{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T17:20:33Z","timestamp":1790184033184,"version":"4.1.0"},"reference-count":28,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec id=\"st1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To investigate differences in case selection, treatment management, and aligner treatment expertise between orthodontists and general practitioners.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>A parallel pair of original surveys with three sections (case selection, treatment management, and demographics) was sent to orthodontists (N = 1000) and general dentists (N = 1000) who were providers of aligner treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Orthodontists had treated significantly more patients with aligners, had treated more patients with aligners in the previous 12 months, and had received more aligner training than general dentists (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .0001). In general, case confidence increased with increasing experience for both orthodontists and general dentists. After adjusting for experience, there was a significant difference in aligner case confidence between orthodontists and general dentists for several malocclusions. General dentists were more confident than orthodontists in treating deep bite, severe crowding, and Class II malocclusions with aligners (\n                      <jats:italic>P<\/jats:italic>\n                      \u2264 .0001). Significant differences were also found for all treatment management techniques except interproximal reduction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st4\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>There was a significant difference in case selection, treatment management, and aligner expertise between orthodontists and general dentists, although the differences in case selection were small. Overall, it was shown that orthodontists and general dentists elected to treat a variety of moderate to severe malocclusions with aligners but with different utilization of recommended auxiliaries, perhaps demonstrating a difference in treatment goals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2319\/062616-500.1","type":"journal-article","created":{"date-parts":[[2016,11,22]],"date-time":"2016-11-22T11:14:24Z","timestamp":1479813264000},"page":"432-439","source":"Crossref","is-referenced-by-count":40,"title":["Treatment management between orthodontists and general practitioners performing clear aligner therapy"],"prefix":"10.2319","volume":"87","author":[{"given":"Alexandra D.","family":"Best","sequence":"first","affiliation":[{"name":"Private practice, Boston, Mass."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhavna","family":"Shroff","sequence":"additional","affiliation":[{"name":"Professor and Postgraduate Program Director, Department of Orthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Va."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline K.","family":"Carrico","sequence":"additional","affiliation":[{"name":"Biostatistician and Assistant Professor, Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Va."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven J.","family":"Lindauer","sequence":"additional","affiliation":[{"name":"Norborne Muir Professor and Chair, Department of Orthodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Va."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i0003-3219-87-3-432-b01","series-title":"Angle Orthod","first-page":"425","article-title":"Comparative use of Invisalign by orthodontists and general practitioners","volume":"80","author":"Vic\u00e9ns \n              J,","year":"2010","unstructured":"Vic\u00e9ns \n              J, \n            \n            \n              Russo \n              A. \n            \n          \n          Comparative use of Invisalign by orthodontists and general practitioners. Angle Orthod. 2010;80:425\u2013434."},{"key":"i0003-3219-87-3-432-b02","series-title":"Am J Orthod Dentofacial Orthop","first-page":"27","article-title":"How well does Invisalign work? A prospective clinical study evaluating the efficacy of tooth movement with Invisalign","volume":"135","author":"Kravitz \n              ND,","year":"2009","unstructured":"Kravitz \n              ND, \n            \n            \n              Kusnoto \n              B, \n            \n            \n              BeGole \n              E, \n            \n            \n              Obrez \n              A, \n            \n            \n              Agran \n              B. \n            \n          \n          How well does Invisalign work? A prospective clinical study evaluating the efficacy of tooth movement with Invisalign. Am J Orthod Dentofacial Orthop. 2009;135:27\u201335."},{"key":"i0003-3219-87-3-432-b03","series-title":"J Calif Dent","first-page":"793","article-title":"An update on present and future considerations of aligners","volume":"34","author":"Boyd \n              RL,","year":"2006","unstructured":"Boyd \n              RL, \n            \n            \n              Oh \n              H, \n            \n            \n              Fallah \n              M, \n            \n            \n              Vlaskalic \n              V. \n            \n          \n          An update on present and future considerations of aligners. J Calif Dent. 2006;34:793\u2013805."