{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T22:08:10Z","timestamp":1793052490775,"version":"4.5.0"},"reference-count":20,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T00:00:00Z","timestamp":1607558400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>In adult patients, treatment of skeletal crossbite requires combined treatment by fixed or removable appliances and orthognathic surgery. In cases of dentoalveolar crossbite, expansion can be achieved with fixed multibrackets and removable transparent aligners. Various researchers have already assessed the Invisalign system\u2019s predictability for arch expansion. However, most of this research was conducted using older appliances, making it necessary to assess the characteristics of the updated system SmartTrack.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Material and methods<\/jats:title>\n<jats:p>A sample of 114 patients with transverse malocclusion were treated with SmartTrack. The predictability of the system\u2019s software (Clincheck) was assessed by comparing planned measurements (width of canines, premolars and molars rotations and inclinations) with the real measurements achieved at the end of the first treatment phase. Measurements were imported to Clincheck software to create three data sets; T1: initial measurements at start of treatment; T2: Clincheck predicted measurements at end of first treatment phase; T3: measurements taken at start of the second treatment phase.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Widths underwent significant advances as a result of treatment. For all widths, virtual planning obtained prognoses of greater expansion than actually achieved: a mean of 0.63 mm more expansion at the canine level (p&lt;0.001), 0.77 mm at first premolar (p&lt;0.001), 0.81 at second premolar (p&lt;0.001), 0.69 mm at first molar (p&lt;0.001), and 0.25 mm at second molar (p = 0.183). All the treatment plan\u2019s estimations, with the exception of the second molar, were significantly higher than the actual outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Aligners are an effective tool for producing arch expansion, being more effective in premolar area and less effective in canine and second molar area. Predictability was reasonable for expansion movement. Overcorrection should be considered at the virtual planning stage in order to obtain the expected outcomes.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0242979","type":"journal-article","created":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T19:21:30Z","timestamp":1607628090000},"page":"e0242979","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":75,"title":["Arch expansion with the Invisalign system: Efficacy and predictability"],"prefix":"10.1371","volume":"15","author":[{"given":"Ignacio","family":"Morales-Burruezo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9-Luis","family":"Gand\u00eda-Franco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Cobo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arturo","family":"Vela-Hern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4363-2713","authenticated-orcid":true,"given":"Carlos","family":"Bellot-Arc\u00eds","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2020,12,10]]},"reference":[{"issue":"2","key":"pone.0242979.ref001","first-page":"E210","article-title":"Interceptive orthodontics: the need for early diagnosis and treatment of posterior crossbites","volume":"11","author":"A Casta\u00f1er-Peiro","year":"2006","journal-title":"Med Oral Patol Oral Cir Bucal"},{"issue":"5","key":"pone.0242979.ref002","doi-asserted-by":"crossref","first-page":"e791","DOI":"10.4317\/medoral.15.e791","article-title":"The pattern of malocclusion in a sample of orthodontic patients from Turkey","volume":"15","author":"M Celikoglu","year":"2010","journal-title":"Med Oral Patol Oral Cir Bucal"},{"issue":"1","key":"pone.0242979.ref003","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.4317\/medoral.19096","article-title":"Cross-sectional study of malocclusion in Spanish children","volume":"19","author":"JM Almerich-Silla","year":"2014","journal-title":"Med Oral Patol Oral Cir Bucal"},{"issue":"4","key":"pone.0242979.ref004","doi-asserted-by":"crossref","first-page":"e638","DOI":"10.4317\/medoral.17722","article-title":"Orthodontic treatment need in a Spanish young adult population","volume":"17","author":"C Bellot-Arc\u00eds","year":"2012","journal-title":"Med Oral Patol Oral Cir Bucal"},{"issue":"2","key":"pone.0242979.ref005","doi-asserted-by":"crossref","first-page":"e311","DOI":"10.4317\/medoral.17389","article-title":"Comparison of the effects of rapid maxillary expansion and surgically assisted rapid maxillary expansion in the sagittal, vertical, and transverse planes","volume":"17","author":"AY Gungor","year":"2012","journal-title":"Med Oral Patol Oral Cir Bucal"},{"key":"pone.0242979.ref006","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1053\/sodo.2001.25414","article-title":"Three-dimensional Diagnosis and Orthodontic Treatment of Complex Malocclusions with the Invisalign Appliance","volume":"7","author":"R Boyd","year":"2001","journal-title":"Semin Orthod"},{"issue":"5","key":"pone.0242979.ref007","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1016\/S0889-5406(03)00577-8","article-title":"Activation time and material stiffness of sequential removable orthodontic appliances. 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Are predicted tooth positions achieved?","volume":"87","author":"T Gr\u00fcnheid","year":"2017","journal-title":"Angle Orthod"},{"issue":"2","key":"pone.0242979.ref013","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.ajodo.2016.06.041","article-title":"Evaluation of Invisalign treatment effectiveness and efficiency compared with conventional fixed appliances using the Peer Assessment Rating index","volume":"151","author":"J Gu","year":"2017","journal-title":"Am J Orthod Dentofacial Orthop"},{"issue":"1","key":"pone.0242979.ref014","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.ajodo.2007.05.018","article-title":"How well does Invisalign work? A prospective clinical study evaluating the efficacy of tooth movement with Invisalign","volume":"135","author":"ND Kravitz","year":"2009","journal-title":"Am J Orthod Dentofacial Orthop"},{"issue":"5","key":"pone.0242979.ref015","doi-asserted-by":"crossref","first-page":"864","DOI":"10.2319\/100106-398.1","article-title":"Invisalign and traditional orthodontic treatment postretention outcomes compared using the American Board of Orthodontics objective grading system","volume":"77","author":"D Kuncio","year":"2007","journal-title":"Angle Orthod"},{"issue":"1","key":"pone.0242979.ref016","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/s12903-018-0695-z","article-title":"A comparison of treatment effectiveness between clear aligner and fixed appliance therapies","volume":"19","author":"Y Ke","year":"2019","journal-title":"BMC Oral Health"},{"issue":"5","key":"pone.0242979.ref017","doi-asserted-by":"crossref","first-page":"881","DOI":"10.2319\/061614-436.1","article-title":"Efficacy of clear aligners in controlling orthodontic tooth movement: a systematic review","volume":"85","author":"G Rossini","year":"2015","journal-title":"Angle Orthod"},{"issue":"1","key":"pone.0242979.ref018","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/s40510-018-0235-z","article-title":"Clinical effectiveness of Invisalign orthodontic treatment: a systematic review","volume":"19","author":"A Papadimitriou","year":"2018","journal-title":"Prog Orthod"},{"issue":"1","key":"pone.0242979.ref019","first-page":"13","article-title":"Evaluation of Invisalign treatment using the Peer Assessment Rating (PAR) index","volume":"2","author":"MR Ramis","year":"2018","journal-title":"Journal of Aligner Ortho"},{"issue":"2","key":"pone.0242979.ref020","first-page":"e61","article-title":"Assessment of Invisalign treatment outcomes using the ABO Model Grading System","volume":"2","author":"W Kassas","year":"2013","journal-title":"Journal World Fed Orthod"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0242979","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T19:21:36Z","timestamp":1607628096000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0242979"}},"subtitle":[],"editor":[{"given":"Andrej M","family":"Kielbassa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2020,12,10]]},"references-count":20,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2020,12,10]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0242979","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,10]]}}}