The very need for orthodontic treatment by a majority of adult patients is derived with a desire for enhancement of dental alignment and facial aesthetics. Although buccal fixed metallic appliances are efficient treatment systems, the reluctance of their use is mainly due to metal look, poor aesthetics and fear of pain. Clear plastic aligners’ offer an excellent alternative to unaesthetic orthodontic treatment with labial fixed appliances
The clear aligner appliance(s) is nearly transparent, colourless and almost invisible. As these devices are removable, they allow the patient an additional option to be without braces for social and professional engagements. The oral hygiene is not a problem with this appliance and most patients adapt to it very quickly. The success of these types appliances is intimately related to the compliance in wearing the appliance for a minimum number of hours and following the required schedule of changing the aligners as per sequence assigned to the case. Patients are asked to wear the aligners for a minimum of 22 h/day. Thus, patient compliance is paramount in clear aligner therapy.
Some of the patients seeking clear aligner treatment are those who have previously received orthodontic treatment using fixed appliances and have had a relapse or are unsatisfied with treatment outcome.
Clear Aligners in Orthodontics
nvisalign is an orthodontic
technique that uses a series of
computer-generated custom
plastic aligners to guide the teeth
gradually into proper alignment.
• Although the use of clear aligner
treatment is not new, it is a
growing part of the orthodontic
market, and, as a result, many
new products have become
available.
hai this is a nice seminar and inculcated all the recent materials and biomaterials and biomechanics of the invisalign techniques , materials to be used and clinical aspects just have a look to it
Once novel, Invisalign is now a digital orthodontic appliance used to treat millions of patients. This customized appliance is created by the aid of sophisticated 3D imaging and animation tools that enable virtual simulation of tooth movements. Tooth movements resemble a filmstrip, and each frame is called a stage. Each stage corresponds to a set of clear plastic aligner trays. As the trays are worn by the patient, every tray pushes the teeth 0.25-0.33mm at a time (Tuncay 2006). Each tray or aligner is composed of clear, removable polyurethane, which provides esthetic and more comfortable appliance wear experience than the traditional fixed appliances. This unique and esthetic alternative to tooth movement continues to recruit more patients to orthodontic therapy.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Pre & post surgical orthodontics /certified fixed orthodontic courses by Indi...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Clear Aligners in Orthodontics
nvisalign is an orthodontic
technique that uses a series of
computer-generated custom
plastic aligners to guide the teeth
gradually into proper alignment.
• Although the use of clear aligner
treatment is not new, it is a
growing part of the orthodontic
market, and, as a result, many
new products have become
available.
hai this is a nice seminar and inculcated all the recent materials and biomaterials and biomechanics of the invisalign techniques , materials to be used and clinical aspects just have a look to it
Once novel, Invisalign is now a digital orthodontic appliance used to treat millions of patients. This customized appliance is created by the aid of sophisticated 3D imaging and animation tools that enable virtual simulation of tooth movements. Tooth movements resemble a filmstrip, and each frame is called a stage. Each stage corresponds to a set of clear plastic aligner trays. As the trays are worn by the patient, every tray pushes the teeth 0.25-0.33mm at a time (Tuncay 2006). Each tray or aligner is composed of clear, removable polyurethane, which provides esthetic and more comfortable appliance wear experience than the traditional fixed appliances. This unique and esthetic alternative to tooth movement continues to recruit more patients to orthodontic therapy.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Pre & post surgical orthodontics /certified fixed orthodontic courses by Indi...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Biomechanical modifications made to accommodate orthodontic treatment of adult dentitions are generally minor and adhere to the basic laws of physics as they apply to orthodontic tooth movement.
Some adult presentations necessitate changes in treatment strategy from what would otherwise be employed in adolescent patients to achieve similar goals.
In other cases, objectives themselves may need to be modified because of lack of growth potential, constraints of treatment mandated by the patient or the presence of multiple missing or compromised teeth.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Root resorption in orthodontics /certified fixed orthodontic courses by Indi...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
This slide gives an full view of the important bio mechanics of temporary anchorage devices (TADS) this slide includes :
# Bio-mechanical principles of miniscrews in orthodontics
# Force Systems
#Biomechanical Considerations : Miniscrews
#Biomechanics For Anterior Retraction
#Biomechanics For Molar Intrusion
#Biomechanics For Molar Distalization
#Biomechanics For Molar Uprighting
#Biomechanics For Molar Protraction
Traditional begg philosophy /certified fixed orthodontic courses by Indian ...Indian dental academy
The Indian Dental Academy is the Leader in
continuing dental education , training dentists
in all aspects of dentistry and offering a wide
range of dental certified courses in different
formats.
