Ortho 7 - Intro to Invisalign

Define the following:

- A SERIES OF CLEAR, CUSTOM MADE, REMOVABLE aligners created to move teeth into a desired position

Invisalign

Define the following:

- Combines orthodontics with 3D computer graphics to project tooth movement

Invisalign

What is different about new Invisalign aligners vs orthodontics in the olden days?

- Three dimensional (3D) geometric model instead of dental casts

- Computer aided appliance design

- Your prescription can be staged from beginning to end without taking impressions at various intervals

What are four benefits of using software for aligners?

- Computer-aided manipulation and calibrated accuracy

- Accurate and efficient staging of movements

- Detects interferences between teeth or collisions

- Quality and consistency checks

What are the five steps for the Invisalign treatment process and workflow?

1. Case submission

2. ClinCheck treatment plan

3. Start treatment

4. Monitor treatment

5. Fine tuning and retention

What are three required patient records for case submission?

- Patient photographs

- Panoramic radiograph

- PVS/VPS Impressions or Intraoral Scan

What are the four steps for the case submission process for aligners?

- Create a New Patient Record

- Complete the Prescription Form

- Print the Prescription form

- Package patient records for shipping

Define the following:

Provides set up technicians with an additional visual reference

Patient photographs

Define the following:

Foundation of aligner shape and fit

PVS/VPS Impressions

What are all of the following?

- iTero Element

- CEREC

- 3shape

- Carestream Dental

Intraoral scanners

What is the total timeline for Invisalign orders (submit case to receiving delievery)?

~25 business days

Scanning decreases timeline by about ~____ business days

10 business days

What are the four steps for the manufacturing process of Invisalign?

1. Mold Fabrication (Stereolithography)

2. Thermal Forming

3. Trimming with CNC

4. Polishing

ID feature of Invisalign:

-Three dimensional shapes added to tooth geometry to enhance the interaction between an aligner and the teeth

- Provide movement control or retention

Attachments

What do the red shapes represent in ClinCheck?

Attachments

(Forms in the ClinCheck software also indicate teeth requiring attachments)

What are aligners better at: pushing or pulling teeth?

Pushing teeth

What are traditional braces better at: pushing or pulling teeth?

Pulling teeth

Aligners maximize surface area to distribute force over larger area an to (increase/decrease) the interface of the object and force vector

Increase

Vector force is most efficient when it is directed __________ to the surface

Perpendicular

(Rather than at a acute angle - make the broader attachment perpendicular to the vector of force being applied/pushed onto the tooth)

T/F: Best to push an object from behind its center of resistance rather than next to it or in front of it. Results in better control of the objects directional movement (ie, shopping cart)

True

Maximize the attachment/aligner surface area interaction in relation to the ________ applied to the tooth

Vector of force

For _________ movements, use attachments that create a contrasting angle to the clinical crown (which typically tapers lingually)

Extrusive and torquing movements

For _______ movements, place the attachments on the mesial or distal so the force vector hits them as far behind the center of resistance as possible for better directional control

Sagittal movements

ID feature of aligner:

- Helps deliver lingual root movements for incisors

- Three dimensional shapes added to the aligner to enhance the interaction between an aligner and the teeth

Power ridge feature

ID feature of aligner:

Power ridge feature

ID feature of aligner:

- Mesial and distal hooks provide direct anchorage for elastics

- Available for buccal placement on cuspids, bicuspids, and molars

Precision cuts: hooks

ID feature of aligner:

Precision cuts: hooks

ID feature of aligner:

- Accommodates buttons bonded to the tooth

- Available for buccal or lingual placement on cuspids, bicuspids, & molars

Precision cuts: button cutouts

ID feature of aligner:

Precision cuts: button cutouts

ID feature of aligner:

- Plastic wedges on the lingual side of the aligners

- Help to prop the posterior bite open if the patient has excessive overbite to allow posterior teeth to erupt and support an improved overbite relationship

Precision bite ramps

ID feature of aligner:

Precision bite ramps

ID feature of aligner:

- Process of removing a small amount of a tooth's enamel between two adjacent teeth.

- Commonly used to create space for the patient’s tooth alignment when teeth are crowded.

-Teeth cannot move past one another if the contacts are heavy

-Based on computerized measurements, staging, and tooth movements

- Specified by amount, and by the stage when it is required

Interproximal reduction (IPR)

ID feature of aligner:

Interproximal reduction (IPR)

What does this interproximal reduction (IPR) instruction mean?

0.3mm IPR between tooth #23 and # 22 before Stage 10

____________ can also help in situations where there is a tooth size discrepancy between the top and bottom teeth. This balances the amount of tooth mass between the upper and lower teeth for them to fit properly in occlusion

Interproximal reduction (IPR)

Is your last aligner a retainer?

No - can order removable retainers directly from Align

All of the following are general properties of aligners and tooth movement EXCEPT:

A. Great at tipping teeth buccolingually, corrects flared out and tipped in teeth well

B. Great at intruding posterior teeth

C. Great at deepening overbites

D. Not so great at maintaining torque while retracting or protracting teeth

E. Great at opening deep overbites

E - NOT so great at opening deep bites

Is the following considered an easy or difficult case?

Class I deep OB / Class II div. II severe deep OB patients with minimal crowding or spacing

Difficult

T/F: ClinCheck always represents an accurate final outcome

False

(Can differ in reality - not all malocclusions are equal in achieving predictable results)

What is more likely...

A) Teeth tipping

B) Root of tooth moving

A) Teeth tipping

T/F: Aligners can easily intrude posterior teeth

True

(Posterior open bites develop easily if not accounted for. This is helpful in correcting anterior open bites)

T/F: Multiple movements can be employed at once with aligners which can decrease treatment time in certain situations

True

What is the ultimate risk factor of aligners?

Patient compliance (Trays must be worn >20hrs a day for treatment to work)