Оглавление
Susana Palma Moya. Aligner Techniques in Orthodontics
Table of Contents
List of Tables
List of Illustrations
Guide
Pages
Aligner Techniques in Orthodontics
Preface
About the Authors
Acknowledgements
About the Companion Website
1 History, Present and Future of Aligners. 1.1 History of Clear Aligners. 1.1.1 Early Beginning
1.2 Origins of Align Technology
1.3 Early Clear Aligner Manufacturers
Orthoclear
ClearCorrect
Orthocaps
Inman aligner
1.4 Align Technology Development
1.5 Current Situation and Future of Aligners
1.6 Promising Aligner Initiatives. 1.6.1 ClearCorrect by Straumann
1.6.2 SureSmile by Dentsply
1.6.3 F22 by Sweden and Martina
1.6.4 Clarity by 3M
1.6.5 Spark, by Ormco
1.6.6 CA Clear Aligner by Scheu
1.6.7 Irok
1.6.8 Angelalign
1.6.9 Alineadent
1.6.10 Remote Aligner Companies
1.7 Future of Clear Aligners
Notes
2 Basic Principles with Aligners
2.1 Forces
2.2 Engagement
2.3 Anchorage
2.4 Case Selection to Start with Aligners Technique
Note
3 Why Invisalign?
3.1 Why Did We Begin Prescribing Invisalign in Our Practice?
3.2 Our Motivation
4 Patient Communication Skills
4.1 Invisalign Equates to Health, Wellness and Outstanding Results
4.2 Effective Patient Communication
5 Keys to Practice Growth
5.1 How to Get the Best Results with Invisalign
6 Patient Selection
7 Predictability of Movement
7.1 Treatments to Gain Familiarity with the Technique
8 Types of Treatments with Invisalign
9 Pillars of the Invisalign Technique
9.1 Aligners
9.2 ClinCheck Software
9.3 Attachments and Features of SmartForce
9.4 Auxiliary Techniques
9.5 Technician (CAD Designer)
Note
10 Conventional Attachments
10.1 Features of SmartForce. 10.1.1 Optimized Attachments
Optimized Rotation Attachment
Optimized Extrusion Attachment
Optimized Root Control Attachments
Optimized Attachments for Lateral Incisors. Multiplane Attachment
Optimized Support Attachment
Optimized Attachments for Molars
Multiplane Attachments for Molars
Optimized Extrusion Attachments for Molars
10.2 Optimized Support Attachments
10.2.1 SmartForces
Power Ridges
Pressure Points
Precision Ramps
Precision Wings
11 Clinical Preferences
12 Attachments Bonding and Interproximal Reduction. 12.1 Bonding Attachments Protocol
12.2 Interproximal Reduction Procedure
Suggested IPR Protocol
Suggested IPR Procedure
Notes
13 Digital Workflow
13.1 Records. 13.1.1 Photographs. Extraoral
Intraoral
13.1.2 Impressions: PVS vs Scan. PVS Impressions
iTero Scan
X‐rays
13.2 Creating a New Patient Record
Submitting a Prescription Form
Prescription Form
14 ClinCheck Software
14.1 The Perfect ClinCheck Review in 10 Steps
14.1.1 Check Initial Occlusion
14.1.2 Review Comments Tab
14.1.3 Review the Final Position
14.1.4 Check the Number of Stages in Treatment
14.1.5 Dynamic Evaluation of the ClinCheck
14.1.6 Reviewing Occlusal Views
Simultaneous Movements
Sequential Movements
Rotation + Tipping Movement on Incisors
Rotation + Tipping Movement on Canines
Reciprocal Movements
Upper Canine Extrusion and Upper Lateral Intrusion
Molar Compression Simultaneously with Incisor Protrusion
Simultaneous Molar Mesialization with IPR and Incisor Retraction
Centre Upper and Lower Midlines Simultaneously with Anteroposterior Movements
Simultaneous Extrusion of the Premolars with Intrusion of the Incisors (in Growing Patients with a Hypodivergent Skeletal Pattern)
14.1.7 Check the Superimposition Tool
14.1.8 Review the Tooth Movement Assessment
14.1.9 Review Attachments
14.1.10 Review IPR
14.1.11 Review Precision Cuts
Precision Cuts – Hooks
Precision Cuts – Button Cutouts
Compatibility of Precision Cuts and Optimized Attachments
14.2 Communication with the Technician
15 Treatment Monitoring and Appointments Protocol
15.1 Tracking Treatment Progress
15.2 Appointments Protocol for Invisalign Patient
15.3 Protocol on Each Appointment
16 Troubleshooting and Retention
16.1 Auxiliary Techniques
16.1.1 Tooth Does Not Follow Rotation Movement
16.1.2 Tooth Does Not Follow Vertical Movement
Auxiliary Technique to Extrude a Lateral Incisor
