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    TREATMENT PROTOCOLS with aligners

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    drvrundashah2007

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    TREATMENT PROTOCOLS with aligners

    Uploaded by

    drvrundashah2007
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    © All Rights Reserved
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    Download as docx, pdf, or txt
    1 views4 pages

    TREATMENT PROTOCOLS with aligners

    Uploaded by

    drvrundashah2007

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 4

    TREATMENT PROTOCOLS

    Selection criteria :

    1. Fully erupted permanent teeth


    2. Growth has minimal or no effect on treatment (i.e., late adoescents and adults). Mild
    spacing (1-3 mm), moderate spacing (4-6 mm),
    3. Mild crowding (1-3 mm), moderate crowding (4-6 mm)
    4. Narrow arches that are dental in origin(4-6 mm)
    5. Treated cases with relapse Orthodontic movements which can be produced
    effectively.
    6. Tooth movement following Interproximal reduction, ,
    7. Flaring,
    8. Distalization,
    9. Space closure following the extraction of a lower incisor

    Certain malocclusion more difficult to treat: Crowding and spacing over 5mm, Centric
    relation and centric occlusion discrepancies, Severely rotated teeth (more than 20 degrees),
    Open bites (anterior and posterior),Extrusion of teeth, Severely tipped teeth (more than 45
    degrees).Teeth with short clinical crowns, Arches with multiple missing teeth, Closure of
    bicuspid extraction spaces.

    Factors consideration

    1. Patient cooperation is a critical factor in achieving success with aligner treatment. The
    aligners should be worn at least 20 hours per day, seven days a week.
    2. Successful clear aligner treatment requires considerable clinical experience with other
    orthodontic methods, proper implementation of diagnosis and treatment planning, and
    a thorough knowledge of biomechanics.
    3. In any case, if the teeth tip more than 5° from the vertical axis during space closure,
    fixed appliances will probably be needed to upright them.
    4. If tipping exceeds 10°, the clinician should either incorporate a fixed appliance
    segment to upright the tipped teeth or convert to full fixed appliances to finish
    treatment.
    5. Recently, Nelson, described several advantages of the aligner software that were
    summarized from a meeting. “The set-up can be used for diagnosis and treatment
    planning –- evaluate the need for IPR, expansion, extraction, distalization, or
    proclination” as well as:
    i. Verifying that the technician has performed modifications,
    ii. A consultation device to show treatment limits to patient,
    iii. Verifying that the aligner is tracking,
    iv. Evaluating anchorage with the superimposition or surgical simulation tools
    and staging, and
    v. Addressing the patient’s chief concern (of anterior tooth alignment) at the
    beginning of the series, and applying simultaneous movements to reduce the
    overall number of aligners.”

    Advantages:

    1. Unlike traditional braces, the trays can be removed for brushing, flossing, and
    eating.
    2. The trays are clear, esthetic, comfortable - no metal brackets or wires to cause
    mouth irritation.
    3. Better oral hygiene than fixed. Teeth can be bleached with the appliance at the
    beginning and during treatment
    4. Shorter appointments.
    5. Decreased doctor & auxiliary time.
    6. Decreased allergic response.
    7. Retention facilitated.
    8. Decreased occlusal abrasion from parafunctional habits during treatment.
    9. Disarticulation of the teeth may be advantageous for patients with TMJ problems.
    Technically much easier than lingual appliances.
    10. Ability to present case to patient with final result prior to treatment.

    Limitation:
    1. Primary among them is compliance. Because the aligners are removable, the
    orthodontist must rely on the patient's motivation and dependability to achieve the
    desired results.
    2. All permanent teeth should be fully erupted for treatment using this appliance.
    3. There is currently no capability to incorporate basal orthopedic change with this
    appliance system.
    4. Due to the fact that the surface anatomy of the teeth cannot undergo change during
    treatment as it will affect the fit of aligners, major restorative work should be
    performed for the commencement of treatment.
    5. Lack of operator control.
    6. Inability to integrate hard and soft tissues of the head into the computer treatment.
    Thus, the clinician has no direct indication of where teeth are in relation to basal bone
    or in relation to the lips or other soft tissues of the head.

    References

    1. Brown P, Bayirli B, Gaynier B, Vazquez D. Comparison of Invisalign to fixed


    orthodontic treatment using
    ABOindices.http://iadr.confex.com/iadr/2007orleans/techprogram/abstract_91
    421.htm., 2007.
    2. Sims MR. Brackets, epitopes and flash memory cards: a futuristic view of
    clinical orthodontics. AustOrthod J. 1999;15(5): 260–268.
    3. Jones ML, Mah J, O’Toole BJ. Retention of thermoformed aligners with
    attachments of various shapes and positions. J ClinOrthod. 2009;43(2):113–
    117.

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