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
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
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
Introduction
History
Indications and contraindications
Timing of distalization
Second molar extraction
Mandibular molar distalization
Rickett’s criterion
Classification and various distalization appliances
References
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
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.
Mode of action of functional appliances /certified fixed orthodontic courses ...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
Loops in orthodontics /certified fixed orthodontic courses by Indian dental ...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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
Hi this is a very good powerpoint presentation on a limited topic on net that is DEPROGRAMMING SPLINT just have a look to it and any suggestions most heartly welcome
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
Dr. William Roth
Introduction
The Roth Rx
Reasons For Modification
Treatment Philosophy
Treatment Goals
Roth Rationale
Selection Of Treatment Mechanics
Roth Set-up
Sequencing Of Treatment Objectives
Treatment Mechanics
Anchorage Considerations
Detailing Of Tooth Position
Advantages
Comparisons
Conclusions
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
Introduction
History
Indications and contraindications
Timing of distalization
Second molar extraction
Mandibular molar distalization
Rickett’s criterion
Classification and various distalization appliances
References
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
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.
Mode of action of functional appliances /certified fixed orthodontic courses ...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
Loops in orthodontics /certified fixed orthodontic courses by Indian dental ...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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
Hi this is a very good powerpoint presentation on a limited topic on net that is DEPROGRAMMING SPLINT just have a look to it and any suggestions most heartly welcome
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
Dr. William Roth
Introduction
The Roth Rx
Reasons For Modification
Treatment Philosophy
Treatment Goals
Roth Rationale
Selection Of Treatment Mechanics
Roth Set-up
Sequencing Of Treatment Objectives
Treatment Mechanics
Anchorage Considerations
Detailing Of Tooth Position
Advantages
Comparisons
Conclusions
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 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.
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.
AI is transforming the field of orthodontics in exciting ways. New technologies like independent tooth movers are using algorithms to customize and automate tooth movement for each patient. ###How It Works
These AI-powered devices use 3D modeling to analyze your unique smile and tooth positions. They then develop a personalized plan to move each tooth independently into the ideal position, all while monitoring progress and making tiny adjustments along the way.
Rather than traditional braces that move all your teeth at once, these smart devices focus on shifting each tooth individually. They use small robotic arms to apply miniscule forces to specific teeth so they glide gently into place. The process is slower but leads to a more natural-looking smile in the end. Patients report significantly less discomfort too.
The best part is how these AI systems learn and improve from every patient. They accumulate massive amounts of data to better understand how teeth respond to different forces. Over time, the algorithms get smarter and treatment becomes faster, more precise, and tailored to your own unique needs. ###A Promising Future
The possibilities seem endless. But for now, the ability to transform your smile with minimal pain and in as little as 6-18 months is pretty groundbreaking. AI-driven orthodontics may soon make a perfect smile more achievable than ever before. The future is digital, personalized, and full of promise.
What to Expect During AI-Guided Orthodontic Care
Once you’ve decided to move forward with AI-guided orthodontic care, here’s what you can expect at your initial appointment and during treatment:
Consultation and Scan
Your orthodontist will examine your teeth and jaw to determine if you’re a candidate for AI-driven tooth movement. If so, they’ll use an intraoral scanner to capture highly detailed 3D images of your teeth and gums. These digital impressions provide precise data for your personalized treatment plan.
Custom Aligner or Wire Fabrication
Based on your unique anatomy, the AI will design a series of tight-fitting plastic aligners or a customized archwire to gradually shift your teeth into proper alignment. Your orthodontist will review and approve the plan before your aligners or wire are fabricated.
Progressive Tooth Movement
Rather than adjusting bulky braces every few weeks, you’ll switch out your aligners or get your wire tightened every 7-14 days to keep slight, constant pressure on your teeth. The AI has calculated how far your teeth can move during each phase to maximize effectiveness and minimize pain. With frequent changes, you’ll start noticing small improvements in just a couple of weeks.
Conclusion
So there you have it, the future of teeth straightening is digital and personalized. Gone are the days of uncomfortable metal braces for years on end. New advancements in AI and 3D printing are making customized clear aligners tailored to your unique smile and needs more accessible than ever before.
