Influence of attachments and interproximal reduction on the accuracy of canine rotation with Invisalign. A prospective clinical study.

OBJECTIVE To evaluate the influence of attachments and interproximal reduction on canines undergoing rotational movement with Invisalign. MATERIALS AND METHODS In this prospective clinical study, 53 canines (33 maxillary and 20 mandibular) were measured from the virtual TREAT models of 31 participants treated with anterior Invisalign. The pretreatment virtual model of the predicted final tooth position was superimposed on the posttreatment virtual model using ToothMeasure, Invisalign's proprietary measurement software. A one-way analysis of variance (ANOVA) (P < .05) compared three treatment modalities: attachments only (AO), interproximal reduction only (IO), and neither attachments nor interproximal reduction (N). Student's t-tests (P < .05) compared the mean accuracy of canine rotation between arches. RESULTS The mean accuracy of canine rotation with Invisalign was 35.8% (SD = 26.3). Statistical analyses indicated that there was no significant difference in accuracy between groups AO, IO, and N (P = .343). There was no statistically significant difference (P = .888) in rotational accuracy for maxillary and mandibular canines for any of the treatment groups. The most commonly prescribed attachment shape was the vertical-ellipsoid (70.5%). CONCLUSIONS Vertical-ellipsoid attachments and interproximal reduction do not significantly improve the accuracy of canine rotation with the Invisalign system.