Invisalign Flashcards
why invisalign - general
- improve health - periodontal occlusal health
- pre-restorative case set up
- minimally invasive pat
- aesthetics
- ## referrals healtthy patient and practice
preventing gingival disease and bone loss shuld include?
proper tooth alignment
anterior crowding of 3mm or more serves as an
individual host factorfor perio disease
study recomends preventative treatment to help patients avoid bigger future problems
everyday opportuntiies for cleat aligner therapy
recession, clefting, cold sensitivity, abfractions, fractured teeth, avoid aggressive ceramics, bruxism, open airway dentistry- increase oral cavity volume via arch shape, pre restorative case set up
50% of population has
one or more sites of gingival recession
- progressive with age
horizontal vs vertical
horizontal more detremental
prevent afractions with
proper tooth alignment
theory of non carious cervical lesions
suggests that tooth flexure arising from cyclic, eccentric occlusal forces causes their formation and progression in vulnerable cervical regions of teeth
oblique HORIZONTAL LOADING on non caroious cervical lesions resulted in greater stress concentration compared with vertical loading
acute angles– displayed higher stress concentrations at the depth of the lsion
T/F invisalign can increase oral cavity volume?
yes - “open airway dentistry”
why ortho
treating malocclusion!
FDI definition of oral health
ability to speak, smile, smell, taste, touch, chew, swalllow and convey a range of emotions through facial expression with confidence and free fom pain or discomfort, and disease of the craniofacial complex
is malocclusion a disease?
yes
- crossbites, open bites, deep bites, and overjet
crowding diastemas spacing and rotations
each section is in their disease classfication
angles classification a disease?
no not active disease
but the crossbites, deep bites, etc are considered a disease
what considered a disease
transverse and vertical discrepencies are considered disease
class I can be healthy and unhealthy
yes
same w/ II and III
uncrowded adults have ___ transverse measurement
35-39 mm
developed a healthy occlusion without orthodontic intervention
shortest distance between teeth 3 and 14 (upper first molars) measure at the gumline
3 main things crowding comes from
- improper arch form
- improper arch width
- improper buccolingual inclinnation
buccolingual inclination
the buccolingual inclination of the maxillary and mandibular posterior teeth is assessed by using a flat surface that is extended between the occlusal surfaces of the right and left posterior teeth
there should NOT BE a significant difference between the heights of the buccal and lingual cusps of the maxillary and mandibular premolars and molars with all cusps within 1MM OF THE STRAIGHT EDGE
proper overbite
1.5 to 2 mm
moderate deep bite
cover 1/2 of lower teeth
patient in permanent dentition with class I treat?
anterior. premolar crossbite
do not correct molar crossbite
open bites less than 2mm
like arches
patient in permanent dentition with class I refer?
molar crossbite
mixed dentition
open bites over 2mm
unlike arches
patient in permanent dentition with class I refer?
molar crossbite
mixed dentition
open bites over 2mm
unlike arches
patient class II what is GP treating
No A-P correction
over jet is less than or equal to 3mm
if need to correct A-P or have overjet of over 3mm REFER
class III gp?
no - never - always refer
how many photos needed for case submission
8
impression material you need to use if non digitial
PVS
5 basic zones
GP stay in what zones?
- expand - transversely
- procline A-P
- IPR (make smaller keep same radius)
- distilize
- extract
1-3 stays within the GPR range
when is IPR useful?
black triangles due to perio and shape of teeth
- crowding with inadequate formation of the papillla in gingival mbrasure
triangular shape teeth
periodontal disease
5 basic IMPORTANT STEPS
- check the initial occlusion
- check the comments tab
- check the final position
- check the animation and staging tabs
- submit changes or approve
check the initial occlusion
step 1 - a-p directio ; check overjet and class relationship
vertical dimension
- check overbite
transverse direction – check midline
check the comments tab
step 2
contains the most recent communication from technicians regarding your ClinCheck tx plan
- quality of impressions
- partially impressioned teeth
- attachments interfering with occlusioon
communication betwenn you and the lab
check the anterior, lateral, and occlusal views
was arch form width and buccolingual inclination addresssed?