},{"key":"i0003-3219-87-3-432-b04","series-title":"J Clin Orthod","first-page":"525","article-title":"Complex orthodontic treatment using a new protocol for the Invisalign appliance","volume":"41","author":"Boyd \n              RL.","year":"2007","unstructured":"Boyd \n              RL. \n            \n          \n          Complex orthodontic treatment using a new protocol for the Invisalign appliance. J Clin Orthod. 2007;41:525\u2013547."},{"key":"i0003-3219-87-3-432-b05","series-title":"J Orofac Orthopod","first-page":"365","article-title":"Invisalign treatment in the anterior region: were the predicted tooth movements achieved?","volume":"73","author":"Krieger \n              E,","year":"2012","unstructured":"Krieger \n              E, \n            \n            \n              Seiferth \n              J, \n            \n            \n              Marinello \n              I, \n            \n            et al. \n          Invisalign treatment in the anterior region: were the predicted tooth movements achieved?\n          J Orofac Orthopod. 2012;73:365\u2013376."},{"key":"i0003-3219-87-3-432-b06","series-title":"Am J Orthod Dentofacial Orthop","first-page":"837","article-title":"Activation time and material stiffness of sequential removable orthodontic appliance. Part 3: premolar extraction patients","volume":"133","author":"Baldwin \n              DK,","year":"2008","unstructured":"Baldwin \n              DK, \n            \n            \n              King \n              G, \n            \n            \n              Ramway \n              DS, \n            \n            \n              Huang \n              G, \n            \n            \n              Bollen \n              AM. \n            \n          \n          Activation time and material stiffness of sequential removable orthodontic appliance. Part 3: premolar extraction patients. Am J Orthod Dentofacial Orthop. 2008;133:837\u2013845."},{"key":"i0003-3219-87-3-432-b07","series-title":"J Clin Orthod","first-page":"583","article-title":"Treatment of severe maxillary crowding using Invisalign and fixed appliances","volume":"43","author":"Giancotti \n              A,","year":"2009","unstructured":"Giancotti \n              A, \n            \n            \n              di Girolamo \n              R. \n            \n          \n          Treatment of severe maxillary crowding using Invisalign and fixed appliances. J Clin Orthod. 2009;43:583\u2013589."},{"key":"i0003-3219-87-3-432-b08","series-title":"Am J Orthod Dentofacial Orthop","first-page":"310","article-title":"A new approach to correction of crowding","volume":"122","author":"Womack \n              W,","year":"2002","unstructured":"Womack \n              W, \n            \n            \n              Ahn \n              J, \n            \n            \n              Ammari \n              Z, \n            \n            \n              Castillo \n              A. \n            \n          \n          A new approach to correction of crowding. Am J Orthod Dentofacial Orthop. 2002;122:310\u2013316."},{"key":"i0003-3219-87-3-432-b09","series-title":"J Dent Educ","first-page":"948","article-title":"Esthetic orthodontic treatment using the Invisalign appliance for moderate to complex malocclusions","volume":"72","author":"Boyd \n              RL.","year":"2008","unstructured":"Boyd \n              RL. \n            \n          \n          Esthetic orthodontic treatment using the Invisalign appliance for moderate to complex malocclusions. J Dent Educ. 2008;72:948\u2013967."},{"key":"i0003-3219-87-3-432-b10","series-title":"J Clin Orthod","first-page":"83","article-title":"Creative adjuncts for clear aligners: part I Class II treatment","volume":"49","author":"Bowman \n              SJ,","year":"2015","unstructured":"Bowman \n              SJ, \n            \n            \n              Celenza \n              F, \n            \n            \n              Sparaga \n              J, \n            \n            \n              Papadopoulos \n              MA, \n            \n            \n              Ojima \n              K, \n            \n            \n              Lin \n              JC. \n            \n          \n          Creative adjuncts for clear aligners: part I Class II treatment. J Clin Orthod. 2015;49:83\u201394."},{"key":"i0003-3219-87-3-432-b11","series-title":"J Clin Orthod","first-page":"439","article-title":"Sequential MARA-Invisalign treatment","volume":"43;","author":"Eckhart \n              JE.","year":"2009","unstructured":"Eckhart \n              JE. \n            \n          \n          Sequential MARA-Invisalign treatment. J Clin Orthod. 2009;43;439\u2013448."},{"key":"i0003-3219-87-3-432-b12","series-title":"Am J Othod Dentofacial Orthop","first-page":"292","article-title":"Outcome assessment of Invisalign and traditional orthodontic treatment compared with the American Board of Orthodontics Objective Grading System","volume":"128","author":"Djeu \n              G,","year":"2005","unstructured":"Djeu \n              G, \n            \n            \n              Shelton \n              C, \n            \n            \n              Maganzini \n              A. \n            \n          \n          Outcome assessment of Invisalign and traditional orthodontic treatment compared with the American Board of Orthodontics Objective Grading System. Am J Othod Dentofacial Orthop. 