DEVELOPMENT AND CLINICAL EVALUATION OF AN ORTHODONTIC TREATMENT METHOD FOR DISTAL OCCLUSION USING DIGITALLY FABRICATED POSITIONING OCCLUSAL OVERLAYS

Oksana Moskovets; Anastasia Ivanova; Samvel Apresyan; Alexander Stepanov; Semen Ignatyev; Karina Apresyan

doi:10.18481/2077-7566-2026-22-3-179-191

VAK Russia 3.1.7 UDC 616.31

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DEVELOPMENT AND CLINICAL EVALUATION OF AN ORTHODONTIC TREATMENT METHOD FOR DISTAL OCCLUSION USING DIGITALLY FABRICATED POSITIONING OCCLUSAL OVERLAYS

Published in Actual problems in dentistry · Volume 22, Issue 3, 2026 · Pages 179–191 · Rubric: PEDIATRIC DENTISTRY, PROPHYLAXIS AND ORTHODONTICS. ORIGINAL RESEARCH PAPERS

DOI: https://doi.org/10.18481/2077-7566-2026-22-3-179-191

Received: 13.09.2026 Accepted: 23.09.2026 Published: 23.09.2026 Language of publication: RUS

Authors

Oksana Moskovets

Anastasia Ivanova

Samvel Apresyan

Alexander Stepanov

et al.

Semen Ignatyev

ORCID Scopus ResearcherID Scholar SPIN

Karina Apresyan

Oksana Moskovets

Academic degree: candidate of medical sciences

Peoples' Friendship University of Russia Associate Professor at the Institute · Institute of Digital Dentistry at the Medical Institute · Russian Federation · Moscow

Anastasia Ivanova

Peoples' Friendship University of Russia named after Patrice Lumumba Institute of Digital Dentistry at the Medical Institute · Russian Federation · Moscow

Samvel Apresyan

Academic degree: doctor of medical sciences

Science rang: professor

Peoples' Friendship University of Russia named after Patrice Lumumba Director · Institute of Digital Dentistry · Russian Federation · Moscow

Alexander Stepanov

Academic degree: doctor of medical sciences

Science rang: docent

Peoples' Friendship University of Russia named after Patrice Lumumba Professor at the Institute · Institute of Digital Dentistry, Medical Institute · Russian Federation · Moscow

Semen Ignatyev

Academic degree: candidate of physical and mathematical sciences

F.F. Erisman FSCH of Rospotrebnadzor Senior research associate · Department of Genetic Toxicology · Russian Federation · Mytishchi

ORCID Scopus ResearcherID Scholar SPIN

Karina Apresyan

Peoples' Friendship University of Russia named after Patrice Lumumba Russian Federation · Moscow

ABSTRACT

Relevance. In adult patients with distal occlusion, correction of sagittal relationships is often performed against the background of a functionally unfavorable position of the mandible. Objective. To develop a method of orthodontic treatment of distal occlusion using digital positioning occlusal pads and evaluate its clinical effectiveness. Materials and methods. The prospective before–after study included 30 patients aged 21-43 years (29.4 ± 5.9 years) with distal occlusion. After a comprehensive diagnosis, the therapeutic position of the lower jaw was determined, an intraoral scan was performed, individual pads were modeled in Exocad, and treatment with aligners was performed. Clinical manifestations of TMJ dysfunction, parameters of articular spaces according to CBCT data, electromyographic parameters, sagittal fissure, depth of incisor overlap, occlusal relationships and structural stability were evaluated. The differences at p < 0.05 were considered statistically significant. Results. The frequency of TMJ discomfort decreased from 80.0 to 13.3%, the pain intensity decreased from 4.8 ± 1.6 to 0.9 ±0.7 points, and the EMG asymmetry coefficient decreased from 24.7 ±6.8 to 8.9 ±3.4% (p < 0.001). The posterior articular space increased from 1.8 ±0.5 to 3.0 ± 0.4 mm, and the proportion of patients with central articular heads increased from 16.7% to 86.7%. The sagittal fissure decreased from 7.4 ±1.5 to 2.1 ±0.6 mm, the incisor overlap depth decreased from 5.8 ±1.4 to 2.4 ±0.7 mm; molar class I was achieved in 90.0% of patients. Of the 60 pads, 2 chips and 3 cases of debonding were registered. Conclusion. The proposed method provided a significant improvement in occlusal and functional parameters with a low incidence of technical complications. The limitations of the study are the absence of a control group and a short follow-up period.

KEYWORDS

distal occlusion, positioning occlusal overlays, digital orthodontics, clear aligners, intraoral scanning, CAD/CAM, temporomandibular joint, electromyography

Funding

Acknowledgment. This article was prepared as part of the state assignment of the Ministry of Science and Higher Education of the Russian Federation (FSSF-2026-0012). 117198, Moscow, Miklukho-Maklaya St., Bldg. 6.