16.1.3 Managing Root Tipping
Uprighting a Molar Root
16.1.4 Managing Posterior Mesialization
Evolution of Mesialization
16.1.5 Reopening Space for Missing Molars
16.1.6 Achieving More than 4 mm of Anterior Intrusion
16.1.7 Managing Intrusion of the Mesiobuccal Cusp of the First Molar
16.1.8 Managing Premolar Rotation Greater than 45 Degrees
16.1.9 Solving a Posterior Open Bite
16.1.10 Correcting Canine Rotation as well as Anteroposterior Discrepancy
16.2 Finishing Techniques
16.2.1 Overcorrection
16.2.2 Overtreatment
Virtual C‐chain
16.3 Retention
17 Arch Length Discrepancies
17.1 Spacing. 17.1.1 Spacing, Case 1
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
Communication with the Technician
17.1.2 Spacing with Frenulectomy
Diagnosis
Treatment Plan
ClinCheck 1: Requirements for the Technician
Clincheck 2: Requirements for the Technician
17.2 Crowding. 17.2.1 Crowding, Case 1
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
Instructions to the Technician
Final Occlusion
17.2.2 Crowding, Case 2
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
17.2.3 Crowding, Case 3
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
Tips for Upper Crowding with Anterior Cross Bite of Lateral Incisors
Tips for Lower Crowding
17.2.4 Crowding, Case 4
Diagnosis
Treatment Plan
ClinCheck 1: Requirements for the Technician
Treatment Summary
ClinCheck 2: Communication with Technician
18 Growing Patients
18.1 First Treatment. 18.1.1 Upper Maxillary Compression
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
18.1.2 First Severe Crowding Treatment
Diagnosis
Treatment Plan
ClinCheck1: Requirements for the Technician
Treatment Summary
Clincheck2: Communication with the Technician
ClinCheck3: Communication with the Technician
18.2 Teenage Patients. 18.2.1 Class II Corrected with Lite Treatment
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
First‐phase Records at 8 Years Old
Second Phase Records at 15 Years Old
18.2.2 Class II Treated with Comprehensive Treatment
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
18.2.3 Class III with Impacted Canine
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
18.2.4 Traditional Technique for Impacted Canine Traction
18.2.5 Deep Bite Lite Treatment in a Teenager
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
18.2.6 Ectopic Palatal Canine
Diagnosis
Treatment Plan
Treatment Summary
Clincheck 1: Requirements for the Technician
ClinCheck2: Communications to the Technician
18.2.7 Temporary Tooth Management
Diagnosis
Treatment Plan
Treatment Summary
ClinCheck 1: Requirements for the Technician
Notes
19 Transversal Problems: Symmetric and Asymmetric Expansion
19.1 Things to Consider in Expansion Cases
19.2 Symmetric Expansion. 19.2.1 Symmetric Compression Causing Anterior Open Bite
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
19.2.2 Symmetric Compression with Edge to Edge Bite
Diagnosis
Treatment Plan
ClinCheck 1: Requirements for the Technician
Treatment Summary
ClinCheck 2: Requirements for the Technician
19.2.3 Symmetric Compression Combined with Skeletal Class III
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
19.2.4 Symmetric Compression with Loss of Attachment
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
19.2.5 Symmetric Compression with Bilateral Posterior Crossbite
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
ClinCheck 2: Communication with the Technician
ClinCheck 3: Communication with the Technician
19.2.6 Symmetric Compression with Class II and Gummy Smile
Diagnosis
Treatment Plan
ClinCheck 1: Requirements for the Technician
Treatment Summary
ClinCheck 2: Requirements for the Technician
19.3 Asymmetric Expansion. 19.3.1 Skeletal Class III Patient with Severe Periodontal Disease
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
19.3.2 Asymmetric Compression with Unilateral Posterior Crossbite from Canine to Second Molar
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
19.3.3 Asymmetric Compression with Unilateral Posterior Molar Crossbite: a Two‐stage Approach
