Susana Palma Moya - Aligner Techniques in Orthodontics

17 Chapter 20Fig. 20.1 Precision cuts and button cutouts: to hold the intermaxillary elas...Fig. 20.2 Precision hooks would equal to archposts in fixed appliances.Fig. 20.3 Button cutouts allow bonding a metal/ceramic button.Fig. 20.4 Class II, division 2 will benefit from two button cutouts for clas...Fig. 20.5 Class II, division 1 will benefit from canine hook and molar butto...Fig. 20.6 Mesial‐in rotation of the canine.Fig. 20.7 Mesial‐out rotation of the canine.Fig. 20.8 Whenever a lingual button is placed on the lingual surface of the...Fig. 20.9 Occlusal view of lingual buttons on upper canines.Fig. 20.10 Pontic to cover missing 34.Fig. 20.11 Traction of impacted canine using elastic from button in canine t...Fig. 20.12 Interproximal reduction can be performed on upper premolars to di...Fig. 20.13 With class II or class III elastics use, visualization will be sh...Fig. 20.14 From a ‘left 90 degrees view’ the sequential distalization is see...Fig. 20.15 Sequential distalization increases surface contact with molars on...Fig. 20.16 Effect of a coil spring opening space is similar to sequential di...Fig. 20.17 Effect of a coil spring opening space would lead to lack of torqu...Fig. 20.18 Effect of a coil spring opening space would lead to anterior proc...Fig. 20.19 Posterior Powerwings on aligner help advancing mandible on growin...Fig. 20.20 Class II profiles will benefit from this feature.Fig. 20.21 Class II, division 2 incisors need treatment sequence like this: ...Fig. 20.22 Class II, division 2 incisors need a treatment sequence such as: ...Fig. 20.23 Upper expansion leads to higher arch depth reduction and resolvin...Fig. 20.24 Clinchecks: a 45 degree upper molar derotation solves up to 1 mm ...Fig. 20.25 Intraoral views: a 45 degree upper molar derotation solves up to ...Fig. 20.26 Lower mesialization is represented in yellow, and results from th...Fig. 20.27 Biomechanics is the basis of an orthodontic treatment, regardless...Fig. 20.28 Distalization should start just after wisdom tooth extraction so ...Fig. 20.29 Growth has to be carefully checked before a mandibular advancemen... Fig. 20.30 Eruption compensator in a canine.Fig. 20.31 Any contact over 12 g will interrupt the tooth eruption.Fig. 20.32 Terminal molar tabs prevent molars supra‐eruption creating poster... Fig. 20.33 Initial intraoral view.Fig. 20.34 Pretreatment extraoral and intraoral views.Fig. 20.35 Initial panoramic X‐ray, teleradiograph and cephalometry.Fig. 20.36 Intraoral situation after Herbst appliance. After the first phase...Fig. 20.37 Upper and lower ClinCheck views.Fig. 20.38 Comparison of initial (upper row) with final result (lower row)....Fig. 20.39 Initial (left) and final occlusal(right).Fig. 20.40 Initial (left) and final overjet (right).Fig. 20.41 Mandibular changes.Fig. 20.42 Changes in profile.Fig. 20.43 Initial smile (left), smile at the end of first phase (middle) an...Fig. 20.44 Initial and final lateral X‐rays. Fig. 20.45 Intraoral initial picture.Fig. 20.46 Initial extraoral and intraoral views.Fig. 20.47 Occlusal contact at the beginning of the treatment.Fig. 20.48 Initial panoramic X‐ray, teleradiograph and cephalometry.Fig. 20.49 Initial upper and lower ClinCheck views.Fig. 20.50 Initial right and left ClinCheck views.Fig. 20.51 Initial frontal Clincheck view.Fig. 20.52 Goal of treatment: mandibular advancement into a bilateral class ...Fig. 20.53 Initial occlusion (upper), month 6 of evolution (middle), with al...Fig. 20.54 Mandibular advancement in the first six months of treatment.Fig. 20.55 New ClinCheck, asking to level the curve of Spee before continuin...Fig. 20.56 Aligner 17 of additional aligners using class II elastics.Fig. 20.57 Position of class II elastics (from lingual of upper first premol...Fig. 20.58 Situation at the end of mandibular advancement phase, before aski...Fig. 20.59 Comparison between initial (upper) and final occlusion (lower).Fig. 20.60 Final arch development.Fig. 20.61 Comparison initial and final overjet.Fig. 20.62 Comparison of initial and final smile.Fig. 20.63 Mandibular changes after 18 months of treatment.Fig. 20.64 Comparison in chin projection between initial, before additional ...Fig. 20.65 Final lateral X‐ray. Fig. 20.66 Initial intraoral view.Fig. 20.67 Pretreatment extraoral and intraoral views.Fig. 20.68 Lower skeletal asymmetry. Normal upper incisors exposure at rest ...Fig. 20.69 Initial panoramic X‐ray, teleradiograph and cephalometry. The AimFig. 