Indian dental academy provides dental crown &
Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit
www.indiandentalacademy.com ,or call
0091-9248678078
Lingual orthodontics /certified fixed orthodontic courses by Indian dental ac...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Molar distalization /certified fixed orthodontic courses by Indian dental aca...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Biomechanical modifications made to accommodate orthodontic treatment of adult dentitions are generally minor and adhere to the basic laws of physics as they apply to orthodontic tooth movement.
Some adult presentations necessitate changes in treatment strategy from what would otherwise be employed in adolescent patients to achieve similar goals.
In other cases, objectives themselves may need to be modified because of lack of growth potential, constraints of treatment mandated by the patient or the presence of multiple missing or compromised teeth.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Root resorption in orthodontics /certified fixed orthodontic courses by Indi...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
This slide gives an full view of the important bio mechanics of temporary anchorage devices (TADS) this slide includes :
# Bio-mechanical principles of miniscrews in orthodontics
# Force Systems
#Biomechanical Considerations : Miniscrews
#Biomechanics For Anterior Retraction
#Biomechanics For Molar Intrusion
#Biomechanics For Molar Distalization
#Biomechanics For Molar Uprighting
#Biomechanics For Molar Protraction
Traditional begg philosophy /certified fixed orthodontic courses by Indian ...Indian dental academy
The Indian Dental Academy is the Leader in
continuing dental education , training dentists
in all aspects of dentistry and offering a wide
range of dental certified courses in different
formats.
Indian dental academy provides dental crown &
Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit
www.indiandentalacademy.com ,or call
0091-9248678078
Lingual orthodontics /certified fixed orthodontic courses by Indian dental ac...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Molar distalization /certified fixed orthodontic courses by Indian dental aca...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Invisalign /certified fixed orthodontic courses by Indian dental academy Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
THE INVISALIGN aligner in orthodontics .pptxMaen Dawodi
- The concept of producing tooth movement using a removable tooth positioning device at 1945, until Align Technology computerized the process (CAD-CAM) in the late 1990s
- The clinician must treat the patient virtually using the computer images long before touching even a single tooth.
- The lnvisalign System consists of mindset, software, impressions, working with the computer, understanding physical properties and behavior characteristics of the plastic and ensuing force systems acting on teeth, as well as patient management.
- Impressions must be taken with poly–vinyl siloxane (PVS) due to its superior accuracy and stability. The patient’s impressions, PVS bite registration, photographs (intraoral and extraoral) and radiographs are submitted to Align Technology in addition to the completed treatment form. (CT)
Each aligner is prescribed to be worn for 2 weeks and
is only removed for eating, drinking, brushing and flossing.
CT images of PVS impressions are transferred to a special software called "Treat" software.
imperfections of the impression are smoothed out and then submitted to the ClinCheck technique . (Santa Clara, California)
1- Bolton's discrepancy
2- Simulate physiological tooth attrition
3- Camouflage a skeletal deformity without surgery
4- Necessity to alter the tooth morphology
Initial concerns of root proximity, caries risk, good depth
of enamel .
In posterior region, use separators prior to IPR.
periapical radiographs are needed, but without such
benefit, one may safely remove 0.3 mm from
the anterior teeth and 0.6 mm from the posterior.
New Fundamental of Lingual Technique - 11 ESLO CONGRESSStudio Robotti
LINGUAL ORTHODONTIC TECHNIQUE, PROBLEMS AND SOLUTION,
DIRECT AND INDIRECT BONDING, STRAIGHT WIRE,TEHNIQUE, 2D LINGUAL APPLIANCE, SOCIAL SIX,EXCEPTIONAL EXPERIENCE, ESTHETIC TREATMENT
Twin block /certified fixed orthodontic courses by Indian dental academy Indian dental academy
Description :
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Description :
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Visualized Treatment Objective was coined by Holdaway.
