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Introduction: Surgically Facilitated Orthodontic Therapy (SFOT) has been utilized for years to overcome the limitations encountered with traditional orthodontic treatment of dentoalveolar and alveoloskeletal malocclusions. The procedure, which consists of full flap corticotomies and bone grafting, has many proposed benefits including increased speed and range of tooth movement. The purpose of this study is to evaluate arch expansion in patients treated with SFOT and clear aligners. Materials and Methods: A retrospective cohort study design was used to evaluate 51 consecutive adult patients that were treatment planned for significant arch expansion with corticotomies, bone grafting, and clear aligners. 17 of the 51 patients refused the surgical procedure and served as controls. Eight transverse arch width measurements were obtained at three different time points (Initial, ClinCheck, Refinement). Five calculations were performed to determine the magnitude, predictability, and efficiency of arch expansion. Results: The difference in treatment time between the two groups was statistically significant at 5.2 months (P < .0001). On average, corticotomies reduced the length of treatment by 46% and increased the rate of expansion 2.4x. Patients that received SFOT achieved a greater magnitude (+28%) of expansion at a significantly higher rate (P< 0.002) than controls for all eight interarch measurements. The SFOT group displayed higher predictability (% goal achieved) and a smaller difference between predicted and achieved tooth movements for all measures obtained. The mean age for the entire sample was 42.81 (+12.51 years). Conclusion: Arch expansion with corticotomy-assisted clear aligner therapy is significantly more effective, efficient, and predictable than with clear aligners alone. The predictability of expansion with aligners appears to have a higher range than initially thought, even in patients that do not receive corticotomies. |