Diagnosis
Treatment Plan
ClinCheck 1: Requirements for the Technician
Treatment Summary
ClinCheck 2: Communication with the Technician
19.3.4 Skeletal Asymmetric Compression with Unilateral Posterior Molar Crossbite: Use of Maxillary Assisted Rapid Palatal Expander
Diagnosis
Treatment Plan
Phase 1: Gingivectomy
Phase 2: MARPE
ClinCheck 1, Communication with the Technician
ClinCheck 2, Communication with the Technician
19.4 Tips for Transversal Arch Compensation
20 Sagittal Discrepancies
Passive Aligners
Precision Cuts
Button Cutouts
Precision Cuts Versus Button Cutouts
Rotating Canines with Elastics
Providing Labial Crown Torque to Upper Canine with the Elastics
Pontics: to Substitute a Missing Tooth
Pontic Selection Criteria
20.1 Filling the Prescription form for Class II/III Patients
Indications for Sequential Distalization
Considerations for Sequential Distalization
Mandibular Advancement (MA)
Orthognathic Surgical Simulation
20.2 Class II Cases
20.2.1 Considerations for Class II Patients
Treatment Options for Class II Patients
Extra Resources for Class II Patients
Expansion
Molar Derotation
Upper Distalization
Lower Mesialization
Extractions
Extraction of Wisdom Tooth
20.2.2 Mandibular Advancement
Ideal Moment for Mandibular Advancement
Features of MA
How Does it Work?
MA Protocol. Pre‐MA Phase (Light Blue Colour)
MA Phase (Dark Blue Colour)
Transitional Phase (Dark Blue Colour)
Features of Treatment in Teenage Patient. Compensation of Eruption for Canines or Second Premolars
20.2.3 Conventional Mandibular Advancement + Aligners
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
20.2.4 Invisalign Mandibular Advancement
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
Tips for Class II Patients Treated with Invisalign Mandibular Advancement
20.2.5 Class II Corrected by Transverse Arch Development and Intermaxillary Elastics
Diagnosis
For the Asymmetric Mandibular Growth
Treatment Plan
Requirements for the Technician
Treatment Summary
20.2.6 Sequential Upper Distalization and Lower Mesialization
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
20.2.7 Sequential Distalization
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
Tips for Sequential Distalization
20.2.8 Simultaneous Distalization
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
20.2.9 Simultaneous Distalization with TADs in Tuberosity
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
20.2.10 Simultaneous Distalization with TADs in Tuberosity
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
20.2.11 Top Jet
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
20.2.12 Class II with Proclined Lower Incisors
Diagnosis
Treatment Plan
Clincheck 1: Requirement for the Technician
Treatment Summary
Clincheck 2: Requirement for the Technician
20.2.13 Full Class II with Posterior Crossbite
Diagnosis
Treatment Plan
Clincheck 1: Requirement for the Technician
Treatment Summary
Clincheck 2: Requirements for the Technician
20.2.14 Class II Patient with Anterior Open Bite and Crossbite
Diagnosis
Treatment Plan
ClinCheck 1: Requirements for the Technician
Treatment Summary
ClinCheck 2: Requirements for the Technician
20.3 Class III
Class III Features
Precision Cuts and Button Cutouts
Power Ridges
Optimized Root Control Attachments
20.3.1 Posterior IPR
20.3.2 Lower Sequential Distalization
Staging for Anterior Crossbites
Tips for Class III
Mixed Dentition
20.3.3 Class III with Anterior Crossbite
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
20.3.4 Dentoalveolar Protrusion, Skeletal Class III
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
20.3.5 Anterior Crossbite, Skeletal Class III with Hypoplasic Upper Maxilla, Dentoalveolar Compensation
Diagnosis
Treatment Plan
ClinCheck 1: Requirements for the Technician
Treatment Summary
ClinCheck 2: Requirements for the Technician
20.3.6 Anterior Crossbite, Skeletal Class III with Hypoplasic Upper Maxilla, Miniscrew‐assisted Rapid Palatal Expander (MARPE) Combined with Aligners
Diagnosis
Treatment Plan
