The predictability of transverse changes with Invisalign

Objectives: To investigate the predictability of arch expansion using Invisalign. Materials and Methods: Sixty-four adult white patients were selected to be part of this retrospective study. Pre- and posttreatment digital models created from an iTero scan were obtained from a single orthodontist practitioner. Digital models from Clincheck were also obtained from Align Technology. Linear values of upper and lower arch widths were measured for canines, premolars, and first molars at two different points: lingual gingival margins and cusp tips. A paired t-test was used to compare expansion planned on Clincheck with the posttreatment measurements. Variance ratio tests were used to determine if a larger change planned was associated with larger error. Results: For every maxillary measurement, there was a statistically significant difference between Clincheck and final outcome (P < .05), with prediction worsening toward the posterior region of the arch. For the lower arch measurements at the gingival margin, there was a statistically significant difference between the Clincheck planned expansion and the final outcome (P < .05). Points measured at the cusp tips of the lower arch teeth showed nonstatistically significant differences between Clincheck prediction and the final outcome (P > .05). Variance ratios for upper and lower arches were significant (P < .05). Conclusions: The mean accuracy of expansion planned with Invisalign for the maxilla was 72.8%. The lower arch presented an overall accuracy of 87.7%. Clincheck overestimates expansion by body movement; more tipping is observed. Overcorrection of expansion in the posterior region of the maxillary arch seems appropriate.