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Imagine Orthodontics

The Event on new horizons in advanced orthodontics in Rimini

Imagine Orthodontics, the event dedicated to the new frontiers of advanced orthodontics, was held in Rimini on July 7. Twelve speakers among the nation’s leading experts took turns on stage to talk about aligners, TADs and sleep disorders. The event initiated by The Point, formerly Dextra Group, explored the potential of digital technologies applied to orthodontics.

More than 200 participants including clinicians and orthodontic technicians have decreed the success of this initiative, which opens the door to the new development project of The Point, a unique reality in Italy with a strong orientation to digitization and innovation. Thanks to decades of work in collaboration with physicians, The Point has developed several patented digital devices and has a widespread presence throughout the country.
The proceedings opened with a greeting from Stefano Negrini, president of The Point, and Dr. Isaza Penco, scientific director of the event.

Functional and aesthetic therapies with aligners and veneers

In the first talk, Prof. Domenico Dalessandri reported on the new direct printing methodologies of aligners, which allow significant savings in time and material by making several steps such as model printing, thermoforming and cutting unnecessary. Studies show that direct printing achieves superior mechanical properties and accuracy to aligners made with traditional methodology.

Professor Paola Cozza highlighted the importance of orthodontic planning in aligner therapies. The biological specificities of the patient, the need to respect periodontal tissues, and the biomechanics of the arches must be taken into account in the planning stages of therapy. The professor illustrated several clinical cases with Class II and III malocclusions treated with aligners and attachments. In addition to being particularly effective in results, this approach is confirmed to optimize treatment time due to the mechanical specificities of the aligners.

The topic of aesthetic rehabilitations was the focus of Dr. Paolo Francesco Gallo’s talk, who, through his own most relevant clinical cases, Gallo shows how the effectiveness of therapies depends on a good diagnostic phase and a thorough case study to detect any tracking loss or criticality early on.

Based on these assumptions, he illustrates some cases of esthetic rehabilitation treated with veneers. The use of veneers is less impactful than prosthodontics because it ensures minimal invasiveness while obtaining a very aesthetically pleasing and long-lasting restoration. The Doctor also showed the excellent results obtained with reverse maryland, whose peculiarity is that it uses the buccal surface instead of the palatine area as anchorage.

Dr. Stefano Gelli and ODT Renzo Relevant described the management of some aesthetic cases based on digital protocols. For them, too, technology supports the diagnostic phase, therapeutic design, and prosthetic element design.

Relationship with patient

Dr. Andrea Alberti, reporting a clinical case of complex canine inclusion, focuses on the patient’s relationship with the dental office staff, the centrality of the patient’s perceptions, and the importance of gathering his or her feedback on treatment.
The least positive feedback statistically comes from canine included patients. This is because the clinician almost never provides certainty about the duration and outcome of therapy.
“I don’t consider canine-inclusive recovery a success,” Alberti says, “if it involves an exaggerated expenditure of means, time and energy.”

Sometimes the best solution may be the extractive route, especially in cases where the position is so critical that successful extrusion is uncertain, suboptimal conservative condition of the canine or occlusal problems caused solely by inclusion. Many clinical cases show that extraction followed by expander and aligner therapy is an extremely effective therapeutic process that can fully meet the patient’s expectations leading to a positive therapeutic experience.

Dr. Matteo Beretta illustrated the importance of being able to intercept malocclusions and oral health problems early in the child that, if left untreated, will impact the child’s future quality of life. The speaker introduced the concept of “spa-inspired oral care” to highlight the importance of prevention and paying attention first to the young patient, his health and family, then to the mouth and clinical problems. The words and language used by the clinician are already part of the care, the study of the small patient’s and family’s state of mind are crucial elements of the diagnostic phase.

In the wake of this approach, Beretta made the first metal-free expander in 2018, which immediately proved to be very effective and comfortable for the patient due to the high degree of customization. In March last year, this device was cited in the European Journal of Pediatric Dentistry for its high degree of innovativeness.

TADs and skeletal anchorage

The contribution of digital design to efficacy and predictivity in skeletal anchorage therapies was covered by Dr. Roberto Rinaldi.
Orthodontic treatment with TADs increases the chances of achieving orthodontic movements, optimizing effectiveness and efficiency compared with traditional devices. Treatment duration and chair time are greatly reduced, also improving patient satisfaction.
In recent years, a digital miniscrew insertion protocol has been gaining ground, which, by replacing the classic manual process, reduces processing time and lowers operator stress. “Even by adopting highly digitized technologies,” Rinaldi concludes, “the clinician’s diagnostic ability, anatomical knowledge, and manual minivite handling skills remain central.”

Orthodontics 4.0 and new frontiers

Dr. Alessandro Gianolio presented clinical cases demonstrating that early treatment with maxillary expanders for overjet and overbite correction can reduce or even eliminate the need for phase 2 in the treatment of transverse, vertical or sagittal problems.

Digital technology allows for custom elastodontic devices that maximize treatment benefits. Uniko, in particular, is a device designed by The Point that provides a much higher performance than preforms. First of all, it allows for holes to be provided to facilitate the patient’s night breathing, increasing comfort substantially. The customization also allows the shape of the arches to be respected and ensures a customized Bolton index.

Sleep disorders

It was Dr. Matteo Cameli who spoke about the role of orthodontics in the treatment of obstructive sleep apnea. The presence of apnea can have relevant symptoms in the patient’s daily life, and the Ministry of Health identifies dentistry as a “diagnostic sentinel.” The primary role of the dentist is also to treat OSAS disorder with specific therapies, keeping in mind that the interdisciplinary approach is always successful. In the case where the cause of the disorder is anatomical, Dr. Sergio Terranova described how the dentist can conduct therapy with customized mandibular advancement devices (MAD), which allow progressive advancement harmonized with the patient’s morphology.

In closing the event, Prof. Marzia Segù described the effectiveness of AIRMad, an innovative MAD device designed with full digital technology and made with metal-free materials.

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