20.70 Initial upper and lower ClinCheck views.Fig. 20.71 Lateral ClinCheck views.Fig. 20.72 Initial frontal Clincheck view.Fig. 20.73 Comparison between initial (upper) and final occlusion (lower).Fig. 20.74 Initial (left) and final occlusal (right).Fig. 20.75 Initial and final smile.Fig. 20.76 Panoramic and lateral X‐rays. Fig. 20.77 Initial intraoral view.Fig. 20.78 Pretreatment extraoral and intraoral views.Fig. 20.79 Initial panoramic X‐ray, teleradiograph and cephalometry.Fig. 20.80 Initial upper and lower ClinCheck viewsFig. 20.81 Initial right and left ClinCheck views.Fig. 20.82 Initial front ClinCheck view.Fig. 20.83 Upper sequential distalization and lower sequential mesialization...Fig. 20.84 Comparison between initial (upper) and final (lower) occlusion.Fig. 20.85 Before (left) and after (right) lower occlusal views.Fig. 20.86 Initial and final smile and overjet.Fig. 20.87 Final panoramic and lateral X‐rays. Fig. 20.88 Initial intraoral view.Fig. 20.89 Pretreatment extraoral and intraoral views.Fig. 20.90 Initial panoramic X‐ray, teleradiograph and cephalometry.Fig. 20.91 Upper and lower occlusal ClinCheck views.Fig. 20.92 Right and left ClinCheck views.Fig. 20.93 Front ClinCheck view.Fig. 20.94 Treatment interproximal reduction.Fig. 20.95 Sequential upper distalization pattern.Fig. 20.96 Before (upper) and after (lower) intraoral views.Fig. 20.97 Initial (left) and final (right) occlusal.Fig. 20.98 Initial and final smile and overjet.Fig. 20.99 Final panoramic and lateral X‐rays. Fig. 20.100 Initial intraoral view.Fig. 20.101 Pretreatment extraoral and intraoral views.Fig. 20.102 Initial panoramic X‐ray, teleradiograph and cephalometry.Fig. 20.103 Superimposition, upper occlusal ClinCheck view.Fig. 20.104 Superimposition, lower occlusal ClinCheck view.Fig. 20.105 Biomechanics for simultaneous distalization.Fig. 20.106 Clincheck view.Fig. 20.107 Right and left ClinCheck views.Fig. 20.108 Initial views (upper), before additional aligners (middle) and f...Fig. 20.109 Before (left) and after (right) occlusal views.Fig. 20.110 Simultaneous distalization pattern.Fig. 20.111 Before and after treatment smile.Fig. 20.112 Final panoramic and lateral X‐rays. Fig. 20.113 Distalization from 3 to 7 in a row pattern.Fig. 20.114 Extraoral analysis: mandibular asymmetry.Fig. 20.115 Initial intraoral views.Fig. 20.116 Scissor bite on left side.Fig. 20.117 Scissor bite on left side.Fig. 20.118 Initial panoramic X‐ray, teleradiograph and cephalometry.Fig. 20.119 ClinCheck upper occlusal view. Correct class II by simultaneous ...Fig. 20.120 ClinCheck lower occlusal view.Fig. 20.121 Interproximal reduction.Fig. 20.122 Lateral views: Class II elastics from upper 4 to lower 7.Fig. 20.123 Evolution after 13 months.Fig. 20.124 Rein horse to distalize upper molars from TADs in the tuberosity...Fig. 20.125 Evolution after 17 months.Fig. 20.126 Correction of scissor bite.Fig. 20.127 Initial (upper) and final occlusion (lower).Fig. 20.128 Before (left) and after (right) occlusal.Fig. 20.129 Comparison of before (left) and after smile (right).Fig. 20.130 Before (left) and after (right) profile.Fig. 20.131 Final panoramic and lateral X‐rays. Fig. 20.132 Simultaneous distalization from 5 to 5 pattern.Fig. 20.133 Pretreatment extraoral and intraoral views.Fig. 20.134 Initial panoramic X‐ray, teleradiograph and cephalometry.Fig. 20.135 Initial upper and lower ClinCheck views.Fig. 20.136 Interproximal reduction from 33 to 43 to upright lower incisors....Fig. 20.137 Right and left ClinCheck views.Fig. 20.138 Intra‐arch Powerchain from upper canine to first molar to guide ...Fig. 20.139 Initial (upper) and final (lowe) intraoral views.Fig. 20.140 Occlusal before (left) and after (right) treatment.Fig. 20.141 Final occlusal contact.Fig. 20.142 Initial (left) and final smile (right).Fig. 20.143 Final panoramic and lateral X‐rays: maintenance of lower incisor... Fig. 20.144 Top jet appliance.Fig. 20.145 Pretreatment extraoral and intraoral views.Fig. 20.146 Initial panoramic X‐ray, teleradiograph and cephalometry.Fig. 20.147 Distalization