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.
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 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
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
3. contents
Introduction
Advantages
Brief history of clear aligner treatment
Impression techniques and digitization
what is Clin check software ?
Smart Force features
and Attachments
4. Biomechanics
Clear Collection instruments for clear aligner treatments
A Clinical Case Treated with Clear Aligners
Accelerated Extraction Treatment
with Invisalign
Periodontal considerations
Summary
5. Introduction
• Clear Aligners are an alternative to traditional braces and
are designed to help guide teeth into their proper position.
• Similar to braces, clear aligners use a gradual force to
control tooth movement, but without metal wires or
brackets.
• The aligners are made of a strong plastic material and are
fabricated to fit each person's mouth. If a series of aligners
are made, each aligner moves the teeth a little bit more into
place until the desired movement is completed.
6. • Aligners are worn for at least 20 hours a day to reach the
desired maximum effectiveness.
• Each aligner is worn for three weeks before changing to
the next one. The length of treatment with aligners
depends upon the severity of each case.
• Typically, aligner treatment can be as short as three
weeks or as long as six months. Still, a much shorter
treatment than traditional braces.
7. • Each aligner is designed to move the teeth a maximum of
about 0.25 to 0.3 mm over a 2-week period, and is worn
in a specific sequence.
• The Invisalign appliance is currently recommended for
adults and for adolescents with fully erupted permanent
teeth who meet an acceptable standard of compliance.
• Excellent compliance is mandatory since the appliance
has to be worn a minimum of 20 to 22 hours a day and
each aligner should be worn 400 hours to be effective.
8. • Scheau et al proposed the first thermoforming machine to synthesize
orthodontic appliances in 1966.
• Currently 2 types of thermoforming machines ,The Ministar and Biostar
(scheau Dental)
9. Advantages
• Clear aligners are removable so it is easier for you to
brush and floss after meals.
• Clear aligners are easier to keep clean.
• Clear aligners are comfortable and less likely to irritate
your gums and cheeks.
• Clear aligners can prevent tooth wear from grinding.
10. Brief history of clear aligner treatment
• Clear aligner treatment falls into
• ESSIX RETAINER INVISALIGN
11. • The first category consists of thermoformed appliances
sometimes known as ESSIX RETAINERS.
• This are fabricated by making adjustments to the tooth
positions on plaster or stone models and fabricating one
or more aligners to correct a minor malocclusion.
• The second category is Invisalign is a proprietary
orthodontic technique that uses a series of computer
generated custom plastic aligners to gradually guide the
teeth into proper alignment.
• It is both a brand name and a technique and is used
synonymously.
12. • Invisalign is the only computer aided design and
manufacturing (CAD – CAM) Precision aligner product
available in united states.
• The company and the technique was the brainchild of
two graduate business student at Stanford university –
1997,Kelsey Wirth and Zia Chishti.
13. Impression techniques and digitization
• Invisalign impression trays are available in various
sizes to accommodate all patients and can be ordered
online for free from Invisalign.
• Specifically designed for Invisalign treatment planning,
the Invisalign trays fit uniquely in the digital scanners
that “read” the impressions.
• Invisalign scanners read only vinylpoly siloxane (VPS)
material, so it is imperative that other materials (e.g.,
alginate alternatives, polyether materials) not be used.
14. • Ideal impression material systems (e.g. Flexitime,
Heraeus Kulzer) include putty and light wash materials,
a combination that captures the details necessary for
creating Invisalign aligners.
• Such details include all margins and anatomical
landmarks. Additionally, these materials set easier and
avoid running and slumping.
16. Digitization
• The Virtual Setup
• After the impression arrives at Align Technology in
Santa Clara ,California they are scanned using an
industrial CT scan to produce a 3D Virtual model.
• Once the Virtual models are produced they are
segmented using boundary recognition software to
define individual teeth.
• Once the interproximal surfaces of the teeth are
assessed and virtual roots are placed and lastly the
gingival margin also created using morphing type
software.
18. • The preparation work is finished and than submitted
to TREAT ( Align Technology Inc).