A VTO is a cephalometric tracing representing the changes that are expected during treatment (Proffit).
Ricketts defines VTO as a visual plan to forecast the normal growth of the patient and anticipated influences of treatment, to establish individual objectives that are to be achieved for that patient.
The understanding of facial growth and occlusal development plays an important role in orthodontic diagnosis and treatment planning of problems encountered in dental and skeletal malocclusions.
What is Growth? An entire series of sequential anatomic and morphologic changes taking place from the beginning of prenatal life to senility-Meredith.
As Proffit says, growth prediction can never be accurate especially when the child is growing. Growth prediction can be defined as the forecast of growth related changes with the objective of predicting the direction and amount of the growth of the maxilla and particularly the mandible as well as the timing of the adolescent growth period.
Maxillomandibular elastics (or intermaxillary elastics) are commonly used because of their simplicity; however, a lack of understanding of their force system can lead to many serious problems.
Elastics are usually classified by the direction of the force (eg, Class II or Class III elastics).
Sometimes force magnitude is considered, but point of force application is left out. Therefore, many different types of Class II elastics can be applied. There are short or long elastics.
Often too many elastics are used when a single resultant elastic at the correct location would work better. However, sometimes more than a single elastic is needed when the attachment point is not directly accessible.
All maxillomandibular elastics and their actions should be analyzed in three dimensions.
Elastics and Elastomeric are routinely used as a active component of orthodontic therapy.
Elastics have been a valuable adjunct of any orthodontic treatment for many years.
There use combined with good patient cooperation provides the clinician with the ability to correct both
Antero-posterior and vertical discrepancies. The latex elastics have become integral part of orthodontics after being first discussed by Calvin. S. case in 1893 at the Columbia dental congress but the credit goes to Henry A. Baker for the use of these elastics in clinical practice to exert a class II intermaxillary forces.
Both natural rubber and synthetic elastomers are widely used in orthodontic therapy. Naturally produced latex elastics are used in the Begg technique to provide intermaxillary traction and intramaxillary forces. Synthetic elastomeric materials in the form of chains find their greatest application with edgewise mechanics where they are used to move the teeth along the arc
After a complete orthodontic diagnosis is made, the next important step is treatment planning. The main objective of treatment planning is to design a strategy to correct the problems. Good strategy helps to design the best appliance indicated for the patient.
Treatment planning is an outline of all the measures that can best instituted for a patient so as to offer maximum long term benefits.
Patients seeks Orthodontic treatment planning for a variety of reasons, most commonly- Esthetics and Function.
There is no simple or fixed formula or a cook book recipe to treat a Orthodontic problem.
Every case is assessed, analysed and and a customised treatment plan is formulated to best suit the individual patient.
The dynamics of the growth of the craniofacial skeleton is a fascinating,complex mechanism.
An understanding of growth events is of primary importance in the practice of clinical orthodontics.
Maturational status can have considerable influence on diagnosis, treatment goals, treatment planning, and the eventual outcome orthodontic treatment.
Various methods have been implemented to measure growth which include measurement on living individual and dry skull and indirect measurement taken by means of virtual reproduction of the craniofacial skeleton.
Essentially,the various study used to assess growth try to find out answers of the following-
pattern of growth
site of growth
amount and rate of growth
direction and factors influencing growth.
Craniofacial growth is a complex and a beautiful phenomenon.
It all begins when a sperm cell fuses with an egg cell, a process called fertilization.
Human fertilization is the union of a human egg and sperm, usually occurring in the ampulla of the fallopian tube. The result of this union is the production of a ’Zygote’ cell, or fertilized egg, initiating prenatal development
Prenatal growth can be divided into 3 main stages:
Germinal stage: From ovulation to implantation(0-2 weeks).
Embryonic stage : 3rd week to 8th week.
Fetal stage: 9th week till birth.
ORTHOPEDIC APPLIANCES:
The appliance that produces skeletal changes by applying orthopaedic forces are known as “Orthopaedic appliance”.
‘Orthopaedic therapy' is aimed at the correction of skeletal imbalance with the correction of any dentoalveolar malocclusion being of less importance, in which little or no tooth movement is desired. Therefore, orthopedic forces are heavier (= 400 gm) when compared to orthodontic forces (50-100 gm).
