Open bite with TADS
TAD’s to extrude upper incisors: TAD’s to intrude molars:
Root torque
Upper teeth palatal root torque. Attachments Prescribe the desired palatal root torque, but I ask my technician to delete the power ridges and add 3 mm wide gingivally beveled rectangular attachments to keep the aligners fully engaged on the teeth. Retroclined upper incisors Add an…
Root tipping
Tipping 11 (movement staging):*First procline +rotate mesial-out*Second: 10-degree tip mesial of the crown + intrusion+ rotate distal-inWhenever there is rotation + tip, do not start correcting the tipping Root tip attachment: vertical beveled (bevel on a different side than root tipping is needed). Diastema closure…
Extraction cases
The elastic properties of clear aligners would generate a clockwise force moment in the anterior part of the arch that would cause the incisors to incline lingually and extrude. The middle part of the arch will receive intrusive force components, that will tend to intrude…
Distalization. Anterior upper retraction
_____ Anterior torque is lost during retraction -> Therefore: add 1 degree of lingual-root of torque and 0.2 mm of intrusion per aligner when the anterior teeth are retracted
Troubleshooting. Posterior open bite etiology and solutions
What may lead to a posterior open bite with aligners? 2. Transverse correction when axial inclinations are already upright/ in buccal-version. It is important to note the Curve of Wilson, especially if any maxillary expansion has been produced. Often the palatal cusps of the molars…
Troubleshooting. Attachment not fitting in the aligner
Solution Don’t force the aligner into place over the misaligned engager (this can move the tooth in unwanted ways) Instead, try the following: Gap in the aligner Though the attachment will still apply pressure to the tooth and work toward completing that difficult movement, there…
Sequential distalization
Protocol options available for class II treatment: It is suggested that staging of sequential distalization should be moving towards the distal half of the total movement of the first tooth before starting distalization of the following one. Elastics Class II elastic until the moment that…
Aligners Change Pattern
Initial change The initial 14-day interval to change the aligners is recommended as smaller orthodontic tooth movement is expected at the start of treatment since the reconstruction processes controlled by osteoblasts and osteoclasts only occur after about 2-4 weeks.
