Principles and Biomechanics of Aligner Treatment

Front Cover
Inside front cover
Front matter
Principles and biomechanics of aligner treatment
Copyright
Dedication
Contributors
Foreword
Table of Contents
1 Diagnosis and treatment planning in the three-dimensional era
Introduction
Intraoral scans and digital models
3D imaging
Cone-beam computed tomography
Benefits of CBCT for orthodontic assessment
3D facial reconstruction techniques
Virtual setup
3D data integration
References
2 Current biomechanical rationale concerning composite attachments in aligner orthodontics
Introduction
Geometry (active surface orientation)
Location
Size
Functions
Providing aligner retention
Avoiding aligner “slipping”
Delivering predetermined force vectors
Basic attachment configurations in current aligner orthodontics
Vertical control
Anterior extrusion
Posterior intrusion
First-order control
Rotation
Second-order control
Anterior teeth
Posterior teeth
Differential moments
Third-order control
Anterior torque
Posterior torque
Excess buccal tipping
Insufficient force levels
References
3 Clear aligners: Material structures and properties
Introduction
Polymer molecular structure and thermal properties
What is a polymer?
Glass transition-the macromolecular basis of viscoelasticity
Physical and chemical aging of aligner polymers
Physical aging of polymers
Chemical aging of polymers
Conclusions and outlook
References
4 Influence of intraoral factors on optical and mechanical aligner material properties
Introduction
Water absorption
Optical changes
Short-term mechanical loading of aligner materials
Single short-term loadings
Multiple short-term loading cycles
Occlusal forces
Long-term loading
Clinical loading patterns of aligner materials
References
5 Theoretical and practical considerations in planning an orthodontic treatment with clear aligners
Introduction
Theoretical and practical considerations in CAT
Analysis of the final position
Analysis of the movements occurring at each stage for each tooth
Aligner auxiliaries
Attachments and pressure areas.
Intraoral elastics.
Interproximal reduction.
Temporary anchorage devices.
Anchorage management and movements sequentialization
OTM staging
Biologic considerations in aligner orthodontics
Patient compliance
CAT fundamentals recap
References
6 Class I malocclusion
Introduction
Diagnostic reference
Treatment plan
Curve of spee leveling
Incisor control
Arch development
Rotation control
Attachment choice
Interproximal reduction
Class I conditions
Dentoalveolar discrepancy
Tooth size discrepancy
Transverse discrepancy
Morphologic discrepancy
Preprosthetic need
References
7 Aligner treatment in class II malocclusion patients
Introduction
Maxillary molar distalization
Maxillary molar rotation
The elastic effect
Extractions
Mandibular advancement
Orthognathic surgery
The clinical protocol
Maxillary distalization case reports
Case summary 1
Case summary 2
Case summary 3
References
8 Aligners in extraction cases
Introduction
Diagnosis and treatment plan
Treatment progress
Treatment results
Discussion
Conclusion
References
9 Open-bite treatment with aligners
Diagnosis of anterior open bite
Biomechanics for anterior open-bite correction
Aligner protocols for open-bite treatment
Clincheck software design
Attachments in open-bite correction
Case report 1
Case summary
Problem list
Treatment objectives
Treatment plan
Treatment alternatives
Treatment sequence
Treatment results
Case report 2
Case summary
Problem list
Treatment objectives
Treatment plan
Treatment alternatives
Treatment sequence
Treatment results
References
10 Deep bite
Introduction
Leveling of the curve of spee
Leveling the upper incisors
Case report 1
Case report 2
References
11 Interceptive orthodontics with aligners
Introduction
Maxillary expansion
Expansion case reports
Case study 1
Case study 2
Class II malocclusion
Mandibular advancement case reports
Case study 3
Case study 4
Conclusions
References
12 The hybrid approach in class II malocclusions treatment
Introduction
Tooth-borne hybrid approach with distalizing device
Case report 1
Diagnostic summary
Case report 2
Diagnostic summary
References
13 Aligners and impacted canines
Introduction
Early diagnosis and treatment
Late diagnosis
Treatment planning and orthodontic management
Labial impactions
Palatal impactions
Clinical case
First visit
Orthodontic diagnosis
Treatment plan
Treatment progress
Final
References
14 Aligner orthodontics in prerestorative patients
Introduction
Space management in the anterior region
Case study
Space management in the posterior region
Management of posterior overerupted molars
Management of patients with a history of temporomandibular disorders
Diagnosis and treatment plan
Case study
References
15 Noncompliance upper molar distalization and aligner treatment for correction of class II malocclusions
Upper molar distalization in aligner treatment
Clinical procedure and rational of the beneslider
Clinical case
Clinical considerations
Conclusions
References
16 Clear aligner orthodontic treatment of patients with periodontitis
Malocclusions related to periodontal disease
Orthodontic treatment in patients with periodontal disease
Diagnosis and treatment planning
Patient expectations
Multidisciplinary team
Periodontal assessment
Orthodontic assessment: Determination of final occlusion
Considerations
Orthodontic movements
Optimal control of biomechanics
Mesiodistal movements
Vestibulolingual movements
Vertical movements
Final flowchart
Retention
Conclusions
Clinical case
First visit
Intraoral clinical exam
X-ray status
Baseline periodontal chart (fig. 16.17)
Periodontal examination
Periodontal reevaluation (figs. 16.18 and 16.19)
Diagnosis
Perio treatment goals
Treatment plan
Clinical examination reevaluation (fig. 16.20)
Treatment plan after etiologic therapy
Orthodontic
Implant therapy
Periodontal supportive therapy
Orthodontic diagnosis (fig. 16.28)
Specific objectives of treatment (figs. 16.29 through 16.39)
References
17 Surgery first with aligner therapy
Historic background
Splint-aided maxillary and mandibular fixation without labial fixed appliances
Transitioning into and out of surgery with clear aligners
Surgery first and CAT
Case study
Conclusions
References
18 Pain during orthodontic treatment: Biologic mechanisms and clinical management
The importance of orthodontic pain
Biologic mechanisms of orthodontic pain and clinical correlates
Orthodontic tooth pain in clear aligner therapy
Modulators of pain: Psychological factors
Clinical considerations for the management of orthodontic pain
References
19 Retention and stability following aligner therapy
Retention and stability in orthodontic treatment
Introduction
Factors influencing long-term stability
Retention protocols and the choice of retention appliance
Retention protocols
Appliances for retention and indications of various retention devices
Specifics of retention following clear aligner therapy
Retention protocol and schedule of checkups in the retention period
References
20 Overcoming the limitations of aligner orthodontics: A hybrid approach
Introduction
Transverse expansion of the posterior teeth
Canine and premolar rotation
Extrusion, intrusion, and overbite control
Molar distalization
Conclusions
References
Index
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