simultaneously providing versatile attachment for clear aligner therapy. The clinician has the option to switch between the two modalities easily depending on the needs of the case in that specific moment. Since the attachment is newly designed, no data exists on the effectiveness of how it performs as an attachment for use in clear aligner therapy.Objective: The objective of this research is to provide data that shows how effective the pre-manufactured attachment can be used for torque control using clear aligner therapy. The research will test common treatment options for use as comparison. It will be an in-vitro simulation of negatively torquing a flared central incisor. Materials and Methods: 3D printed study models will be made for testing. 15 degrees of positive torque is added to UL1. 6 stages at 2.5 degrees for each stage to negatively torque the UL1 back into the arch. 8 different groups will be tested and compared including 2 groups of CADMUS brackets. The groups are Scallop, Straight line, 1.5mm extended, Horizontal rectangular – flat trim, Vertical rectangular – flat trim, Power ridge, CADMUS half bracket, and CADMUS full bracket. Several diagnostic areas will be identified to place radiopaque silicon nitride ceramic bearing balls to help with DICOM statistical data capture. A CBCT scan of each study model is taken at each stage. Intraoral scans will be taken pre and post treatment. Digital data will be analyzed. Results: The study evaluating torque control in orthodontic aligners found significant differences between bracket designs. Measuring torque in degrees across 112 data points, it is determined the CADMUS single wing design yielded the highest average torque per stage (2.48 degrees) and the most favorable crown-to-root ratio (1.13), indicating superior performance. Conversely, the Power Ridge design demonstrated the lowest average torque (1.49 degrees) and the least favorable ratio (3.8). A one-way ANOVA confirmed statistically significant differences (P < 0.05) between groups, highlighting the impact of bracket design on torque efficacy. Conclusions: This study aimed to evaluate the effectiveness of the CADMUS bracket system in achieving torque movement during orthodontic aligner therapy, yielding key conclusions. Primarily, the CADMUS bracket, particularly the single-wing design, demonstrated superior performance compared to other control groups. Exhibiting 99% of planned torque movement, it surpassed the next best non-CADMUS option, the 2mm trimline, which achieved 87%. This enhanced performance was further substantiated by a more favorable crown-to-root ratio of 1.13 for the CADMUS single wing, compared to 1.65 for the 2mm trimline, indicating more efficient and controlled force application. While overall torque movement showed statistically significant differences between groups, root movement, although positive, did not reach statistical significance due to the study's limited sample size. Secondly, this research reinforces the importance of attachments in orthodontic aligner therapy, particularly when prescribing torque movements. This finding aligns with existing literature, further validating the clinical utility of attachments in achieving predictable and effective tooth movement. Finally, the study corroborated previous findings regarding the impact of trimline location on aligner therapy, emphasizing the need for careful consideration of this factor in treatment planning. This investigation contributes to the ongoing development of more efficient orthodontic systems. By combining the benefits of fixed and clear aligners, the CADMUS system represents a promising advancement, potentially streamlining treatment and enhancing patient outcomes. Further research with larger sample sizes is warranted to solidify these findings, particularly regarding root movement.

Keywords

CADMUS; Clear Aligners; Torque

Disciplines

Biomechanics | Dentistry

Degree Grantor

University of Nevada, Las Vegas

Language

English

Rights

IN COPYRIGHT. For more information about this rights statement, please visit http://rightsstatements.org/vocab/InC/1.0/

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