1/26/2011. To Start or Not to Start? Secrets to Invisalign Patient Selection. 4 Secrets to Patient Selection

Transcription

1 To Start or Not to Start? Secrets to Invisalign Patient Selection Dr. Ben Miraglia Ask the Expert Webinar January 21, 2011 The statements, views and opinions expressed in this program and related course materials are those of the speaker. Align Technology, Inc. may not endorse such statements, views or opinions. Attendees are responsible for legal and regulatory compliance of any marketing and referral programs. 4 Secrets to Patient Selection Stable/Healthy Periodontal Structures Secret 1 The Maxillary Arch is The Key Secret 2 Diagnose and Treat The Cause Secret 3 Transverse Measurement Secret 4 Buccolingual Inclination 1

2 Secret 1 The Maxillary Arch is The Key The Maxillary Arch is The Key It is NOT about the amount of crowding It is NOT about the lower anterior teeth It is NOT about the age of the patient It is ALL about the shape and width of the maxillary arch which means It is ALL about the POSTERIOR TEETH which leads us directly into... WHAT CAUSES CROWDING? Secret 2 Diagnose and Treat The Cause 2

3 Causes of Crowding 1. Improper Arch Form Improper Arch Form V shaped arch Omega shaped arch Square/Box shaped arch Any combination of the above ALL BAD ARCH FORMS What does good arch form look like? 3

4 Causes of Crowding 2. Improper Arch Width Improper Arch Width Uncrowded adults have a 35 39mm Transverse Measurement(Secret 3). The Transverse Measurement is the shortest distance between teeth 3 and 14 (upper first molars) measured at the gum line. Transverse Measurement 4

5 Causes of Crowding 3. Improper Torque of Anterior Teeth i.e. The roots are out of position Causes of Crowding 4. Large Teeth Small Average Large < 8.0 mm 8.9 mm >10 mm Width of upper central incisor 5

6 NOT Causes of Crowding Too Many Premolars Too Many Lower Incisors Secret 4 Buccolingual Inclination Buccolingual Inclination The buccolingual inclination of the maxillary and mandibular posterior teeth is assessed by using a flat surface that is extended between the occlusal surfaces of the right and left posterior teeth. There should not be a significant difference between the heights of the buccal and lingual cusps of the maxillary and mandibular premolars and molars with all cusps within 1mm of the straight edge. 6

7 Buccolingual Inclination Buccolingual Inclination Buccolingual Inclination 7

8 What is the significance of this? Occlusal Forces Axial (vertical) vs. Lateral (horizontal) Mario & Luigi Beth 8

9 Beth Beth Beth 9

10 Beth Beth Beth Clincheck File 10

11 11

12 Beth Robert - Before Before 12

13 Before Before Before 13

14 Before Before Robert - Clincheck Clincheck File 14

15 15

16 28 Total Aligners Laura Laura 16

17 Laura - Before Laura - Before Laura - Before 17

18 Laura - Before Laura - Before Laura ClinCheck File 18

19 Laura Laura Laura 19

20 Laura Laura 4 Years Later Laura Before & 4 Year Follow Up 20

21 Laura Before & 4 Year Follow Up Laura Before & 4 Year Follow Up Laura Before & 4 Year Follow up 21

22 Olivia Olivia Olivia 22

23 Olivia Olivia Olivia 23

24 Olivia Olivia Clincheck File 11 Aligners 24

25 Aligner 12 6 Months Aligner months Aligner 23 25

26 Aligner Aligners - Refinement 26

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28 Summary Focus on the Maxillary Arch Pay attention to the Posterior Teeth Arch Form and Arch Width What Caused the Crowding? Transverse Measurement Buccolingual Inclination 28

29 Thank You To obtain your CE certificate for this program please complete a brief survey at: Upon completion of your survey* you will have immediate access to your CE certificate. *This survey is only available to the participants who attend the live presentation via the webinar/phone. Participants who complete the archived program on AligntechInstitute.com need to complete a CE test to obtain their CE certificate. 29