• It is a Proprietary software that align technology
uses to simulate treatment and set the virtual model
to allow the manufacture of the aligners.
• Once the virtual model is completed and approved
by the orthodontist , a series of plastic models is
fabricated using stereolithography on which the
aligners are then made by thermoforming process.
21. Clin Check
• The software used by the
orthodontist in the office is called
clin check.
• It allows the orthodontist to view the
treatment in all the aspects as well as
superimpose one stage of treatment
over another to visualize individual
tooth movements so as to gauge the
probability of accomplishing the
desired movement that will be
biologically feasible.
22. Attachments
• The New Attachment Protocol allows for attachments to be
passive or active. Passive attachments are for aligner retention
and anchorage for intrusion.
• Active attachments are used for rotations of rounded teeth,
extrusion and root correction. Currently Align Technology has
three types of attachments for commercial use: the ellipsoid,
rectangular and the beveled attachment.
23. • Ellipsoid attachments are often placed horizontally and are the
default for anterior tooth extrusions.
• They are 1mm in thickness and placed between the cervical and
middle third of the tooth.
24. • Vertical rectangular attachments as seen in are the default for rotations of
canines and premolars.
• In addition, these attachments are used for root control on teeth adjacent to
extraction spaces. For premolar extraction cases, the default is placement of
two rectangular attachments distal to the space and one mesial to the
extraction space.
• Typically these attachments are 1mm thick, 2mm wide and either 3, 4 or 5
mm long.
25. • The vertical rectangular attachments are very retentive, so take
care when placing multiple attachments in one quadrant. The
aligner can become too retentive for patient convenience. An
interesting option is the beveled attachment for rotations.
• Sometimes the rectangular attachments don’t fi t perfectly and
during rotation can put unintended forces on the tooth, resulting
in side effects. Beveling the attachment can ease the fi t and
make the attachment “active,” causing rotation.
26. Smart Force features
and Attachments.
Designed to help you treat with confidence.
SmartForce Features are:
Engineered to deliver the force systems necessary to achieve more
predictable tooth movements.
Customised to each tooth using advanced virtual modeling, including such
features as the width, long axis, and contour of the entire tooth.
Positioned more precisely to deliver the necessary forces while eliminating
interferences. automatically placed in accordance to the desired movement.
27.
28.
29.
30. • IT CAN BE USED FOR
• For diagnosis and treatment planning evaluate the need for
IPR, Expansion, Extraction, Distalization or proclination.
• For verifying that technician has performed modifications.
• As a consultation device to show treatment limits to patient
• For verifying if aligner is tracking.
• Indian journal of Dental Sciences June 2011 Issue 2,Vol 3
32. Biomechanics
• “ The use of aligners is far more complicated than most people believe
.It takes a knowledgeable clinician with considerable experience to use
the appliance to its maximum. What that maximum is I don’t know”
• In order to determine just what that maximum height be
with invisalign in its current rendition of aligner
materials , we must examine the biomechanics of tooth
movement with invisalign.
33. • Aligner Bio-Mechanics!
• By: Dr Willy Dayan
• Willy Dayan's Golden Rules of lnvisalign Bio-mechanics
1) Think Like Plastic and Feel Like a Tooth: lnvisalign is a
removable
• appliance and thus cannot glue to teeth in order to "pull" them;
the aligner can only "push" on surfaces of the teeth or surfaces
of attachments. When a force is placed upon at tooth, it will
move according to biomechanical principles that exist, no matter
what the computer screen shows.
34. 2) The Clincheck Video is not Teeth Moving: Stop watching the
• ClinCheck movements as "moving teeth"! Think of the images as
representing the anatomy of the "changing inner aligner
surfaces", and then analyze the resulting forces the aligner will
exert upon the teeth.
www.orthoclined.com
www.orthocoaching.com
drwillydayan@gmail.com
35. Controlling Torque
• A net force of 40gm (base level force of an aligner after 48hrs)
intended to move the teeth lingually would require the moment
of 320 to 400g-mm (M/F ratio- 8/10) for bodily movement or
greater than 400gmm for lingual root movement.
• Improper attachment design or placement allows the delivery of
only 280g-mm moment in conjuction with 40g force resulting in
controlled lingual crown tipping .
