Read TT Using detailing pliers text version

INVISALIGN TIPS & TRICKS

USING INVISALIGN ALIGNER DETAILING PLIERS

Tips by: Eric Kuo, DDS, MS Section Editor: Mitra Derakhshan, DDS, MS

PURPOSE

After the initial Aligner sequence is completed, in select cases it may be necessary to detail the case to correct minor anterior rotations, perform minor anterior in-out movements, tighten light interproximal contacts or enhance Aligner retention in undercut regions. Since movements are pre-built into the Aligners, all that may be needed is a little extra push to move the teeth to the desired location. In such instances, given that the last Aligner fits, Invisalign Detail Pliers may be used to introduce pressure-point dimples into the Aligners and reduce the need for or extent of case refinement Aligners required to finish the treatment.

METHO DS

The Invisalign Detail Pliers take advantage of the Aligner material's ability to be reshaped in order to create pressuregenerating dimples for achieving minor tooth movements (less than 1 mm of movement). The tip of the Detail Plier is used to form force-generating dimples without requiring heat treatment of the pliers (figure 1). Furthermore, the Aligners do not need to be cut or relieved to accommodate the intended movements, since each Aligner should already have its specific toothmovement goals built-in. The pressure points simply help the teeth reach the movement already programmed into the Aligner. To create a pressure point, the pliers are oriented with the dimple-forming tip pointed inwards at the desired location on the Aligner (figure 2). A gentle squeeze forms pressure points up to 1.0 mm in depth (figure 3). These pressure points can be used to correct minor incisor rotations and inout discrepancies, tighten light interproximal contacts, and enhance Aligner retention. It is important to remember that the greater the number and depth of the pressure points, the greater the Aligner retention and the greater the possibility of the Aligner not fully seating. Pressure points can also be repositioned by using a special Invisalign "Eraser" Plier, which flattens the created bumps (figure 4). Three important keys to success when using the pliers should be noted: 1) The desired movement must already be present in the Aligner. The purpose of the detailing pliers is to optimize movements already programmed in the Aligner that have not been fully expressed. Therefore, if the desired movements are not already present in the Aligner, then using the pliers will not help, and case refinement Aligners and/or auxiliary techniques will be required instead. 2) Given that the space for desired movement is pre-built into the Aligner, for best results, these movements should fall within categories of movements known to be predictable for Aligners. Extrusions, for example, are still likely to be challenging, even with the creation of pressure points. 3) Any interproximal interferences present in areas of crowding should be relieved.

These tips have not been tested in clinical trials but are personal techniques from experienced colleagues using Invisalign. Some tips have been used on many cases and some on only a few. It is at your discretion to use them where appropriate to best get the results you want with Invisalign.

aligntechinstitute.com

Copyright © Align Technology, Inc. All Rights Reserved.

INVISALIGN TIPS & TRICKS

Invisalign Aligner Detailing Pliers

A common cause of residual crowding is inadequate interproximal reduction during treatment that results in the tooth's dimensions being larger than its intended space in the Aligner. To ensure success when using the detailing pliers, the doctor should monitor interproximal contacts for

binding, and remove interferences with reproximation strips or disks as needed. If interferences are absent, the patient should feel pressure on the teeth from the pressure points. Lack of pressure in spite of the pressure points may be a sign that interferences are still present.

SUMMARY

Greater control of treatment outcome can be achieved by using Invisalign Detail Pliers to create pressure points in the Aligner whenever supplemental forces are needed to correct minor discrepancies between the Aligner and the positions of the teeth. Invisalign Detail Pliers are easy to use chairside, because neither the pliers nor the Aligner need to be pre-treated in order to create the force-generating pressure points. By using a series of Aligner adjustments with the Invisalign Detail Pliers, the incidence and/or extent of case refinement needed to achieve the desired treatment results can be dramatically reduced.

Figure 1

Figure 2

Figure 3

The tip of the Detail Plier features a unique design that can create pressure points without requiring any heating.

To create a pressure point, simply orient the tip over the desired area of the aligner and gently squeeze.

The created bump will help push the tooth into its intended space in the aligner. Cutting of the aligner is not needed.

These tips have not been tested in clinical trials but are personal techniques from experienced colleagues using Invisalign. Some tips have been used on many cases and some on only a few. It is at your discretion to use them where appropriate to best get the results you want with Invisalign.

aligntechinstitute.com

Copyright © Align Technology, Inc. All Rights Reserved.

INVISALIGN TIPS & TRICKS

Invisalign Aligner Detailing Pliers

Figure 4

Figure 5

Figure 6

Bumps that need to be repositioned or reduced can be flattened with the Eraser Plier.

An upper lateral incisor where the derotation was not fully expressed. The primary cause of the residual rotation was an extrusive movement that did not fully express. The poor adaptation around the lateral incisor led to poor expression of rotation. However, a pressure generating point placed on the mesio-lingual area as well as the disto-facial area in the Aligner would create the necessary force to complete the rotation. A small interproximal space is already present on the mesial of the lateral incisor, but not on the distal, so the distal contact should be monitored for binding.

Two rotated lower central incisors where alignment can be achieved by placement of pressure points in the areas indicated and monitoring interproximal contacts for binding. Since multiple pressure points are required, shallow points may be indicated to ensure complete appliance seating. These points can be gradually increased until the desired correction is achieved. The "eraser" plier can be used to reduce pressure-point depth if the Aligner becomes difficult to fully seat.

Figure 7

Figure 8

Figure 9

A lower right central incisor that needs to be rotated lingually. This movement is easy to achieve, simply by creating a pressure point on the mesio-facial surface of the Aligner. The mesial contact should be monitored for binding to ensure success.

A lower left central incisor that is facially displaced, where in the Aligner, all the teeth are straight. To tighten the contacts, two pressure points are placed on the facial surface to push the tooth lingually. The distal-most point is positioned near the line angle to squeeze the tooth mesially and lingually.

This image is from a case where composite attachments were not initially placed for appliance retention. Since the dental crowns are somewhat short (especially in the lower right), Aligner retention is enhanced by placing pressure points in the appliance in the interproximal areas. Points that are made too deep for complete seating of the appliance can be flattened using the "eraser" plier.

These tips have not been tested in clinical trials but are personal techniques from experienced colleagues using Invisalign. Some tips have been used on many cases and some on only a few. It is at your discretion to use them where appropriate to best get the results you want with Invisalign.

aligntechinstitute.com

Copyright © Align Technology, Inc. All Rights Reserved.

Information

TT Using detailing pliers

3 pages

Find more like this

Report File (DMCA)

Our content is added by our users. We aim to remove reported files within 1 working day. Please use this link to notify us:

Report this file as copyright or inappropriate

552390


You might also be interested in

BETA
TT Using detailing pliers