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Normal Labour/ Stages of Labour/ Mechanism of LabourWasim Ak
Normal labor is also termed spontaneous labor, defined as the natural physiological process through which the fetus, placenta, and membranes are expelled from the uterus through the birth canal at term (37 to 42 weeks
Safalta Digital marketing institute in Noida, provide complete applications that encompass a huge range of virtual advertising and marketing additives, which includes search engine optimization, virtual communication advertising, pay-per-click on marketing, content material advertising, internet analytics, and greater. These university courses are designed for students who possess a comprehensive understanding of virtual marketing strategies and attributes.Safalta Digital Marketing Institute in Noida is a first choice for young individuals or students who are looking to start their careers in the field of digital advertising. The institute gives specialized courses designed and certification.
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Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Azure Interview Questions and Answers PDF By ScholarHat
Clear aligner treatment
1. Clear Aligner Treatment
Guided by- Dr. Jeevan M. Khatri sir
(Professor & HOD)
Dept. of Orthodontics and Dentofacial Orthopaedics
Presented by- Dr. Krutika A. Patankar (2nd YR MDS)
2. Contents:
• Introduction
• Historical aspects
• CLEAR ALIGNERS apart from Invisalign
• Overview of steps in clear aligner treatment
• Case selection and records
• Virtual setup
• Clincheck
• Clinical management.
3. Introduction
• The very need for orthodontic treatment by a majority of adult patients is derived with a desire
for enhancement of dental alignment and facial aesthetics. Although buccal fixed metallic
appliances are efficient treatment systems, the reluctance of their use is mainly due to metal
look, poor aesthetics and fear of pain. Clear plastic aligners’ offer an excellent alternative to
unaesthetic orthodontic treatment with labial fixed appliances
• The clear aligner appliance(s) is nearly transparent, colourless and almost invisible. As
these devices are removable, they allow the patient an additional option to be without
braces for social and professional engagements. The oral hygiene is not a problem with
this appliance and most patients adapt to it very quickly. The success of these types
appliances is intimately related to the compliance in wearing the appliance for a
minimum number of hours and following the required schedule of changing the aligners
as per sequence assigned to the case. Patients are asked to wear the aligners for a
minimum of 22 h/day. Thus, patient compliance is paramount in clear aligner therapy.
• Some of the patients seeking clear aligner treatment are those who have previously
received orthodontic treatment using fixed appliances and have had a relapse or are
unsatisfied with treatment outcome.
4.
5. Historical Aspects:
• You will be surprised to learn that it took almost hundred years to develop the invisible
braces that are being used in the modern days. Here is a phase by phase evolution of the invisible
braces that will provide you with a knowledge of how these tooth aligners were developed and
modified until the invisible braces came into use.
• 1925 – The origin of the dental aligners dates back to 1925 when the ‘Flex-O-Tite’ gum massaging
appliance was invented by Orrin Remensnyder for the treatment of dental diseases like
periodontitis. A slight movement of the teeth was noticed as a side effect.
6. • 1946: KESLING CREATED TOOTH POSITIONER : 20 years down the road in 1946, Kesling invented
his ‘tooth positioner’ which was made from an elastic vulcanite plastic. It was meant to be used
after the orthodontic treatment along with fixed appliances, like dental brackets. The
‘Positioner’ was made based on the ideal position for teeth by way of a cast model at the end of
the treatment, and he found that significant movements could be achieved. Somewhat ahead of
his time, he remarked in his notes the following:
"Major tooth movements could be accomplished with a series of positioners by changing the teeth
on the setup slightly as treatment progresses. At present this type of treatment does not seem to
be practical. It remains a possibility, however, and the technique for its practical application might
be developed in the future."
7. • 1964: NAHOUM’S PLASTIC SHEETS:It wasn’t until 1964 that Dr. Henry Nahoum would build on
Kesling’s idea, albeit with a twist. Nahoum created a method using thermoformed plastic sheets
to move teeth ("The Vacuum Formed Dental Contour Appliance"). This was arguably the first
dental ‘aligner’ to be produced, but Nahoum found that the process was somewhat limited
because of the difficulty found in evenly dividing larger movements into small precise stages.
