Predictability of Root Movements Using Virtual Root Setup in a Patient With Periodontal Disease Treated With Clear Aligners

Stefano Martina1, *, Marco Martini2, Monica Bordegoni3, Armando Viviano Razionale4
1 Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Allende, 84081, Baronissi (SA), Italy
2 Department of Mechanical Engineering, Polytechnic University of Milan, Private Practice, 48100, Ravenna, Italy
3 Department of Mechanical Engineering, Via Privata Giuseppe La Masa 1, Polytechnic University of Milan, 20156, Milano, Italy
4 Department of Civil and Industrial Engineering Largo Lucio Lazzarino, University of Pisa, 56122, Pisa, Italy

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© 2021 Martina et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via Allende, 84081, Baronissi (SA), Italy; Email:



The aim of the study was to show a case with a midline diastema in a patient with high periodontal risks and gingival recessions treated with clear aligners. The objective was to predict and quantify root movements using a dedicated software that extrapolates data from the Cone Beam Computed Tomography (CBCT).

Case Presentation:

A 31-year-old female with a mandibular midline diastema asked for an aesthetic treatment. She had vertical bone loss on the lower central incisors, so a CBCT was necessary in order to plan the root movements. The purpose of the treatment was to avoid an uncontrolled tipping of the incisors and, therefore, a vestibular movement of the roots, which could cause serious periodontal problems.


At the end of the treatment, the complete closure of the diastema and the radiographic healing of the vertical bone loss between mandibular central incisors were achieved. The superimpositions with the virtual setup demonstrated predictability of root movements of 76%.

Keywords: Clear aligners, Virtual root setup, Cone beam computed tomography, Periodontal disease, Midline diastema, Periodontal conditions.