1. Alhammadi M.S., Halboub E., Fayed M.S., Labib A., El-Saaidi C. Global distribution of malocclusion traits: A systematic review. Dental Press Journal of Orthodontics. 2018;23(6):40.e1–40.e10. https://doi.org/10.1590/2177-6709.23.6.40.e1-10.onl

2. Lombardo G., Vena F., Negri P., Pagano S., Barilotti C., Paglia L. et al. Worldwide prevalence of malocclusion in the different stages of dentition: A systematic review and meta-analysis. European Journal of Paediatric Dentistry. 2020;21(2):115–122. https://doi.org/10.23804/ejpd.2020.21.02.05

3. Batista K.B.S.L., Thiruvenkatachari B., Harrison J.E., O’Brien K.D. Orthodontic treatment for prominent upper front teeth (Class II malocclusion) in children and adolescents. Cochrane Database of Systematic Reviews. 2018;3(3):CD003452. https://doi.org/10.1002/14651858.CD003452.pub4

4. Santana L.G., Avelar K., Flores-Mir C., Marques L.S. Incremental or maximal mandibular advancement in the treatment of Class II malocclusion through functional appliances: A systematic review with meta-analysis. Orthodontics & Craniofacial Research. 2020;23(4):371–384. https://doi.org/10.1111/ocr.12388

5. Mangano F., Gandolfi A., Luongo G., Logozzo S. Intraoral scanners in dentistry: A review of the current literature. BMC Oral Health. 2017;17(1):149. https://doi.org/10.1186/s12903-017-0442-x

6. Baan F., de Waard O., Bruggink R., Xi T., Ongkosuwito E.M., Maal T.J.J. Virtual setup in orthodontics: Planning and evaluation. Clinical Oral Investigations. 2020;24(7):2385-2393. https://doi.org/10.1007/s00784-019-03097-3

7. Sereewisai B., Chintavalakorn R., Santiwong P., Nakornnoi T., Neoh S.P., Sipiyaruk K. The accuracy of virtual setup in simulating treatment outcomes in orthodontic practice: A systematic review. BDJ Open. 2023;9(1):41. https://doi.org/10.1038/s41405-023-00167-3

8. Marcel R., Reinhard H., Andreas K. Accuracy of CAD/CAM-fabricated bite splints: Milling versus 3D printing. Clinical Oral Investigations. 2020;24(12):4607–4615. https://doi.org/10.1007/s00784-020-03329-x

9. Prpić V., Špehar F., Štajdohar D., Bjelica R., Čimić S., Par M. Mechanical properties of 3D-printed occlusal splint materials. Dentistry Journal. 2023;11(8):199. https://doi.org/10.3390/dj11080199

10. Abad-Coronel C., Ruano Espinosa C., Ordóñez Palacios S., Paltán C.A., Fajardo J.I. Comparative analysis between conventional acrylic, CAD/CAM milled, and 3D CAD/CAM printed occlusal splints. Materials. 2023;16(18):6269. https://doi.org/10.3390/ma16186269

11. Patzelt S.B.M., Krügel M., Wesemann C., Pieralli S., Nold J., Spies B.C. et al. In vitro time efficiency, fit, and wear of conventionally- versus digitally-fabricated occlusal splints. Materials. 2022;15(3):1085. https://doi.org/10.3390/ma15031085

12. Rivero-Millán P., Barrera-Mora J.-M., Espinar-Escalona E., González-Del Pino C.A., Martín-Salvador D., Llamas-Carreras J.-M. Comparison of condylar position in normal occlusion, Class II Division 1, Class II Division 2 and Class III malocclusions using CBCT imaging. Journal of Clinical and Experimental Dentistry. 2021;13(12):e1216–e1226. https://doi.org/10.4317/jced.58970

13. Al-Hadad S.A., AlYafrusee E.S., Abdulqader A.A., Al-Gumaei W.S., Al-Mohana R.A.A.M., Ren L. Comprehensive three-dimensional positional and morphological assessment of the temporomandibular joint in skeletal Class II patients with mandibular retrognathism in different vertical skeletal patterns. BMC Oral Health. 2022;22(1):149. https://doi.org/10.1186/s12903-022-02174-6

14. Michelotti A., Rongo R., D’Antò V., Bucci R. Occlusion, orthodontics, and temporomandibular disorders: Cutting edge of current evidence. Journal of the World Federation of Orthodontists. 2020;9(3, Suppl):S15–S18. https://doi.org/10.1016/j.ejwf.2020.08.003

15. Manfredini D., Lombardo L., Siciliani G. Temporomandibular disorders and dental occlusion. A systematic review of association studies: End of an era? Journal of Oral Rehabilitation. 2017;44(11):908–923. https://doi.org/10.1111/joor.12531