• It must be kept in mind that the aligner provides the same level
of force on both sides of the teeth,even though the forces may be
in opposite direction .
36. • This means that in the absence of spaces to close, Just as with
fixed appliances, There must be some outside force system such
as interarch elastics to provide a net distalizing force on the
maxillary anterior teeth to produce lingual root movement.
• There is an inherent problem with rectangular attachments,
because it is difficult for the patient to insert and remove the
aligners.
• If the attachment and the aligner are not completely coupled then
the result is an unwanted force system and unpredictable tooth
movement.
37.
38. • In order to facilitate greater ease of insertion and removal as well
as eliminate the all or none situation the beveled attachment was
developed by rotating a portion of the rectangular attachment
virtually into tooth surface. ( see fig)
39. • The beveled attachment can be utilized in multiple orientations
simply by having the technician rotate the attachment in a
different manner.
• There are theories that rotating the bevel in a specific directions
will enhance specific movements.
• An alternative to the attachments that help facilitate torque
control is the power ridges. These are engineered corrugations
placed at specific locations to enhance the undercut near the
gingival margin of teeth undergoing torqueing movements.
40. • The ridge function in two ways . The first is to stiffen the gingival
third of the aligner to make it more resilient .
• The other is to provide additional force as close to the gingival
margin as possible to increase the effective moment arm of the
aligner .
• The obvious advantage to power ridges is that attachment need
not be placed or removed and they are more esthetically
acceptable to the patient.
41. Root parallelism
• Another aspect of biomechanics especially pertinent to extraction
treatment is to control tipping in order to achieve root parallelism.
• An idea dating back to the late 1800s was to place an attachment
on the gingival aspect of a bracket extending toward the center of
resistance in an attempt to decrease the amount of tipping when
teeth are moved mesiodistally.
• These gingival extensions are often described as power arms, they
are added to the force system with invisalign in an attempt to alter
the force- moment system.
42. • It accomplishes two things, first it moves the application of force
closer to the center of resistance, second it creates a secondary
moment due to presence against the distal of the aligner.
• Unfortunately, often canines remain upright during retraction into
premolar spaces, while the molars especially maxillary molars
tend to tip mesially.
• This is frequently referred to as dumping. It also occurs when the
molars are simply being used as anchorage for anterior retraction.
This is probably caused by the undesirable crown to root ratio
combined with the large root surface area over which the forces
are distributed.
43. • Work is currently being done with various attachment designs, to
demonstrate the ability to predictably avoid molar dumping by
placing two 2mm*2mm*2mm attachments on the upper first or
second molar as shown in the fig
44. Rotations
• Correcting rotations with aligner can be problematic.
• There are primary reasons for this.
• 1) first is that aligners produce tooth movement by the plastic
being slightly distorted and then elastically rebounding back to
the predetermined shape and carrying the tooth with it.
• Even with the properly designed attachment ,another problem
with rotations is that the tooth root is not a cylinder, and because
of dilacerations and root surface variations, there is no way the
computer software can adequately estimate the true rotational
long axis.
45. • For this reason we need to use auxiliaries either before ,during or
after aligner treatment in order to accomplish the rotational
correction.
46. Extrusions
• Extrusion can also present problems with the aligners. The
reasons for this is similar to that of rotations.
• One method being used to overcome this problem with some
promising results is to use the gingivally beveled attachment to
provide a longer surface that can be elastically deformed and
provide an extrusive force on the tooth.
47.
48. • Other auxiliaries can be used to facilitate specific movements.
Class II and class III elastics are frequently needed just as they are
with fixed appliances.
• One can either attach the elastics directly to the aligner or attach
elastics to buttons bonded to the teeth.
49. • Keep in mind that if the elastics are directly attached to
the aligner, then attachments are generally required to
prevent displacement of the aligner.
• Toe nail clippers can be used to cut slits in the aligners
for elastic placement.
• They have the advantage of producing a slit that is both
contoured to the papillary embrasure form and that has
a blunt apex to the slit does not tend to propagate and
split the aligner.
