Lower Incisor Extraction Cases. With Invisalign. Thank You 4/15/2010. Dr. Willy Dayan April 9, 2010

Transcription

1 Lower Incisor Extraction Cases With Dr. Willy Dayan April 9, Thank You 2 The statements, views and opinions expressed in this workshop 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. 3 1

2 After Today s Presentation Before After Case 1 Case 2 Case 3 4 What is the secret to this success. New Thinking! Today s Objective Introduction to Bio-Mechanics The Lower Incisor Extraction Case 6 2

3 Today s Objective Introduction to Bio-Mechanics The Lower Incisor Extraction Case 7 How do we achieve control and predictability with? 8 How do we achieve control and predictability with? Think Like Plastic & Feel Like a Tooth! 9 3

4 How do we achieve this control and predictability with? Think Like Plastic & Feel Like a Tooth! Do we pull the doors open or push them open? Value of the right kind of handle shape and location. 10 ATTACHMENTS 11 1 year old and still intact, fitted and complete. Today s Objective Introduction to Bio-Mechanics The Lower Incisor Extraction Case 12 4

5 Orthodontics is not just Straight Teeth Skeletal Foundation Posterior Interdigitation Anterior Guidance ( used inward to Cr, checked outward from Cr) Transverse Relations Vertical Dimension of Occlusion Lip Support Lip Competency Neutral Zone Straight Teeth Smile Lines Orthodontics Diagnostics 101 Who is the doctor and who is the lab. 13 The Lower Incisor Extraction Case Indications and Contra-indications Advantages and Disadvantages 14 Before During 15 IY: Mx16 Md27 RF: no imp,atts off ; Mxd6 5

6 Clincheck A powerful tool!!!!! Before After Before After 16 Not undoing what is working, unless going to undo it all! IY:Mx37Md38 Clincheck A powerful tool!!!!! Before After Before After Original Superimposition Refinement Superimposition 17 Not undoing what is working, unless going to undo it all! IY:Mx37Md38 Before After During 18 Not undoing what is working, unless going to undo it all! IY: Mx16 Md27 RF: no imp,atts off ; Mxd6 6

7 Lower Incisor Extraction: In the Beginning Before After Refinement Refinement Tray 6 Trimmed For Braces RM:Md:27 19 The first cases. Extraction Cases: Anticipate, Plan, Inform Rf:Md:6 Lower Incisor Extraction: Today Before Tray 12 Go to Clincheck Tray Later cases. Anticipate Challenging Movement RM: Mx14 Md26 Learning To Think Like Plastic and Feel Like and Tooth 21 Clincheck, Details!!!!! 7

8 Learning To Think Like Plastic and Feel Like and Tooth 22 Clincheck, Details!!!!! 23 RM: Mx14 Md26 24 JB:Mx20Md30 8

9 25 JB:Mx20Md30 26 JB:Mx20Md30 dayanorthodontics.com 27 JB:Mx20Md30 9

10 Tray 0 Tray 11 Tray JB:Mx20Md30 You can move roots with Tray 17 Final 29 Gable Bend First JB:Mx20Md30 You can move roots with Tray 17 Final 30 Gable Bend First JB:Mx20Md30 10

11 31 JB:Mx20Md30 32 SF:Md27 RF6 Before After 33 SF:Md27 RF6 11

12 34 Tartar Can Stop Movement VB:Mx34Md24 RF3 dayanorthodontics.com 35 Tartar Can Stop Movement VB:Mx34Md24 RF3 Lower Incisor Extraction Case: Start to Finish 36 Go to Clincheck Original Go to Clincheck Refinement JK: Mx21 Md27 Rf: Mx 10 Md4 12

13 Lower Incisor Extraction Case: Start to Finish 37 Go to Clincheck Original Go to Clincheck Refinement JK: Mx21 Md27 Rf: Mx 10 Md4 Lower Incisor Extraction Case: Start to Finish 38 Go to Clincheck Original Go to Clincheck Refinement JK: Mx21 Md27 Rf: Mx 10 Md4 39 JK: Mx21 Md27 Rf: Mx 10 Md4 13

14 40 Go to Clincheck and Orthognathic Surgery. LD Lower Incisor Extraction Case Start to Finish Play to Stage 13 Stage 13 Play to End Stage LD: Mx30 Md30 Pre-Surgical Case Lower Incisor Extraction Case Start to Finish Stage 13 Stage 13 Stage 17 Stage LD: Mx30 Md30 Pre-Surgical Case 14

15 Lower Incisor Extraction Case Start to Finish End Stage 13 Stage 17 Stage LD: Mx30 Md30 Pre-Surgical Case Note: LL1 removed LR1 over corrected gable bend. 44 Pre-Surgical Records LD 45 and Orthognathic Surgery: Braces on molars, ceramic cleats on selected other teeth for post surgical elastics,. Trim last active aligner, and wear them, no wires. Must wear aligners after surgery to prevent selected teeth extrusion during post surgical elastic wear. Once healed, use templates to replace attachments and continue treatment as indicated. LD 15

16 Note: LL1 removed LR1 over corrected gable bend. 46 Go to RF1 LD Go to RF2 47 Post Refinement 1 Records, and at start of Refinemnt 2. LD Natural After Smile 48 and Orthognathic Surgery. LD 16

17 Lower Incisor Extraction Case Start to Finish As much as possible teeth are separated from each other to allow plastic to contact all sides of the tooth Pontics are small, thin and away from adjacent teeth Pontics disappear as adjacent teeth get close to it Starting movements are tipping or bodily movements to separate teeth Virtual gable bends are placed when teeth surrounded by plastic, and before full space closure Attachments designed to provide push surfaces 49 Lower Incisor Extraction Case With 17