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In an effort to control torque movement of the mobile segment, we placed the implant placement driver and with the shaft coming through the pilot drill holes of the second guide.
Therefore, the aim of the present study was to evaluate the efficiency of a clear aligner system (Nuvola®, GEO S.r.l., Rome, Italy) [17] in controlling the torque movement of upper and lower anterior teeth.
To the best of our knowledge, there is a lack of reliable literature on this subject, especially on the effective clinical predictability of torque movement of the anterior teeth using different clear aligners.
The maximum torque movement planned was 12.7° in the upper arch (mean 2.6°) and 20.8° in the lower arch (mean 2.7°) for cases presenting mild to moderate crowding, and those amounts of torque were easily achieved clinically.
Torque movement requires the presence of a force couple acting on the tooth, and the biomechanics of this type of tooth movement was described by Hahn et al. [10]: the movement inside each aligner determines that initially the aligner does not fit the tooth crown perfectly, and a certain amount of reversible deformation is present at the gingival margins of the aligner.
During translational spring force measurements distinct dislodgement and torque movement of the ferro- and paramagnetic-composed bullets was observed.
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Considering subsequent treatment steps of 12 aligners each, this allowed achievement of predictable torque movements.
The null hypothesis was that no difference exists between planned and achieved torque movements.
Few articles are available in the literature regarding torque movements with clear aligners [7, 10, 11, 27, 28].
No statistically significant difference was found for all the anterior teeth between predicted and achieved torque movements.
The studied clear aligner system was able to produce clinical outcomes comparable to the planning of the digital setup relative to torque movements of the anterior teeth.
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