Week 7 Coyne- Intro to clear aligners and digital ortho Flashcards

1
Q

What malocclusion do aligners make worse?

A

Deep bite can worsen

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2
Q

What are the principles of ortho tx?

A

Records (hx, photos, radiographs, i/o scans)
Diagnosis (summary & problem list)
Aims of tx (how you know when you’re done)
Tx options (incl no tx, informed consent)
Tx (incl review and retention)

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3
Q

What are the 2 types of dental aligners?

A

DIY (e.g. smile direct club)
In-office (e.g. invisalign)

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4
Q

What does the pt need to be aware of before starting aligner tx?

A
  • Possibility of root resorption and root shape change
  • Let them know that you aren’t ortho specialist and offer referral to ortho
  • Talk about cost of care and replacement for aligners.
  • Discuss importance of compliance
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5
Q

What are clear aligners?

A
  • 3D printed and made from clear plastic
  • Direct or thermoformed on model
  • Proactive (need to envisage where you want teeth to go)
  • Need space for tooth to move
  • Need a force to apply to the tooth
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6
Q

What are advantages of clear aligners?

A
  • Aesthetic
  • Removable
  • Comfortable
  • Compromised teeth/missing teeth (if you have traumatised central or pt goes away you can take aligners off and then continue tx after)
  • Protection from parafunction
  • OH better as you can take out to clean
  • Good for correcting ant open bite
  • No broken wires as with braces
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7
Q

What are disadvantages of clear aligners?

A
  • Removable
  • Compliance (24hrs/day with 2hrs off to eat)
  • Some movements are difficult
  • Can cause lateral posterior open bite (if you have anterior interference or lack of material posteriorly)
  • Can worsen class III and deep bite
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8
Q

How to manage offtrack/lag?

A
  • Figure out what the main thing is
  • Rescan or continue
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9
Q

How do aligners move teeth?

A

Pushing on aligner/tooth and/or aligner/attachment interface

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10
Q

Why do we need attachments for some aligners?

A
  • Some movements require additional surface to push on
  • Need attachments for posterior rotations (round)
  • Generally don’t need attachments for anterior rotations (bc there are flat surfaces to push on)
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11
Q

What happens if force is applied to centre of resistance vs away from centre of resitance? + role of attachments in this?

A
  • On centre of resistance: translation with no tipping
  • Away from centre of resistance: rotation (moment)
  • Attachments help prevent tipping
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12
Q

What are attachments required for?

A
  • Prevent tipping
  • Bodily
  • Rotations
  • Torque
  • Expansion
  • Intrusion (place on supporting teeth either side)
  • Extrusion (place on extruding tooth)
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13
Q

Why do aligners worsen deep bites and class III and improve open bites and class II?

A
  • When you put aligners on, there is intrusive force on molars. Md rotates forward.
  • Helpful for open bite bc intruding posterior teeth can fix this. Overjet is also reduced so class II is reduced.
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14
Q

What is the new hybrid model going to be like for ortho tx?

A

Mix of virtual assessments and in-office visits

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15
Q

What is the benefit of hybrid tx monitoring?

A
  • Improve pt compliance
  • Better engage, communicate and educate pts
  • Provide more convenience to pts
  • Provide constant feedback and updates on tx
  • Reduce unnecessary in-office appts
  • Evaluate fit of aligners
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16
Q

What is the only force for aligners?

A

Pushing (braces have push and pull)

17
Q

What are attachments on aligners?

A

Attachments are tiny composite resin “bumps” that are bonded to the teeth. They will be placed at precise locations to allow the aligners to grip the teeth as they are guiding them to their new locations.

18
Q

What do clinicians often miss that can impact clear aligner tx?

A
  • Class III’s
  • Skeletal discrepancies
  • Growth patterns
  • Deep bite
  • Bite jump corrections
19
Q

What is the issue with digital plans??

A

Doesn’t account for teeth staying in bone. Only lines up teeth in some software.

20
Q

What clinical records are required?

A
  • Pt assessment & evaluation
  • I/o scan
  • I/o photographs (incisal edges, gingival margins)
  • E/o photographs
  • 3D facial scans and dynamic records
  • Radiographs (OPG, lat ceph, CBCT)
  • Other investigations
21
Q

What is digital orthodontics?

A

In digital orthodontics, the provider uses technology to collect information, analyze the potential teeth or jaw problems and use digital software platforms to formulate a treatment plan, manufacture the appliances, execute the treatment and monitor the progress using systems and technology built on digital ecosystems

22
Q

How can you change scan interval with remote monitoring?

A

If pt is not tracking well- lengthen scan interval

If pt is tracking well- might shorten scan interval