8. • Sheridan et al. introduced the concept of interproximal tooth
reduction (IPR) for resolution of the lower incisor crowding and alignment of
teeth with the help of labio-lingual clear plastic retainer. His appliance is named
‘Essix appliance’. The method adopted by Sheridan required newest of dental
study model to fabricate each appliance, making this technique cumbersome and
time-consuming for patient, orthodontist and laboratory technician alike.
9. • 1997: ALIGN TECH, GOING MAINSTREAM:In 1997, two MBA students put
together a business plan for what would later become Invisalign. If Remensnyder
was the one creating the concept, Kesling/Nahoum were the ones who began
using it as a treatment method, and Sheridan was the one to clinically validate it,
then it was Align Tech that popularized dental aligners.
10. CLEAR ALIGNERS apart from Invisalign
• CLEAR CORRECT
• BYTE
• CANDID
• ALIGNERCO
• SMILE DIRECT CLUB
• SIX MONTHS SMILE
• INVISALIGN EXPRESS
11. • It is important to understand that clear aligner treatment is a
technique, not a product.
• Certain terminologies associated with Clear Aligner.
• A MIDCOURSE CORRECTION
• REFINEMENT
• INTERPROXIMAL REDUCTION
• ATTACHMENTS
12. Overview of steps in clear aligner treatment
1. Case records and case selection
2. High-quality impressions or intraoral scans
3. 3D virtual set-up and treatment progress stages
4. Approval of treatment steps on the web
5. Construction of aligners’ delivery to treating doctor. Issue of aligners
and review
7. Finishing and retention
13. A COMPARISON BETWEEN EDGEWISE APPLIANCES
AND CLEAR ALIGNERS
• Clear aligner treatment is an orthodontic technique. As such, the
orthodontic principles of force application, engagement, anchorage,
and biomechanics need to be applied to clear aligner technique.
However, clear aligners move teeth differently than fixed appliances
do. Therefore, a clear understanding of the similarities and
differences between fixed appliances and clear aligners is essential for
the clinician when making a decision whether to treat a case with
fixed appliances or clear aligners. Clear aligners are uniquely suited to
treat some malocclusions more efficiently than fixed appliances,
offering better vertical control and superior management of
anchorage considerations. Knowing the strengths and weaknesses of
clear aligners as an orthodontic appliance will assist the clinician in
selecting the best orthodontic appliance to address a specific
malocclusion.
14. FORCE
• A fundamental difference between the way a bracket and wire system
moves teeth and the way clear aligners move teeth is that fixed
appliances pull on teeth while clear aligners push on teeth.
15. Engagement
• Fixed appliances engage teeth via an archwire ligated into the bracket slot. The thicker and more
rigid the archwire, the better the engage- ment. The archwire sequence starts with round, flexible
archwires with a long working range and high elasticity and gradually moves toward rigid,
rectangular stainless steel archwires.
• Clear aligners engage teeth by having align- er material wrapped around teeth. The more aligner
material wrapped around a tooth, the better the engagement.
16. ANCHORAGE
• In fixed edgewise appliances, the most common anchorage model is
that of reciprocal anchorage, based on Newton’s third law: For every
action, there is an equal and opposite reaction.
• In clear aligner treatment, the anchorage segments can be
predetermined and may change at different stages in treatment.
17. Capabilities of fixed appliances versus clear aligners in terms of
extrusion, intrusion, torque, and root inclinations
24. Capabilities of fixed appliances versus clear aligners in terms of
incisor inclination, vertical control, midline correction, and tooth
size discrepancy
25. • Traditionally, orthodontists are trained to be reactive. An adjustment
is made to the appliance and, based on the patient’s treatment
response and the resultant tooth movement, another treatment
decision is made at the next appointment and the archwire adjusted
accordingly. Each treatment decision is made reactively, based on the
treatment response to the adjustment to the orthodontic appliance
made previously.
• Clear aligner technique requires a more pro- active, disciplined
approach. Before a single tooth is moved, the correction of the
malocclusion is visualized through a series of tooth movements made
on a software program and the final occlusion designed into the
treatment outcome. This requires a paradigm shift in the thought
process from being a reactive orthodontist to being a proactive
orthodontist.