check overbute, overjet, intercuspation, occlusion, canine position
if required – apply changes
check the final position
step 3
- checking this can give you the movement difficulty
blue and black dots are
red flags – complicated movements happening on that area
blue means
moderate movements
at times benefit from longr wear time or additinal techniques
close monitoring is recommended
black
advanced movements
often require longer wear time or additional techniques
very close monitoring is recommended
check the animation and staging tbs
step 4
- evaluate the amount of movement having in mind
- biology
- consitency with paitent (perio, profile)
- consistency with your tx plan
submit changes or approve
step 5
- check 1 -4
review and approve
patient first visit - starting tx
aligner delivery
placing attachments
IPR set up
patient aligner care
3 ways to preform IPR
interproximal reduction
- manual method with strips
- slow speed disks
- high speed bur
1-3 –> easiest ot hardest
red lines show
where you should be doing IPR’s and when
materials required to perform IPR
manual diamond strip polishing strips measuring gause unwaxed floss fluoride varnish
attachments provide
movement control or retention
three dimensional shapes added to tooth geometry to enhance interaction between an aligner and the teeth
red shaped in clincheck represents
where you will put attachments
retention for life during?
night only
amount of anterir crowding that serves as an individual host factor for perio disease
anteior crowdning of 3mm or more
so can prevent gingival disease and bone loss should include recommending proper tooth alignment
what is considered in the disease classifications
KO7.2
KO7.3
KO7.2 –> crossbites, open bites, deep bited, and overjets
KO7.3 –> crowding, diestema, spacing, and rotations are disease classifications
+ transverse and vertical discrepancies are considered disease
malocclusion (corwding) comes from
improper arch form
improper arch width
improper buccolingual inclination
*transverse dimension
arch forms
proper
improper - v shaped
improper omega (hardest to treat)
transverse measurement is
uncrowded average in adults?
shortest distance between 3 and 14 (upper first molars) measured at the gumline
uncrowded adults have 35-39 mm transverse measurement
can use cotten role test or boley gauge
32 mm transvverse is
improper arch width
proper buccolingual inclination of max and mand posterior teeth
assess by usnig plat surface that is extended between the occlusal surfaces of right and left poaterior teeth
should NOT be a significant difference between the buccal and lingual cups – all cusps should be within 1mm of the straigh edge
proper overbite
1.5-2mm
open bite
<2.0 mm
moderate deep bite
cover 1/2 of lower teeth
longevity of dental work is directly related to
severity of malocclusion
relative extrusion vs absoute extrusion
absolute – comes straight down
relative moves down and back at an angle - root tip moves too
to increase the radius you
expand/ procline
*increase arch length
movements to increase arch length
movements to decrease tooth mass
increase arch length
- expand / procline
- distalize
decrease tooth mass
- IPS – keep same radius, but resize the teeth (interproximal reduction)
- extract – keep same radius’ extract
-
first two choices when possible for correction of crowding
- expand / procline
2. IPR
to open a bite:
a vertical issue
- flare teeth forward (relative intrusion)
- upright posterior teeth
- intrude incisore (
- build up posteriors after
to deepen bite
retract anteirors (relative extrusion)
- extrude incisors
- posterior equilibration
midline correctins
subtract?
add?
subtract - may require IPR
add- may need to leave space for bonding
centering midlines may be challenging
what is invisalign therapy
series of custom built Invisalign aligners engineered to apply specific forces to achieve the desired tooth movements
wear 20-22 hours / day
GP three P’s to follow
predictable, preventive, profitable
impressions that are ideal?
digital
digital impression material
itero element intr-oral scanner
myitero software
itero scan sleeve
PVS impression material
PVS material
vinyl or nitrile gloves
INVISALIGN IMPRESSION TREY
treating maloccclusion with crowding deep bite vs straightening teeth crowing deep bite
malocclusion – primary using expansion
straightening / cosmetic focus – IPR and intrusion
spacing with treating malocclusion vs straightening
malocclusion — consider leaving spaces for restorative solutions
spacing with straightening - close spaces or position teeth for ideal restorative dentistry
when is IPR useful
black triangles due t perio and the shape of the teeth
- crowding with inadequate formation of the papilla in the gingival embrassure
triangular shaped teeth
periodontal disease
first steps on the computer
- new patient file
- tooth movement restrictions (ankylosis or implant supported) – need to mark these
- attachments
- place as needed - A-P relatinship
- G-P select maintain - overjet
- overbite
- bite ramps
- protrusions on the aligner for discluding posteiror teeth) - midline
9 posterior crosbite
- do not correct - spacing and crowding
special instructions override?
yes - override clinical prefernces
requests and restorative preference
weekly aligners?
this is the recommendation
but depending on patient response to tx , particularly mature adults and non-compliant patients – consider longer periods between aligner changes