2005;128:292\u2013298."},{"key":"i0003-3219-87-3-432-b13","series-title":"Clin Orthod Res","first-page":"147","article-title":"Orthodontic process and outcome: efficacy studies\u2014strategies for developing process and outcome measures: a new era in orthodontics","volume":"1","author":"Vig \n              K,","year":"1998","unstructured":"Vig \n              K, \n            \n            \n              Weyent \n              R, \n            \n            \n              Vayda \n              D, \n            \n            \n              O'Brien \n              K, \n            \n            \n              Bennett \n              E. \n            \n          \n          Orthodontic process and outcome: efficacy studies\u2014strategies for developing process and outcome measures: a new era in orthodontics. Clin Orthod Res. 1998;1:147\u2013155."},{"key":"i0003-3219-87-3-432-b14","series-title":"Am J Orthod Dentofacial Orthop","first-page":"293","article-title":"Predictors for Class II treatment duration","volume":"127","author":"Popowich \n              K,","year":"2005","unstructured":"Popowich \n              K, \n            \n            \n              Nebbe \n              B, \n            \n            \n              Heo \n              G, \n            \n            \n              Glover \n              K, \n            \n            \n              Major \n              P. \n            \n          \n          Predictors for Class II treatment duration. Am J Orthod Dentofacial Orthop. 2005;127:293\u2013300."},{"key":"i0003-3219-87-3-432-b01","series-title":"Angle Orthod","first-page":"425","article-title":"Comparative use of Invisalign by orthodontists and general practitioners","volume":"80","author":"Vic\u00e9ns \n              J,","year":"2010","unstructured":"Vic\u00e9ns \n              J, \n            \n            \n              Russo \n              A. \n            \n          \n          Comparative use of Invisalign by orthodontists and general practitioners. Angle Orthod. 2010;80:425\u2013434."},{"key":"i0003-3219-87-3-432-b02","series-title":"Am J Orthod Dentofacial Orthop","first-page":"27","article-title":"How well does Invisalign work? A prospective clinical study evaluating the efficacy of tooth movement with Invisalign","volume":"135","author":"Kravitz \n              ND,","year":"2009","unstructured":"Kravitz \n              ND, \n            \n            \n              Kusnoto \n              B, \n            \n            \n              BeGole \n              E, \n            \n            \n              Obrez \n              A, \n            \n            \n              Agran \n              B. \n            \n          \n          How well does Invisalign work? A prospective clinical study evaluating the efficacy of tooth movement with Invisalign. Am J Orthod Dentofacial Orthop. 2009;135:27\u201335."},{"key":"i0003-3219-87-3-432-b03","series-title":"J Calif Dent","first-page":"793","article-title":"An update on present and future considerations of aligners","volume":"34","author":"Boyd \n              RL,","year":"2006","unstructured":"Boyd \n              RL, \n            \n            \n              Oh \n              H, \n            \n            \n              Fallah \n              M, \n            \n            \n              Vlaskalic \n              V. \n            \n          \n          An update on present and future considerations of aligners. J Calif Dent. 2006;34:793\u2013805."},{"key":"i0003-3219-87-3-432-b04","series-title":"J Clin Orthod","first-page":"525","article-title":"Complex orthodontic treatment using a new protocol for the Invisalign appliance","volume":"41","author":"Boyd \n              RL.","year":"2007","unstructured":"Boyd \n              RL. \n            \n          \n          Complex orthodontic treatment using a new protocol for the Invisalign appliance. J Clin Orthod. 2007;41:525\u2013547."},{"key":"i0003-3219-87-3-432-b05","series-title":"J Orofac Orthopod","first-page":"365","article-title":"Invisalign treatment in the anterior region: were the predicted tooth movements achieved?","volume":"73","author":"Krieger \n              E,","year":"2012","unstructured":"Krieger \n              E, \n            \n            \n              Seiferth \n              J, \n            \n            \n              Marinello \n              I, \n            \n            et al. \n          Invisalign treatment in the anterior region: were the predicted tooth movements achieved?\n          J Orofac Orthopod. 2012;73:365\u2013376."