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Brackets and materials > Invisalign > Flashcards

Invisalign Flashcards

1
Q

Desired properties of aligners

A
  • constant f delivery
  • correct stiffness
  • low material stress relaxation
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2
Q

Why are attachments imp

A

Design and placement imp for controlled 2 point force application -> control moment - force ratio

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3
Q

Conventional vs optimised attachments

A

Conventional: passive, increase engagement of aligner to tooth

Optimised: placed when certain thresholds of OTM detected

Karras et al., 2021: NO. sig. diff. in mean accuracies of OTM

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4
Q

M/F ratio in Invislign

A

Uncontrolled tipping: tooth rotates around center of R
M/F: 1-7: controlled tipping, center of R displaced by attachment design

M/F: 8-10: translation e.g molar distalisation
- conventional attachments used for backward mvm, rotation and root tip

M/F >10: torque mvm

  • power ridges when >3 deg Lirtq
  • force applied on crown cervically to create couple
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5
Q

Attachment of extrusion

A

Bevelled attachment on gingival side

- exert more force on active surface

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6
Q

Intrusion attachment

A

NO need - light f

- KIV passive attachment on anchor tth for anchorate and relative extrusion

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7
Q

Rotation attachment

A

Optimised rotation attachments (U/L3s,L4s,L5s)

Aux

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8
Q

What is staging

A

the sequence and speed of OTM with aligner

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9
Q

Velocity of OTM in aligners

A

Up to
Rotation - 2deg/aligner
Torque - 1 deg
AP - 0.25mm

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10
Q

considerations for staging plan

A
  • biologically possible
  • clinically predictable
  • anchorage demand
  • attachment design
  • auxillary technique
  • stage linear and rotational velocities separately
  • slow down OTM for better predictability
    esp difficult mvm: extrusion, derotation of premolars/canines
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11
Q

Space closure CAT mechanics

A

torque 2-3 trays before incisor retraction

- reduce bowing effect

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12
Q

Migitating poor rotational correction

A

overcorrection

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13
Q

Staging pattern for anchorgage

A

Max: G6, posterior mesialisation <2mm
Canine retraction 1st into 1/3 of exo space + Cl. II elastics

Mod: 2-5mm anchorage loss
- reciprocal SC -> simultaneous staging where tth are moving

Molar distalization:

  • sequential
  • attachments on premolars and canines for bodily translation
  • Cl. II
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14
Q

What is leap frog staging pattern

A

early OJ reduction -> longer tx time

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15
Q

Non-exo + IPR Case

A

avoid round tripping
post IPR first -> sequential distalisation
- special instructions to maintain position of most labially displaced Li

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16
Q

Adv of CAT

A
  • better perio with less PI,GI,PD (Jiant et al., 2018)
  • sig. shorter time in mild-moderate malocclusion (Zheng et al., 2017)
  • molar distalisation
  • better vert.control
  • predetermine torque/tip
  • avoid proclination of incisors
  • better aesthetics
  • less pain
  • less emergency visits
17
Q

Compliance rate

A

36% wore recommended amt of time >75% of aligners
25.7% wore as recommended for <50% aligners
(Timm et al., 2021)

  • dyed indications not accurate
  • subjected to oral cavity, dishwashing process, soft drinks, fruits
18
Q

Disadv of CAT

A
  • compliance
  • no diff. in root resorption
    same changes in pulpal blow flow no prem. pulp damage as FA (Alhaija et al., 2019)
19
Q

Less predictable OTM with CAT

A
  • rotations of canine and premolars >10-15deg
  • extrusion
  • OB control
20
Q

Predictable OTM in CAT

A
  • intrusion of post tth
  • distalization
  • M-D crown tip
21
Q

Case selection (AP)

A

< 4mm in buccal rs: elastics, IPR, distalisation

>4mm: exo

22
Q

Case selection (exo)

A

If pretx root angulation divergent from exo site
OR >6mm root mvm
- use FA (better torque and root control)

23
Q

Case selection (vert)

A

Avg-high MPA cases: Invisalign can resolve deep bite
Low MPA: FA more post. extrusion, more sk. change

Resolve AOB via incisor mvm: min change to MPA

24
Q

Case selection (transverse)

A

Invisalign expansion: largely tipp, good for lingually tipped molars

If bodily mvm and torque req.: FA + RME/MARPE

25
Q

DTC aligners

A
  • more value on cost and convenience than tx outcome
  • no attachments
  • unsatisfied pt on NDA for refunds

Zenyum: no liability for any advice/consultationa nd service furnished , not dr-pt rs

AAO:

  • lack of industry standards
  • lack of pt follow up

Behrents 2016:
serious health risk w/o supervision

Brackets and materials (5 decks)

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