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DS4102 > W7 - Clear Aligners - Coyne > Flashcards

W7 - Clear Aligners - Coyne Flashcards

1
Q

What malocclusions are worsened by ortho aligners? Why?

A

Deep bites

Class 3

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2
Q

Principles of ortho tx (5)

A
  1. Gather records
  2. Diagnosis - problems?
  3. Aims of tx - What do you want to achieve
  4. Tx options
  5. Treatment
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3
Q

What must you be sure the patient is aware of before beginning aligner tx?

A

Root shape change / root resorption

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4
Q

Features of clear aligners therapy

A
  • 3D printed - either direct of thermoformed on a model
  • Proactive (vs reactive like braces)
  • Envisage where you want teeth to go
  • Need space for teeth to move
  • Need force to apply to tooth
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5
Q

Advantages of clear aligners (6)

A

Aesthetics

Removable

Comfortable

Compromised/missing teeth

Protection from parafunction

No emergencies (unlike broken braces)

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6
Q

Disadvantages of clear aligners (3)

A

Removable

Compliance

Some movements are difficult

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7
Q

How long do aligners need to be worn for?

A

24 hours per day with 2 hours off to eat

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8
Q

Why may aligners cause lateral posterior open bites? (2)

A

Anterior interference (did not accomodate for material thickness posteriorly)

Missed class 3

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9
Q

How to manage common problems regarding aligners (3)

A

Lag / off track → What’s the main issue? Rescan or continue

Lost aligners → Keep old sets or skip ahead

Compliance → can always swap to braces

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10
Q

How does tooth movement differ btw aligners and braces

A

Braces push and pull

Aligners can only push (must have surface area for aligner to push)

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11
Q

Why may aligners require attachments / buttons?

A

Requires surface to push on

Ex. buttons → give aligner something to push down on

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12
Q

What tooth movements require attachments in aligner tx? (5)

A

Posterior rotations

Extrusions

Bodily movement

If tx requires elastics

Expansion (moving buccally)

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13
Q

Why dont anterior rotations require attachments?

A

Enough broad suface area for aligner push

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14
Q

How do attachments relate to couples and moment forces

A

Since we are unable to put a bracket on centre of resistance, a moment will be created (rotation/tipping)

  • Braces usually have a bracket (couple) to create counter force and thus whole bodily movements
  • Aligners will require attachment to achieve the bodily movement
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15
Q

Do you need attachments for intrusion?

A

Not on the specific tooth → however, must place on supporting teeth

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16
Q

Where is the attachment needed for extrusion? what must be considered?

A

Make sure there is room for tooth to be extruded

17
Q

Why do aligners make class 3 worse?

Why is it good for open bites?

A

Aligners will apply intrusive force on posterior teeth

md rotates forward, making class 3 worse

  • good for open bite
  • bad for deep bite
18
Q

Reasons for treatment monitoring (6)

A

Evaluate fit of aligners

Monitor treatment

Adapt tx plan to patients biological response

Improve patient compliance

Increase efficiency (reduce unneccessary appts, anticipate upcoming appts)

Provides better pt experience (more convenient, feedback/updates)

  • Can get pt to track their own progress virtually, assess to shorten time
  • if tracking well can shorten, if not, lengthen time
19
Q

How often to change aligners?

A

Adults - usually every 14 days

Growing kids - every 10 days, 7 days

Depends on pt specific biology

  • Can get pt to track their own progress virtually, assess to shorten time
  • if tracking well can shorten, if not, lengthen time
20
Q

What is the hybrid model of modern orthodontics?

A

In-office AND virtual consult / appointments

  • Better treatment monitoring
  • Pts can track their own progress
21
Q

What records are needed for digital orthodontics? (5)

A

Intraoral scanning

Intraoral photos

Extraoral photos

OPG / Lat ceph / CBCT

3D facial scans & dynamic records

22
Q

What is digital orthodontics?

A

Use of technology to collect information, analyse problems, formulate a treatment plan, manufacture the appliances, execute the treatment and monitor the progress using systems and digital technology

Ex. iTero scanning, 3D printing, automatic lat ceph tracing, digital tracking, etc.

23
Q

How do you monitor treatment progress?

A

Can do physical appts

Digital better → get pt to take pic / scan teeth at set intervals (ex. daily)

  • Can encourage pt to stay compliant because if they are ontop of their scanning, you may be able to reduce treatment time (aka see if they are ready for their next tray or not)
  • Track how frequently (or lack of) aligner being used
24
Q

What are common ortho problems GP’s miss when doing aligner tx (5)

A

Class 3

Skeletal discrepancy

Growth patterns

Deep bite

Bite jump correction

25
Q

Why do you need attachments for expansion? (4)

A

Otherwise it will lead to tipping outwards → palatal cusps extruded → interference → lateral openbite

DS4102 (37 decks)

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