},{"key":"i0003-3219-87-3-432-b06","series-title":"Am J Orthod Dentofacial Orthop","first-page":"837","article-title":"Activation time and material stiffness of sequential removable orthodontic appliance. Part 3: premolar extraction patients","volume":"133","author":"Baldwin \n              DK,","year":"2008","unstructured":"Baldwin \n              DK, \n            \n            \n              King \n              G, \n            \n            \n              Ramway \n              DS, \n            \n            \n              Huang \n              G, \n            \n            \n              Bollen \n              AM. \n            \n          \n          Activation time and material stiffness of sequential removable orthodontic appliance. Part 3: premolar extraction patients. Am J Orthod Dentofacial Orthop. 2008;133:837\u2013845."},{"key":"i0003-3219-87-3-432-b07","series-title":"J Clin Orthod","first-page":"583","article-title":"Treatment of severe maxillary crowding using Invisalign and fixed appliances","volume":"43","author":"Giancotti \n              A,","year":"2009","unstructured":"Giancotti \n              A, \n            \n            \n              di Girolamo \n              R. \n            \n          \n          Treatment of severe maxillary crowding using Invisalign and fixed appliances. J Clin Orthod. 2009;43:583\u2013589."},{"key":"i0003-3219-87-3-432-b08","series-title":"Am J Orthod Dentofacial Orthop","first-page":"310","article-title":"A new approach to correction of crowding","volume":"122","author":"Womack \n              W,","year":"2002","unstructured":"Womack \n              W, \n            \n            \n              Ahn \n              J, \n            \n            \n              Ammari \n              Z, \n            \n            \n              Castillo \n              A. \n            \n          \n          A new approach to correction of crowding. Am J Orthod Dentofacial Orthop. 2002;122:310\u2013316."},{"key":"i0003-3219-87-3-432-b09","series-title":"J Dent Educ","first-page":"948","article-title":"Esthetic orthodontic treatment using the Invisalign appliance for moderate to complex malocclusions","volume":"72","author":"Boyd \n              RL.","year":"2008","unstructured":"Boyd \n              RL. \n            \n          \n          Esthetic orthodontic treatment using the Invisalign appliance for moderate to complex malocclusions. J Dent Educ. 2008;72:948\u2013967."},{"key":"i0003-3219-87-3-432-b10","series-title":"J Clin Orthod","first-page":"83","article-title":"Creative adjuncts for clear aligners: part I Class II treatment","volume":"49","author":"Bowman \n              SJ,","year":"2015","unstructured":"Bowman \n              SJ, \n            \n            \n              Celenza \n              F, \n            \n            \n              Sparaga \n              J, \n            \n            \n              Papadopoulos \n              MA, \n            \n            \n              Ojima \n              K, \n            \n            \n              Lin \n              JC. \n            \n          \n          Creative adjuncts for clear aligners: part I Class II treatment. 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J Clin Orthod. 2009;43;439\u2013448."},{"key":"i0003-3219-87-3-432-b12","series-title":"Am J Othod Dentofacial Orthop","first-page":"292","article-title":"Outcome assessment of Invisalign and traditional orthodontic treatment compared with the American Board of Orthodontics Objective Grading System","volume":"128","author":"Djeu \n              G,","year":"2005","unstructured":"Djeu \n              G, \n            \n            \n              Shelton \n              C, \n            \n            \n              Maganzini \n              A. \n            \n          \n          Outcome assessment of Invisalign and traditional orthodontic treatment compared with the American Board of Orthodontics Objective Grading System. Am J Othod Dentofacial Orthop. 2005;128:292\u2013298."},{"key":"i0003-3219-87-3-432-b13","series-title":"Clin Orthod Res","first-page":"147","article-title":"Orthodontic process and outcome: efficacy studies\u2014strategies for developing process and outcome measures: a new era in orthodontics","volume":"1","author":"Vig \n              K,","year":"1998","unstructured":"Vig \n              K, \n            \n            \n              Weyent \n              R, \n            \n            \n              Vayda \n              D, \n            \n            \n              O'Brien \n              K, \n            \n            \n              Bennett \n              E. \n            \n          \n          Orthodontic process and outcome: efficacy studies\u2014strategies for developing process and outcome measures: a new era in orthodontics. Clin Orthod Res. 1998;1:147\u2013155."},{"key":"i0003-3219-87-3-432-b14","series-title":"Am J Orthod Dentofacial Orthop","first-page":"293","article-title":"Predictors for Class II treatment duration","volume":"127","author":"Popowich \n              K,","year":"2005","unstructured":"Popowich \n              K, \n            \n            \n              Nebbe \n              B, \n            \n            \n              Heo \n              G, \n            \n            \n              Glover \n              K, \n            \n            \n              Major \n              P. \n            \n          \n          Predictors for Class II treatment duration. 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