ClinCheck 2: Requirements for the Technician
Treatment Summary
ClinCheck 2: Requirements for the Technician
20.3.7 Anterior Crossbite, Skeletal Class III
Diagnosis
Treatment Plan
ClinCheck 1: Requirements for the Technician
ClinCheck 2: Requirements for the Technician
20.4 Dentoalveolar Protrusion Skeletal Class II. 20.4.1 Upper and Lower Simultaneous Distalization Protocol
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
21 Vertical Problems. 21.1 Open Bite
Factors Determining How to Resolve an Open Bite. Smile Analysis
Patient Biotype
Posterior Anchorage Analysis
Anterior Open Bite Anchorage
Requirements for the Technician
Anterior Open Bite Biomechanics. Relative Extrusion of Incisors
Pure Extrusion of Incisors using Multi‐tooth Optimized Extrusive Attachments
Open Bite Prescription
Question 6 of the Prescription Form
Specific Features of an Open Bite
Predictability of the Open Bite Treatment
Overcorrection
Occlusal Attachments
21.1.1 Open Bite: Transversal and Sagittal Cause. Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
21.1.2 Open Bite: Transversal, Sagittal and Vertical Cause
Diagnosis
Treatment Plan
Requirements for the Technician
Resolving the Transversal Problem
Resolving the Sagittal Problem
Resolving the Vertical Problem
Treatment Summary
21.1.3 Open Bite: Vertical Cause Treated with TADs
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
Tips for Open Bites
Communication with the Technician
21.1.4 Open Bite with Tongue‐thrusting Habit
Diagnosis
Treatment Plan
ClinCheck 1: Requirements for the Technician
Treatment Summary
ClinCheck 2: Requirements for the Technician
21.1.5 Open Bite with Insufficient Incisor Display
Diagnosis
Treatment Plan
ClinCheck 1: Requirements for the Technician
Treatment Summary
ClinCheck 2: Requirements for the Technician
21.1.6 Open Bite with 4 Day Aligner Change
Diagnosis
Treatment Plan
ClinCheck 1: Requirements for the Technician
Treatment Summary
ClinCheck 2: Requirements for the Technician
21.2 Deep Bite: Classification According to Complexity
Deep Bite Prescription Form
Specific Features for Deep Bite. Pressure Areas
Optimized Deep Bite Attachments
Precision Bite Ramps
Optimized Support Attachments
Deep Bite Diagnosis
Incisor Retraction Protocol
Absolute Intrusion Greater than 4 mm
Final Suggested Incisor Torque
Biomechanics for Deep Bite Correction
Anchorage
Tips for Deep Bite
21.2.1 Deep Bite and Bruxism: Skeletal Class I with Crowding
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
21.2.2 Deep Bite, Class II: Skeletal Class II with Deep Bite and Lower Severe Crowding
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
21.2.3 Deep Bite: Skeletal Class I
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
21.2.4 Deep Bite: Skeletal Class II with TADs
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
21.2.5 Deep Bite with Lite Treatment
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
Bibliography
22 Asymmetries
22.1 Growing Patients with Asymmetry. 22.1.1 Skeletal Class II with Asymmetry
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
22.1.2 Skeletal Class II with Asymmetry
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
22.2 Non‐growing Patients with Asymmetry. 22.2.1 Skeletal Class III with Maxillomandibular Asymmetry
Diagnosis
Treatment Plan
Requirements for the Technician
Biomechanics of the Case
Treatment Summary
Intraoral Analysis
Biomechanics
22.2.2 Skeletal Class III with Mandibular Asymmetry
Diagnosis
Treatment Plan
Requirements for the Technician
Biomechanics for Lower Mesialization
Treatment Summary
22.2.3 Midline Shift with Anterior Open Bite Tendency, Posterior Crossbite, Left Class II, Right Class III
Diagnosis
Treatment Plan
ClinCheck 1: Requirements for the Technician
Treatment Summary
ClinCheck 2: Requirements for the Technician
23 Extraction Cases. 23.1 Incisor Extraction
Prescription for Extraction Cases
Factors to Choose the Incisor to be Extracted 1
Software Consideration on Incisor Extraction Cases
23.1.1 Class III with Lower Incisor Extraction
Diagnosis
