do's dont's with invisalign

Question 1

class I treatment

Answer 1

permanent dentition
anterior/ premolar crossbite
open bites

Question 2

class I referral

Answer 2

mixed dentition

molar cross bite

open bites greater than 2 mm

unlike arches

Question 3

class II treat?

Answer 3

No A-P correction

overject less than equal to 3mm

Question 4

class II refer

Answer 4

A-P correction

overjet greater than 3mm

Question 5

class III treatment?

Answer 5

REFER ALL CASES

Question 6

treat lingual incliniation

Answer 6

yes –GP everyday can do this

Question 7

GP can treat what with transverse discrepancies?

Answer 7

crowding, spacing, lingual inclinations, anterior crossbite

Question 8

GP treat vertical discrepency?

Answer 8

yes – deep bites

no moderate to advance open bites

Question 9

GP treat A-P discrpencies?

Answer 9

class I and II with NO AP correction

must refer class II or III ap correctin

Question 10

overjet needing referral

Answer 10

over 3 mm

Question 11

GP treat anteiror crossbite

Answer 11

yes if limited to anterior and pre molar

no posterior crossbite

Question 12

5 WAYS TO create space and which can GP do?

Answer 12

1. expansino
2. prclinatino
3. IPR.
4. Distilization
5. Extractin

GP in 1-3

Question 13

expansion in mm how much arch length increase? prclination relationship?

Answer 13

proclintatino relationship is the same

1mm expansion = .7 mm arch length increase
so 2 mm expansion = 1.4 arch length increase

Question 14

6mm expansion + 2mm proclination

Answer 14

6 mm = 4.2 (.7x6)
2mm = 1.4 (.7X2)

so 5. 6

Question 15

clincheck plan review 5 important steps

Answer 15

check the INITIAL OCCLUSION

check the COMMENTS TAB

check the FINAL POSITION

check the ANIMATION and STAGING TABS

submit CHNGES or APPROVE

Question 16

in step on of clin check regarding initial occlusion look what in A-P and what in vertical direction? transverse?

Answer 16

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

Question 17

step 2 with clin check

Answer 17

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

Question 18

step 3 in clin check

blue vs black?

Answer 18

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

Question 19

checking the animatin and staging tabs?

Answer 19

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

Question 20

three ways to perform IPR

easiest to hardest

Answer 20

1. manual method with strips
2. slow speed disks
3. high speed bur

Question 21

materials required to perform IPR

Answer 21

manual diamond strip 
polishing strips
measuring gauge 
UNWAXED FLOSS
fluoride varnish

Question 22

describe the attachments and their use

Answer 22

provide movement control or retention

- 3D dimensional shapes added to tooth geometry to ENHANCE INTERACTION BETWEEN AN ALIGNER AND THE TEETH

Question 23

where to place attachments?

Answer 23

forms in clincheck software also indicate teeth requiring attachments

represented by the red shapes seen in the clincheck tx plan

Question 24

routine appointment proceudre

Answer 24

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

Question 25

T/F you can use as many aligners as are needed to complete treatment, beginning from the date of shipment

Answer 25

true

- helps ensure you get the patient outcomes you expect

Question 26

additinal liners at no charge for how long?

Answer 26

5 years

Question 27

retention for life?

Answer 27

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

Question 28

example of a retainer wear protocol

Answer 28

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

Question 29

potential effects of uprighting

Answer 29

adjusting wilson

• can increase vertical dimenstion
• crown moving

easier to do than translation movement (crown and root together)

Question 30

relative extrusion vs absolute

Answer 30

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

Question 31

midline discrepencies may require

Answer 31

adding space on one side and taking away space on other