Week 7 Coyne- Intro to clear aligners and digital ortho Flashcards
What malocclusion do aligners make worse?
Deep bite can worsen
What are the principles of ortho tx?
Records (hx, photos, radiographs, i/o scans)
Diagnosis (summary & problem list)
Aims of tx (how you know when you’re done)
Tx options (incl no tx, informed consent)
Tx (incl review and retention)
What are the 2 types of dental aligners?
DIY (e.g. smile direct club)
In-office (e.g. invisalign)
What does the pt need to be aware of before starting aligner tx?
- Possibility of root resorption and root shape change
- Let them know that you aren’t ortho specialist and offer referral to ortho
- Talk about cost of care and replacement for aligners.
- Discuss importance of compliance
What are clear aligners?
- 3D printed and made from clear plastic
- Direct or thermoformed on model
- Proactive (need to envisage where you want teeth to go)
- Need space for tooth to move
- Need a force to apply to the tooth
What are advantages of clear aligners?
- Aesthetic
- Removable
- Comfortable
- Compromised teeth/missing teeth (if you have traumatised central or pt goes away you can take aligners off and then continue tx after)
- Protection from parafunction
- OH better as you can take out to clean
- Good for correcting ant open bite
- No broken wires as with braces
What are disadvantages of clear aligners?
- Removable
- Compliance (24hrs/day with 2hrs off to eat)
- Some movements are difficult
- Can cause lateral posterior open bite (if you have anterior interference or lack of material posteriorly)
- Can worsen class III and deep bite
How to manage offtrack/lag?
- Figure out what the main thing is
- Rescan or continue
How do aligners move teeth?
Pushing on aligner/tooth and/or aligner/attachment interface
Why do we need attachments for some aligners?
- Some movements require additional surface to push on
- Need attachments for posterior rotations (round)
- Generally don’t need attachments for anterior rotations (bc there are flat surfaces to push on)
What happens if force is applied to centre of resistance vs away from centre of resitance? + role of attachments in this?
- On centre of resistance: translation with no tipping
- Away from centre of resistance: rotation (moment)
- Attachments help prevent tipping
What are attachments required for?
- Prevent tipping
- Bodily
- Rotations
- Torque
- Expansion
- Intrusion (place on supporting teeth either side)
- Extrusion (place on extruding tooth)
Why do aligners worsen deep bites and class III and improve open bites and class II?
- When you put aligners on, there is intrusive force on molars. Md rotates forward.
- Helpful for open bite bc intruding posterior teeth can fix this. Overjet is also reduced so class II is reduced.
What is the new hybrid model going to be like for ortho tx?
Mix of virtual assessments and in-office visits
What is the benefit of hybrid tx monitoring?
- Improve pt compliance
- Better engage, communicate and educate pts
- Provide more convenience to pts
- Provide constant feedback and updates on tx
- Reduce unnecessary in-office appts
- Evaluate fit of aligners