50. • Mini screws can also be used effectively with the aligners in the
same manners as they can with fixed appliances, either planned
initially as part of the treatment or to help with movements that
are not progressing as desired.
• H highly placed
• canine
51. • Another vertical movement that is easily enhanced with mini
screws is the intrusion of molars that have supra erupted into an
edentulous space.
52. Clear Collection instruments for clear aligner
treatments
• The Tear Drop
• The Tear Drop pliers is an instrument created for the purpose of
adding a notch or hook at the gingival margin of clear aligners.
• A standardized notch is easily cut in a single step, creating a
teardrop-shaped “reservoir” to hold the elastic on the tray ,
thereby making it easier for the patients to seat their aligner and
connect their elastics.
53. Hu-Friedy’s Clear Collection of instruments
designed to enhance clear aligner treatment
Orthodontic Practice US Volume 6 Numbers 3 & 4
54. Teardrop-shaped hooks retain elastics when aligners are seated, making the
addition of “rubber bands” easier for patients to manipulate. Notches are
made at an angle to resist forces applied by the elastics
Orthodontic Practice US Volume 6 Numbers 3 & 4
55. The Hole Punch
• The Hole Punch is used to cut a half-moon shaped hole at the
gingival margin of aligners.
• These half-circle cuts permit the addition of bonded buttons,
bonded orthodontic tubes or brackets with associated hooks, or
are simply used to relieve impingement of plastic on soft tissue.
Orthodontic Practice US Volume 6 Numbers 3 & 4
56. Class I intramaxillary elastics connected from teardrop hook to a miniscrew (i.e., to support molar
distalization) plus Class II intermaxillary elastics from teardrop notch to bonded button.. Intermaxillary
elastics hookedto bonded buttons to assist with seating of teeth into aligners and improve occlusion
57. The Hole Punch pliers can be used to
relieve plastic impingement of gingival tissues anywhere
along the aligners (e.g., incisive papilla irritation
Orthodontic Practice US Volume 6 Numbers 3 & 4
58. Bootstrap mechanics
• If certain teeth are not “tracking” or are lagging behind (i.e., not
fitting into the tray; Aligner Chewies™ are employed (Chewies™
Aligner Tray Seaters, Dentsply Raintree Essix, York, Pennsylvania).
Patients are asked to hold the Chewie between the teeth in
question and squeeze 10-15 seconds, release, and repeat for 5
minutes, 2-3 times per day.
Orthodontic Practice US Volume 6 Numbers 3 & 4
59. Aligner “lag” or lost tracking is most often characterized as an “air gap”
between the incisal or occlusal of teeth and the plastic, indicating teeth
are not following the prescribed tooth movement
Orthodontic Practice US Volume 6 Numbers 3 & 4
60. Aligner Chewies are held tightly been specific “lagging” teeth for 10-15
seconds. This process is repeated for 5 minutes, 2-3 times daily, especially
when changing to a new pair of aligner trays
61. Bootstrap mechanicsto forcibly erupt a “lagging” tooth using
orthodontic elastics . The Hole Punch is employed to clear aligner
plastic to permit the addition of bonded buttons. The Tear Drop is
used to cut notches in mesial and distal embrasures
Orthodontic Practice US Volume 6 Numbers 3 & 4
62. The Vertical
• The Vertical is used to produce an indentation at the mesial or
distal of a specific tooth in the facial and/or lingual aspects of the
aligner plastic.
• These indentations are made without heating the pliers and at a
very shallow depth so as to not compromise the integrity of the
plastic.
Orthodontic Practice US Volume 6 Numbers 3 & 4
64. The shallow indentations are produced without heating the pliers,
producing “contact points”
to assist with rotational
couples, including situations with composite “attachments”
, enhancing molar distalization , or root paralleling
65. The Horizontal
• There are instances where we would like to accentuate root
torque for specific teeth during clear aligner treatment.
• In other instances, there is a need to increase the retentiveness
of aligners or clear retainers. The Horizontal is an instrument
designed to accent labial or lingual torque for individual teeth,
and it can also be used to simply increase the retentiveness of
clear aligners or retainers.
