EARLY TREATMENT WITH
INVISALIGN FIRST FOR A
COMPLETE INTERCEPTIVE
ORTHODONTIC APPROACH
DR ALESSANDRO GRECO

TRADITIONAL ORTHO VS DIGITAL ORTHODONTICS
• Reactive model to proactive model
• Contrast collaterals vs prevent collaterals
• More work on the digital side of the treatment
• Tads can be incorporated for complex treatments

outline
• Ideal timing
• Invisalign first approach
• conclusion

When is the time to start orthodontic
treatment?
• Starting before pubertal peak
-no better skeletal changes
-no better arch modification
-no better outcome in 2 phase treatment

At the end of treatment both groups were essentially equal, no significative difference on cephalometrics,
same correction for overjet

• When it is useful or need to start a treatment before ideal timing?
oCrossbite with mandibular shift
oMaxillary constriction
oEruption anomalies and need for space management
oClass III cases

RME VS SME
• Nasal volume
• Tongue posture
• Upper airways
• Nasal ventilation
• All this perspectives are possible only if the expansion is rapid and
should be over expanded
• an expansion of 10mm in 16 days is rapid expansion

When aligners can be used in early treatment approach
oCrossbite with mandibular shift – after rme
oMaxillary constriction – after rme
oEruption anomalies and need for space management- immediately
oClass III cases- after rme

Indicatioins for patients at age- 6-9years
• Arch development
• Expansion upto 4mm
• spacing/crowding
• Anterior crossbite
• Dental protrusion
• Space management for permanent dentition

In Invisalign expansion
• First the permanent molars are expanded using deciduous teeth as
anchorage
• And then primary canine and molars are expanded

Eruption compensator
• The system creates and maintains space for erupting canines and
premolars and upper and lower lateral incisors

The First system induced shape modifications of the upper arch during expansion in contrast to RME.
The FG presented an improvement in the maxillary arch shape, while the RG maintained the initial
triangular shape

Conclusion
• 5 days change
• Short clinicalcrowns = use large number of attachments
• Spaces mesial and distal to canine
• Remove unnecessary movement on deciduous teeth
 No root tipping
 No intrusion and extrusion more than .5mm
 No rotation more than 5 degrees