Treatment Plan
Requirement for the Technician
Treatment Summary
23.1.2 Class I with Lower Crowding and Periodontal Problem Lower Incisor Extraction
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
Tips for Incisor Extraction Treatment
23.2 Extraction of Premolars
23.2.1 Absolute Anchorage
23.2.2 Maximum Anchorage
Extractions of First Premolars: Maximum Anchorage (Less Than 2 mm of Posterior Mesialization)
G6 Align Protocol
Medium or Moderate Anchorage
How to Prescribe it
Staggered Staging Technique
Minimum Anchorage: Extraction of Second Premolars (5s)
Powerarms Extraction Staging for Space Closure
Tips for Extraction Cases with Aligners
23.2.3 Class II with 14 and 24 Extraction
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
23.2.4 Extraction of 14 for Right Full Class II Patient, G6 Protocol
Diagnosis
Treatment Plan
ClinCheck 1: Requirements for the Technician
Treatment Summary
ClinCheck 2: Requirements for the Technician
23.2.5 Extraction of 14 for Right Full Class II Patient, Modified G6 Protocol
Diagnosis
Treatment Plan
ClinCheck 1: Requirements for the Technician
Treatment Summary
ClinCheck 2: Requirements for the Technician
ClinCheck 3: Requirements for the Technician
23.2.6 Extraction of 14 for Right Full Class II Patient, Modified G6 Protocol and Powerarms for Root Straightening
Diagnosis
Treatment Plan
ClinCheck 1: Requirements for the Technician
Treatment Summary
ClinCheck 2: Requirements for the Technician
ClinCheck 3: Requirements for the Technician
23.2.7 Extraction of 14 and 24 on Bilateral Full Class II
Diagnosis
Treatment Plan
ClinCheck 1: Requirements for the Technician
Treatment Summary
ClinCheck 2: Requirements for the Technician
23.2.8 Lower Space Closure for Class III Patient
Diagnosis
Treatment Plan
ClinCheck 1: Requirements for the Technician
Treatment Summary
ClinCheck 2: Requirements for the Technician
Note
24 Multidisciplinary Cases: Implants. 24.1 TADs to Intrude Upper Molars
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
24.2 Upper Midline Shift. 24.2.1 Opening Space for Implant of 23
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
24.3 Posterior Bite Collapse
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
24.4 Posterior Bite Collapse with Deep Bite
Diagnosis
Treatment Plan
Mock up to Estimate Vertical Dimension. Implants and Provisional Crowns Were Placed Before Treatment Started
Requirements for the Technician
Treatment Summary
24.5 Biomechanics of the Locatelli for Mesialization of the Lower Dental Arch Opening Space for Implants
24.5.1 Locatelli to Open Space for Single Tooth Posterior Implant Side. Simultaneous Lower Mesialization
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
24.6 Gingivectomy, Passive Eruption Case
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
Clincheck 1: Communication with Technician
Clincheck: Communication with Technician
24.7 Anterior Intrusion Anchored on Dental Implant
Diagnosis
Treatment Plan
ClinCheck 1: Requirements for the Technician
Treatment Summary
24.8 Anterior Torque Anchored on Dental Implant
Diagnosis
Treatment Plan
ClinCheck 1: Requirements for the Technician
Treatment Summary
ClinCheck 2: Requirements for the Technician
25 Prerestorative Orthodontics: Veneers
25.1 Bleaching
25.2 Veneers to Solve Lateral Bolton Discrepancy in a Class III Patient
Diagnosis
Treatment Plan
Requirements for the Technician
Treatment Summary
Requirements for the Technician
25.3 Space Opening for Anterior Crowns and Implants
Diagnosis
Treatment Plan
Clincheck 1: Requirements for the Technician
Treatment Summary
Clincheck 2: Requirements for the Technician
25.4 Anterior Intrusion for Two Central Incisor Veneers
Treatment Plan
Clincheck 1: Requirements for the Technician
Treatment Summary
25.5 Edge‐to‐Edge Bite Preparation for Veneers
Diagnosis
Treatment Plan
Treatment Summary
Clincheck 1: Requirements for the Technician
Clincheck 2: Requirements for the Technician
Note
Index. a
b
c
d
e
f
g
h
i
k
l
m
n
o
p
r
s
t
u
v
w
z
WILEY END USER LICENSE AGREEMENT
