Invisalign ClinCheck can predict open gingival embrasures in adult extraction cases: a pilot study

Abstract

Objectives: To evaluate the accuracy of Invisalign ClinCheck in predicting open gingival embrasures (OGEs) and to identify predictors of OGEs in adult extraction cases. Materials and Methods: Fifty-seven adult patients treated with Invisalign and four first premolar extractions were included in this retrospective study. OGEs were measured in maxillary and mandibular anterior regions using posttreatment intraoral photographs (actual OGEs) and the final step from the first treatment plan in ClinCheck (predicted OGEs). Prediction performance indicators including precision, sensitivity, specificity, false positive rate, false negative rate, and accuracy were evaluated at each tooth site. Predictors of OGEs (age, crowding, crown morphology, tooth movement, tooth site, treatment duration, and attachment design) were analyzed using binary logistic regression. Results: Incidence of actual OGEs was like that of the ClinCheck predicted OGEs in the maxillary and mandibular anterior regions. The predictability of ClinCheck was satisfactory in both the maxilla and mandible, with accuracy rates of 94.0% and 86.0%, respectively. The most accurate prediction was for the maxillary central incisors, achieving a precision of 100% and an accuracy of 96.6%. The most significant predictors of OGEs included patient age at initial consultation, anterior crowding, tooth crown morphology, and type of tooth movement. Conclusions: Invisalign ClinCheck predicted OGEs in adult patients treated with four premolar extractions. The accuracy of the prediction was satisfactory, 94% in the maxilla and 86% in the mandible, demonstrating great potential for clinical application.