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EARLY TREATMENT WITH
INVISALIGN FIRST FOR A
COMPLETE INTERCEPTIVE
ORTHODONTIC APPROACH
DR ALESSANDRO GRECO
TRADITIONAL ORTHO VS DIGITAL ORTHODONTICS
• Reactive model to proactive model
• Contrast collaterals vs prevent collaterals
• More work on the digital side of the treatment
• Tads can be incorporated for complex treatments
outline
• Ideal timing
• Invisalign first approach
• conclusion
When is the time to start orthodontic
treatment?
• Starting before pubertal peak
-no better skeletal changes
-no better arch modification
-no better outcome in 2 phase treatment
At the end of treatment both groups were essentially equal, no significative difference on cephalometrics,
same correction for overjet
• When it is useful or need to start a treatment before ideal timing?
oCrossbite with mandibular shift
oMaxillary constriction
oEruption anomalies and need for space management
oClass III cases
RME VS SME
• Nasal volume
• Tongue posture
• Upper airways
• Nasal ventilation
• All this perspectives are possible only if the expansion is rapid and
should be over expanded
• an expansion of 10mm in 16 days is rapid expansion
When aligners can be used in early treatment approach
oCrossbite with mandibular shift – after rme
oMaxillary constriction – after rme
oEruption anomalies and need for space management- immediately
oClass III cases- after rme
Indicatioins for patients at age- 6-9years
• Arch development
• Expansion upto 4mm
• spacing/crowding
• Anterior crossbite
• Dental protrusion
• Space management for permanent dentition
In Invisalign expansion
• First the permanent molars are expanded using deciduous teeth as
anchorage
• And then primary canine and molars are expanded
Eruption compensator
• The system creates and maintains space for erupting canines and
premolars and upper and lower lateral incisors
The First system induced shape modifications of the upper arch during expansion in contrast to RME.
The FG presented an improvement in the maxillary arch shape, while the RG maintained the initial
triangular shape
Conclusion
• 5 days change
• Short clinicalcrowns = use large number of attachments
• Spaces mesial and distal to canine
• Remove unnecessary movement on deciduous teeth
 No root tipping
 No intrusion and extrusion more than .5mm
 No rotation more than 5 degrees
IOC.pptx

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IOC.pptx

  • 1. EARLY TREATMENT WITH INVISALIGN FIRST FOR A COMPLETE INTERCEPTIVE ORTHODONTIC APPROACH DR ALESSANDRO GRECO
  • 2. TRADITIONAL ORTHO VS DIGITAL ORTHODONTICS • Reactive model to proactive model • Contrast collaterals vs prevent collaterals • More work on the digital side of the treatment • Tads can be incorporated for complex treatments
  • 3. outline • Ideal timing • Invisalign first approach • conclusion
  • 4. When is the time to start orthodontic treatment? • Starting before pubertal peak -no better skeletal changes -no better arch modification -no better outcome in 2 phase treatment
  • 5. At the end of treatment both groups were essentially equal, no significative difference on cephalometrics, same correction for overjet
  • 6. • When it is useful or need to start a treatment before ideal timing? oCrossbite with mandibular shift oMaxillary constriction oEruption anomalies and need for space management oClass III cases
  • 7. RME VS SME • Nasal volume • Tongue posture • Upper airways • Nasal ventilation • All this perspectives are possible only if the expansion is rapid and should be over expanded • an expansion of 10mm in 16 days is rapid expansion
  • 8.
  • 9. When aligners can be used in early treatment approach oCrossbite with mandibular shift – after rme oMaxillary constriction – after rme oEruption anomalies and need for space management- immediately oClass III cases- after rme
  • 10. Indicatioins for patients at age- 6-9years • Arch development • Expansion upto 4mm • spacing/crowding • Anterior crossbite • Dental protrusion • Space management for permanent dentition
  • 11.
  • 12. In Invisalign expansion • First the permanent molars are expanded using deciduous teeth as anchorage • And then primary canine and molars are expanded
  • 13. Eruption compensator • The system creates and maintains space for erupting canines and premolars and upper and lower lateral incisors
  • 14.
  • 15.
  • 16. The First system induced shape modifications of the upper arch during expansion in contrast to RME. The FG presented an improvement in the maxillary arch shape, while the RG maintained the initial triangular shape
  • 17. Conclusion • 5 days change • Short clinicalcrowns = use large number of attachments • Spaces mesial and distal to canine • Remove unnecessary movement on deciduous teeth  No root tipping  No intrusion and extrusion more than .5mm  No rotation more than 5 degrees

Notas do Editor

  1. Planning part of treatment
  2. Not one activation per day in 30 days
  3. 2021 European journal of pediatric dentistry