32. • Steps and treatment stages with Invisalign system of clear aligners
• 1. A collection of high-quality records. The pre-treatment records are
obtained for documentation and purpose of comprehensive diagnosis
and treatment planning. The essential records include extra and
intraoral photographs, lateral (and PA if required) cephalograms OPG
and relevant X- rays. High quality impressions are obtained with a
polyvinylsiloxane material. The bite is also recorded. The impressions
are sent to the Invisalign office. Since 2007, the iTero scanner, has
replaced the need for traditional dental impressions. In 2013, Align
Technology introduced the iTero imaging system available as a single
hardware platform with software options for restorative or
orthodontic procedures. It has a direct connectivity with Invisalign
and has the option to show patients the outcome of their Invisalign
treatment.
33. • Treatment success begins with a high-quality polyvinyl siloxane (PVS)
impression. Initially, Align Technology used a process called destructive
scanning to produce the three-dimensional (3D) digital image of the
patient’s teeth. It involved pouring the impressions with plaster to produce
a conventional 3D model. Those models were then “scanned” using a
destructive technique whereby the model was photographed from the
occlusal view, milled down slightly, photographed again, milled down some
more, photographed again, etc.
• The destructive scanning method had the advantage that a lab technician
could fix minor imperfections in the impression by repairing the model
prior to scanning. The disadvantage was that it was expensive and time
consuming and produced huge quantities of plaster dust. Align Technology
no longer uses the destructive scanning technique but converts the
impression directly into a 3D virtual model by means of a high-resolution
industrial computed tomography (CT) scan. The special plastic impression
trays must not interfere with the x-ray scanning and there is no plaster
model intermediary on which a lab technician can repair defects, so the
impressions must be perfect.
34. There are three basic impression techniques:
• The easiest but most likely to result in defective impressions involves a one-step
impression using a suitable “medium body” PVS material in the proprietary
Invisalign impression trays. Many orthodontists prefer this method because of the
potential for reduced chair time and expenses. The problem with this one- step
technique is that there is a higher probability of missing the critical anatomy of
one or more teeth, especially the areas distal to the second molars which are
required for proper fit of the aligners.
35. • The second impression technique that can be used is a combination
technique wherein impressions of the second molars are first
captured using a PVS putty material to create a posterior dam. The
medium body material is used over the putty to gain a more detailed
impression of the second molars, as well as to capture the rest of
dentition.
37. • The third impression technique involves a more involved two-step
process. The first step involves making custom trays and Essix-type
retainers that we later describe to the patient as “training aligners.”
When the patient elects to start treatment, an alginate impression is
taken of both arches. The patient is then scheduled to return for final
impressions. The rest of the first step is completed in the laboratory.
The impressions are poured up in the office using standard dental
stone and trimmed as though they were to be used to make Essix-
style retainers
43. • Troubleshooting Problems with Impressions
• The aligner fit is only as good as the quality of the impressions.
• The most common shortcoming with impressions is failure to capture
sufficient detail of the distal of the second molars
• A common error is multiple areas of “drag” near the gingival margin.
These are triangular voids caused by seating the tray with impression
material too quickly into the mouth and not allowing sufficient time
for the material to flow around the gingival margins. This is a critical
error because there is no way to have the appliances properly
trimmed for comfort and effectiveness if the gingival margins cannot
be identified. This can be avoided by seating the impression tray more
slowly
45. • A third common error involves surface or immediate
subsurface air bubbles in the impression. These are created
either by capturing air in folds of the material while loading
the tray due to moving the syringe tip in and out of the
material or by seating the impression tray too quickly into
the mouth and trapping air between the tooth and the
material. If the air bubble is immediately below the surface
of the impression material, the impression may appear to be
of good quality, but when it is scanned with the CT, the PVS
material may not be of sufficient thickness to be resolved on
the image and the tooth will have a large area of distortion
on the virtual model. Both these errors can be avoided by
using proper technique.
47. • The last common error is seating the impression tray too far from or
too close to the buccal or lingual tooth surface so that the impression
material bleeds through to the impression tray and the material
becomes too thin to be resolved on the CT image. These errors
produce a virtual model with the same problems as an air bubble.