Orthodontic Practice US Volume 6 Numbers 3 & 4
66. In addition, the Horizontal is used to reduce “lag” by
accenting extrusive or intrusive movement by applying
contact points immediately adjacent to composite
attachments
67. A Clinical Case Treated with Clear Aligners
• Clinical Case
• A 26-year-old female presented with a Class I malocclusion and
an orthognathic profile. She was in the permanent dentition with
retroclined maxillary central incisors, moderate overbite, spacing
distal to the maxillary canines and mild crowding in the
mandibular arch Her primary concern was the alignment of her
maxillary incisors and she refused to have fixed appliances. The
treatment objectives using Invisalign® were to align her front
teeth, close space in the maxillary arch and alleviate crowding in
the mandibular arch
IJO VOL. 22 NO. 2 SUMMER 2011
69. • Invisalign® treatment involved 24 upper and 10 lower aligners.
Attachments were placed on several teeth to achieve a more
predictable tooth movement using aligners. The patient wanted
to reduce treatment time as much as possible and was instructed
to change the aligners every 10 days instead of 14 days.
• After 8 months of initial treatment, a Case Refinement with 7
more aligners was needed to finish the maxillary arch. Once
treatment was completed (Figure 7), a bonded lingual fixed
retainer was placed on the maxillary incisors to prevent relapse
IJO VOL. 22 NO. 2 SUMMER 2011
71. • The aligners have demonstrated excellent results in anterior
alignment and good improvement in occlusion, transverse
relationships and overbite correction.
• It is also possible to notice a reasonable improvement in midline
position and overjet.17-18 Invisalign® can be quite effective in
correcting deep bites and mild crossbites by facilitating anterior
intrusion while disocluding the posterior teeth.
• Patients with bruxism are good candidates for this treatment, as the
aligners prevent occlusal wear and reduce pain in facial muscles and
joints. Patients with extensive restorations and/or prostheses can
benefit as well, as bonding orthodontic accessories can be more
difficult
73. Accelerated Extraction Treatment
with Invisalign
• This 26-year-old female expressed a desire to correct her
maxillary anterior crowding and improve the esthetic appearance
of her smile. The patient’s facial profile was straight, but both lips
were slightly recessive with regard to the E-line.
• Intraoral examination showed a Class II molar relationship with a
3mm overjet, a 1mm overbite, and coincident midlines. The arch
length discrepancy was 13mm in the maxilla and 10mm in the
mandible. We noted infralabioversion of both upper canines
74.
75.
76.
77.
78.
79.
80.
81.
82.
83.
84.
85.
86.
87. • Aligners are not only esthetically pleasing to adult patients but,
because they are easily removed, extremely safe. In the future,
aligners are likely be used in even more complex cases involving
rotations, deep overbites, open bites, and unusual extractions.
• Further clinical investigations are needed into the effects of
accelerated tooth movement in such cases.
88. Periodontal considerations
• There is a body of evidence growing that orthodontic treatment
with aligners has less detrimental periodontal impact than that of
fixed appliances.
• Miethke and Vogt and Miethke and Brauner compared the
periodontal health of the patients who underwent the treatment
with aligners to that of patients who underwent treatment with
both labial and lingual fixed appliances
• Boyd found that periodontal health could actually improve during
the course of the treatment.
89. Summary
• Not all malocclusions are amenable to treatment solely with the
invisalign system.
• Treatment of many malocclusions with proper tip ,torque, arch form
and aesthetic crown inclination is possible to achieve with aligners.
90. References
• 1) orthodontics current principles and techniques – Graber,
Varnsdall,Vig
• 2) Invisalign – Emperor’s New cloth – Indian journal of dental
sciences june 2011 ;2;3
• 3) INVISALIGN INSTRUCTION MANUAL – McGill University
• 4) Aligner Bio-Mechanics - ORTHODONTIC CLINICAL
• EDUCATION CORP.
91. • 5) Invisalign ClinCheck 3.0 User Guide
• 6) Invisalign Orthodontic Treatment - Richard Bouchez
• 7) Clear Collection instruments for clear aligner treatments -
Orthodontic Practice US Volume 6 Numbers 3 & 4
• 8) Smart Force features and Attachments – Invisalign.