do's dont's with invisalign Flashcards
class I treatment
permanent dentition
anterior/ premolar crossbite
open bites
class I referral
mixed dentition
molar cross bite
open bites greater than 2 mm
unlike arches
class II treat?
No A-P correction
overject less than equal to 3mm
class II refer
A-P correction
overjet greater than 3mm
class III treatment?
REFER ALL CASES
treat lingual incliniation
yes –GP everyday can do this
GP can treat what with transverse discrepancies?
crowding, spacing, lingual inclinations, anterior crossbite
GP treat vertical discrepency?
yes – deep bites
no moderate to advance open bites
GP treat A-P discrpencies?
class I and II with NO AP correction
must refer class II or III ap correctin
overjet needing referral
over 3 mm
GP treat anteiror crossbite
yes if limited to anterior and pre molar
no posterior crossbite
5 WAYS TO create space and which can GP do?
- expansino
- prclinatino
- IPR.
- Distilization
- Extractin
GP in 1-3
expansion in mm how much arch length increase? prclination relationship?
proclintatino relationship is the same
1mm expansion = .7 mm arch length increase
so 2 mm expansion = 1.4 arch length increase
6mm expansion + 2mm proclination
6 mm = 4.2 (.7x6)
2mm = 1.4 (.7X2)
so 5. 6
clincheck plan review 5 important steps
check the INITIAL OCCLUSION
check the COMMENTS TAB
check the FINAL POSITION
check the ANIMATION and STAGING TABS
submit CHNGES or APPROVE
in step on of clin check regarding initial occlusion look what in A-P and what in vertical direction? transverse?
A-P = check overjet and class relationship
vertical = check overbite
transverse = check midline
make sure the occlusion is consistent with the actual clinical situation of the patient
step 2 with clin check
check commentts tab
- contains most recent communication from technicians regarding the clin check tx plan
check in anterior, lateral and occlusal views
is arch form, arch width and buccolingual incliniation addressed?
check overbite, overjet, interuspation, occlusion, canine position
if required = apply changes
step 3 in clin check
blue vs black?
check the final position
- determine the difficulty of movements in the end
blue vs black (harder)
blue
- moderate movements
- at times benefit from longer wear time or additional techniques
- close monitoring recommended
black
- advanced movements
- often require longer wear time or additional techniques
- very close monitoring recommended
checking the animatin and staging tabs?
step 4 in clin check
- check animations in different views and evaluate the amount of movement having in mind
- biology
- constistnecy w/ patient (perio, profile)
- consistency w treatment plan
three ways to perform IPR
easiest to hardest
- manual method with strips
- slow speed disks
- high speed bur
materials required to perform IPR
manual diamond strip polishing strips measuring gauge UNWAXED FLOSS fluoride varnish
describe the attachments and their use
provide movement control or retention
- 3D dimensional shapes added to tooth geometry to ENHANCE INTERACTION BETWEEN AN ALIGNER AND THE TEETH
where to place attachments?
forms in clincheck software also indicate teeth requiring attachments
represented by the red shapes seen in the clincheck tx plan
routine appointment proceudre
evaluate aligner fit
- should seat well with no visible gaps or rocking and make sure attachments are engaged and compliant patient
- check IPR sites if applicable
- ensure teeth have space to move by monitoring ALL contacts
- releive tight contacts with strips if needed
T/F you can use as many aligners as are needed to complete treatment, beginning from the date of shipment
true
- helps ensure you get the patient outcomes you expect
additinal liners at no charge for how long?
5 years
retention for life?
yes at night
- studies show minimum retention for life during nights only
- but based on patients lifestyle, periodontal health, compliance, TMD condition may want to consider wearing retainers for a period of time (from 3-9 months) FULL TIM PRIOR to moving to just nights only
example of a retainer wear protocol
first set - worn full time for 3 months
second set - worn full time for 3 months
third set - worn by nights only for 9 months
fourth set - worn 3 night a week for 1 year / 9 monhts
potential effects of uprighting
adjusting wilson
- can increase vertical dimenstion
- crown moving
easier to do than translation movement (crown and root together)
relative extrusion vs absolute
relative – vertical positino does NOT CHANGE
- crown gets tipped lingually loking like came down - like closing anterior open bit but with
ABSOLUTE
- root tip also moving vertically
- hard to do with aligners alone
midline discrepencies may require
adding space on one side and taking away space on other