16. Coronel-Zubiate F.T., Marroquín-Soto C., Geraldo-Campos L.A., Aguirre-Ipenza R., Urbano-Rosales L.M., Luján-Valencia S.A. et al. Association between orthodontic treatment and the occurrence of temporomandibular disorders: A systematic review and meta-analysis. Journal of Clinical and Experimental Dentistry. 2022;14(12):e1032–e1038. https://doi.org/10.4317/jced.59970

17. Apresyan S.V., Stepanov A.G., Moskovec O.O., Malieva E.A. Cifrovoe planirovanie ortodonticheskogo lecheniya: literaturnyy obzor. Rossiyskiy stomatologicheskiy zhurnal. 2024;28(6):601–611. [Apresyan S.V., Stepanov A.G., Moskovec O.O., Malieva E.A. Digital planning of orthodontic dental treatment: A literature review. Russian Journal of Dentistry. 2024;28(6):601-611. (In Russ.)]. https://doi.org/10.17816/dent634964

18. Apresyan S.V., Stepanov A.G., Moskovec O.O., Apresyan K.S., avtory; Federal'noe gosudarstvennoe avtonomnoe obrazovatel'noe uchrezhdenie vysshego obrazovaniya "Rossiyskiy universitet druzhby narodov imeni Patrisa Lumumby", patentoobladatel'. Sposob ustraneniya distal'noy okklyuzii zubnyh ryadov. Rossiyskaya federaciya, patent RU 2825047. Opubl. 19.08.2024, Byul. № 23. [Apresyan S.V., Stepanov A.G., Moskovets O.O., Apresyan K.S., inventors; Federal State Autonomous Educational Institution of Higher Education "Patrice Lumumba Peoples' Friendship University of Russia", assignee. Method for eliminating distal occlusion of dentition. Russian Federation, patent RU 2825047. Published 19.08.2024, Bulletin No. 23. (In Russ.)]. https://www1.fips.ru/ofpstorage/BULLETIN/IZPM/2024/08/20/INDEX_RU.HTM

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GOST

Moskovets O. O., Ivanova A. V., Apresyan S. S., Stepanov A. G., Ignatyev S. D., Apresyan K. S. DEVELOPMENT AND CLINICAL EVALUATION OF AN ORTHODONTIC TREATMENT METHOD FOR DISTAL OCCLUSION USING DIGITALLY FABRICATED POSITIONING OCCLUSAL OVERLAYS // Actual problems in dentistry. 2026. no. 3. pp. 179-191. DOI: https://doi.org/10.18481/2077-7566-2026-22-3-179-191. (Date of access 25.09.2026).

MLA

Oksana Moskovets, Ivanova A. V., Apresyan S. S., Stepanov A. G., Ignatyev S. D., Apresyan K. S.. "DEVELOPMENT AND CLINICAL EVALUATION OF AN ORTHODONTIC TREATMENT METHOD FOR DISTAL OCCLUSION USING DIGITALLY FABRICATED POSITIONING OCCLUSAL OVERLAYS." Actual problems in dentistry 22.3 (2026): 179-191. DOI: https://doi.org/10.18481/2077-7566-2026-22-3-179-191.

APA

Moskovets O. O., Ivanova A. V., Apresyan S. S., Stepanov A. G., Ignatyev S. D., Apresyan K. S. (2026). DEVELOPMENT AND CLINICAL EVALUATION OF AN ORTHODONTIC TREATMENT METHOD FOR DISTAL OCCLUSION USING DIGITALLY FABRICATED POSITIONING OCCLUSAL OVERLAYS. Actual problems in dentistry, 22(3), 179-191. https://doi.org/10.18481/2077-7566-2026-22-3-179-191

Chicago

Oksana Moskovets, Ivanova A. V., Apresyan S. S., Stepanov A. G., Ignatyev S. D., Apresyan K. S.. "DEVELOPMENT AND CLINICAL EVALUATION OF AN ORTHODONTIC TREATMENT METHOD FOR DISTAL OCCLUSION USING DIGITALLY FABRICATED POSITIONING OCCLUSAL OVERLAYS." Actual problems in dentistry 22, no. 3 (2026): 179-191. https://doi.org/10.18481/2077-7566-2026-22-3-179-191.

WIKI

{{cite journal | author = Moskovets O. O., Ivanova A. V., Apresyan S. S., Stepanov A. G., Ignatyev S. D., Apresyan K. S. | title = DEVELOPMENT AND CLINICAL EVALUATION OF AN ORTHODONTIC TREATMENT METHOD FOR DISTAL OCCLUSION USING DIGITALLY FABRICATED POSITIONING OCCLUSAL OVERLAYS | journal = Actual problems in dentistry | year = 2026 | volume = 22 | issue = 3 | pages = 179-191 | doi = 10.18481/2077-7566-2026-22-3-179-191 }}

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DEVELOPMENT AND CLINICAL EVALUATION OF AN ORTHODONTIC TREATMENT METHOD FOR DISTAL OCCLUSION USING DIGITALLY FABRICATED POSITIONING OCCLUSAL OVERLAYS

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