This can be avoided by using the correct size impression tray and
seating it properly in the mouth. It should be noted that the
impression trays that are provided by Align Technology are plastic and
are easily customized to the patient by heating the tray and forming it
to the individual patient’s arch form
49. • The Virtual Setup
• When the impressions arrive at Align Technology in Santa Clara,
California, they are scanned using an industrial CT scan to produce a
3D virtual model. The technician uses a best-fit occlusion based on
wear facets and virtual contacts along with the intraoral photographs
provided in the submission kit to articulate the models.
• It is important to understand that the occlusal registration sent with
the impressions is used to verify the occlusion only if the photographs
are of poor quality
51. • Once the virtual models are produced, they are segmented using
Boundary recognition software to define individual teeth. It is
important to remember for future discussion that the impression
generally does not capture the interproximal surfaces of the teeth, so
the software must interpolate that information and estimate the loca-
tion of interproximal surfaces and contact areas. Once that is
accomplished, virtual “roots” are placed
52. • The technicians recreate the virtual gingival margins using morphing-
type software to mimic the gingival conditions seen on the clinical
photographs
53. • The preparation work is finished at this point, and the virtual model is
forwarded electronically to the TREAT (Align Technology, Inc.)
operator to perform the virtual setup and staging. TREAT is the
proprietary software that Align Technology uses to simulate
treatment and set up the virtual model to allow the manufacture of
the aligners. It is a sophisticated 3D graphics program that gives the
operator great control of tooth position and rate of tooth movement.
It is not the software that the orthodontist uses to view the virtual
model, which is called ClinCheck (Align Technology, Inc.).Once the
virtual setup is completed and approved by the orthodontist, a series
of plastic models is fabricated using stereolithography on which the
aligners are then made by a thermoforming process.
54. Direct Digital Manufacturing
• Due to the time and expense of producing PVS impressions, shipping them
to Align Technology, scanning them once received, and subsequent
processing of the image data into a usable format, there is emphasis on
finding a method of direct digital conversion of the dentition into a usable
3D image. Currently, there are two promising technologies: cone beam CT
(CBCT) and intraoral light scanners. Both of these technologies have the
potential of producing an image that would be of a sufficiently high quality
that the orthodontist would be able to capture the image directly in their
office and then electronically transmit that image to Align Technology to
have the appliances made.
• The advantage of direct digital capture of the dentition would be (1) the
elimination of the need for PVS impressions and their inherent potential
for clinical errors and (2) reducing the time needed to produce appliances
because the image would be transmitted instantly to Align Technology via
the Internet. There are still multiple challenges remaining with both
approaches. However, prototype appliances have been made using both
techniques and it is likely that one or both approaches to direct digital
manufacturing will be available in the future.
55. Clincheck
• The clinicians download the virtual treatment set-up, stage by stage
at the dedicated Internet site and if required request for modification
of treatment/tooth movement sequence. This step is called ‘Clin
Check’. In 2016, Invisalign launched the new Clin-Check Pro 6.0 that
provides a 3D modelling of the whole treatment
56. • Once the step-by-step progress of the patient’s treatment is reviewed by
the treating doctor, he may ask for any changes at this stage concerning the
sequence of tooth movement or plan of the treatment. Once precise
treatment plan and course of tooth movement has been finalised, the
aligners are made and dispatched to the Orthodontists.
• The number of Aligner made may vary.
• Clinical management with Invisalign aligners. Some aligners
• for a patient vary according to the severity of the malocclusion. Invisalign
offers the following treatment modalities:
• a. Invisalign Full: It is the most commonly used course of therapy.
“Invisalign Full” is used for treating complex malocclusion conditions.
• b. Invisalign Lite: Providing for less complex alignment problem cases,
Invisalign Lite uses up to 14 aligners.
• c. Invisalign i7: This was developed for the cases of minor dental
corrections. It comprises up to seven aligners.
• d. Invisalign Teen: With teenagers, there is commonly a period of rapidly
shifting changes occurring as they grow. Invisalign Teen was developed to
help accommodate these issues with some special features.
57. • Historically, each aligner was supposed to be worn for 2 weeks, and
patient visits the doctor every 4–6 weeks. The new G7 features,
introduced in 2016, allow the patients to change aligners every week.
However, it is the practitioner’s discretion and the type of movement
required which decides the schedule of change of the aligners. The
appliance is recommended to be removed during eating and to brush
the teeth. The patient should be warned to safeguard the appliance
as its chance of being lost is great due to its colour-less structure.