invisalign study club meeting 1 - treatment planning
TRANSCRIPT
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Invisalign Study Club:Invisalign Study Club:Session 1Session 1
Treatment Planning Treatment Planning
March 20, 2008
Brian H. Bergh, DDS, MS1111 N Brand Blvd, Ste 201
Glendale, CA 91202(818) 242-1173
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Doctor BackgroundDoctor Background
• Loma Linda University Dental School• USC Dental School, Certificate in Orthodontics• USC Graduate School, MS Craniofacial Biology• Invisalign Premier Provider • Over 260 cases submitted• Email: [email protected]• Phone #: 818-242-1173
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Setting Treatment GoalsSetting Treatment Goals
• An ideal outcome starts with with a good treatment plan.
• Keys to Treatment Planning with Invisalign.
QualityTreatment Outcomes
Treatment PlanningTreatment Planning
FinishingFinishing ClinCheckClinCheck
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Keys To Keys To Treatment PlanningTreatment Planning
• Understand the appliance and difficult movements:– Absolute extrusions– Severe rotations of round teeth– Large – span
translations/extractions• Recognize and incorporate solutions
into the treatment plan– Auxiliary Treatment
• IPR, Detail Pliers, Button Kit, Attachments, Elastics
• Strategic staging in ClinCheck• Build in case refinement
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Keys To Keys To Treatment PlanningTreatment Planning
• Communication• Be clear.• Be specific.
Examples of Communication:• Be explicit in your requests:
– Instead of “leave spaces for restoration.” – Write: “Leave 2mm of space distal to the upper
right lateral incisor for post orthodontic restoration.”• Instead of “improve anterior esthetics”
– Write: “Add 5 degrees of mesial rotation to the upper left central and distal root tip to the upper left canine.”
• Instead of “Line up teeth with proper alignment”– Write: “Rotate upper lateral incisor mesial in to line
up with upper central.”
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1. Invisalign Treated Arches1. Invisalign Treated Arches
• Is there enough overjet to treat one arch only?• If expansion is needed, will it be easier to
coordinate the movement if both arches are treated?
• If anterior crossbite correction is needed, is it easier to coordinate if both arches are treated?.
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2. Do Not Move These Teeth2. Do Not Move These Teeth
• Are all teeth marked that should not be moved?
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3. Do Not Place Attachments 3. Do Not Place Attachments on These Teeth on These Teeth
• Have all facial / buccal restorations (esp. veneers & buccal alloys) been noted (even if teeth are not being moved)?
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4. Midline4. Midline
• If a large midline correction is required, is IPR acceptable to resolve the midline shift?
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5. Overjet5. Overjet
• If a large overjet correction is required, is IPR or an A-P change acceptable to resolve the overjet?
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6. Overbite6. Overbite
• Is overbite correction required or only incisor leveling?
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7. A-P (Sagittal) Relationship7. A-P (Sagittal) Relationship
• Is current A-P relationship / posterior occlusion acceptable as it currently exists?
• If distalization is desired, is patient willing to accept longer treatment time?
• If A-P change is desired, are goals realistic?.
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8. Posterior Crossbite(s)8. Posterior Crossbite(s)
• If the crossbite is unilateral and many teeth are involved, then is the patient comfortable with the use of auxiliary techniques to resolve the crossbite?
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9. Resolve Spacing and Crowding9. Resolve Spacing and Crowding
• Can all spacing be closed without losing overjet?
• If space must be left, will I simply leave it or have it restored?.
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9. Resolve Spacing and Crowding9. Resolve Spacing and Crowding
• Can tooth anatomy prohibit IPR (e.g. small narrow teeth)?
• Do periodontal conditions prohibit proclination or expansion?
• Is there a method of resolving crowding that should definitely be performed or not performed?
• If extracting, is the patient comfortable with the use of auxiliary techniques to achieve an ideal finish?.
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10. Tooth Size Discrepancy10. Tooth Size Discrepancy
• If all spaces cannot be closed, can IPR be performed in the opposite arch to close the space
• If not restoring to close spaces, where would it be best to leave space?
• If performing a bonding or veneers, what position of the laterals would allow for best restoration?.
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11. Overcorrection11. Overcorrection
• Recommended at Case Refinement Stage
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12. Treatment Preferences12. Treatment Preferences
• Is the way I prefer to have this case set-up very different than what is listed in the current treatment preferences?
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13. ClinCheck Objectives13. ClinCheck Objectives
• Is the patient comfortable with the use of auxiliary techniques to achieve an ideal finish?
• Real vs. Ideal is the key.
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14. Special Instructions14. Special Instructions
• Are there any restorative plans that should be noted?
• Are there any attachment requests that are different than protocol (e.g. lingual, additional, etc.)?
• Will black triangle reduction be necessary?• Are there periodontal concerns that I should note?• Was there pre-Invisalign treatment that would cause
the occlusion to be different than the photos?.