with top‐jet before Invisalign treatment.Fig. 20.148 Sequential distalization with class II elastics.Fig. 20.149 Upper and lower ClinCheck views.Fig. 20.150 Lateral ClinCheck views.Fig. 20.151 Comparison of initial (upper) and final (lower) intraoral views....Fig. 20.152 Initial (left) and final (right) occlusal.Fig. 20.153 Initial (right) and final overjet (left).Fig. 20.154 Initial and final smile.Fig. 20.155 Final panoramic and lateral X‐rays. Fig 20.156 Initial intraoral view.Fig 20.157 Deferred sequential distalization, in which some teeth move ‘alon...Fig. 20.158 Initial intraoral views (right, front, left, upper, lower). Pati...Fig. 20.159 Initial extraoral pictures and cephalometric analysis.Fig. 20.160 Initial Clinchecks.Fig. 20.161 Intraoral pictures at refinement.Fig. 20.162 Refinement Clinchecks.Fig. 20.163 Final: intraoral pictures showing improvement of the lower incis...Fig. 20.164 The cone beam computed tomography comparisons show how lower the...Fig. 20.165 Final comparison of lateral X‐rays.Fig. 20.166 Comparison of before and after smile.Fig. 20.167 Extraoral profile views. Fig. 20.168 Initial intraoral view.Fig. 20.169 Manual precision cut on 13 allows optimized attachment on this t...Fig. 20.170 Initial intraoral views (right, front, left, upper, lower).Fig. 20.171 Initial panoramic and lateral X‐rays.Fig. 20.172 Initial Clinchecks.Fig. 20.173 Refinement: initial intraoral views (right, front, left, upper, ...Fig. 20.174 Refinement Clinchecks.Fig. 20.175 Final intraoral views (right, front, left, lower, upper).Fig. 20.176 Final panoramic and lateral X‐rays.Fig. 20.177 Before and after smiles, before aesthetic anterior restoration.... Fig. 20.178 Initial intraoral view.Fig. 20.179 Initial intraoral views (right, front, left, upper).Fig. 20.180 Initial intraoral models to check class II relationship before 1...Fig. 20.181 Pretreatment panoramic and lateral X‐rays and cephalometry.Fig. 20.182 Initial extraoral views.Fig. 20.183 Initial Clinchecks (right, front, left, upper, lower).Fig. 20.184 Intraoral refinement (right, front, left, upper, lower).Fig. 20.185 Refinement Clinchecks: right, front, left, upper, lower.Fig. 20.186 Final intraoral views: right, front, left, upper with tongue tam...Fig. 20.187 Before and after smile, showing improvement in upper incisor dis...Fig. 20.188 Final cephalometric measurements (before and after).Fig. 20.189 Final panoramic X‐ray.Fig. 20.190 Posterior interproximal reduction will help create space (before...Fig. 20.191 Posterior interproximal reduction might be up to 1 mm per contac... Fig. 20.192 Sequential lower distalization is meant to be predictable up to ...Fig. 20.193 In class III cases, anchorage is extremely important. The anchor...Fig. 20.194 Temporary implant supported crowns help create posterior anchora... Fig. 20.195 Initial intraoral view.Fig. 20.196 Pretreatment extraoral and intraoral views.Fig. 20.197 Implant placement on 47 before starting Invisalign treatment.Fig. 20.198 Initial panoramic X‐ray, teleradiograph and cephalometry.Fig. 20.199 Initial front view.Fig. 20.200 Initial ClinCheck front view..Fig. 20.201 Initial occlusal contact.Fig. 20.202 Sagittal priority of movements to solve the anterior crossbite. ...Fig. 20.203 Upper and lower ClinCheck views.Fig. 20.204 Initial (upper), evolution (middle) and situation after 12 month...Fig. 20.205 Arch evolution after treatment for 12 months.Fig. 20.206 Right and left initial ClinCheck views.Fig. 20.207 Arch development after 12 months.Fig. 20.208 Initial and final overjet and smile. Fig. 20.209 Initial intraoral picture.Fig. 20.210 Pretreatment extraoral and intraoral views.Fig. 20.211 Initial X‐ray: panoramic, teleradiograph and cephalometry.Fig. 20.212 Interproximal reduction.Fig. 20.213 Simultaneous movement pattern.Fig. 20.214 Extrusion of 27 owing to missing 47.Fig. 20.215 Anterior cross bite of 12.Fig. 20.216 Initial superimposition, ClinCheck upper and lower occlusal view...Fig. 20.217 Comparison of initial (upper) and final occlusion (lower).Fig. 20.218 Comparison of initial (left) and final occlusal (right).Fig. 20.219 Initial and final smile.Fig. 20.220 Final panoramic and lateral X‐rays.Fig. 20.221 Initial intraoral view.Fig. 20.222 Initial intraoral views.Fig. 20.223 Initial extraoral views.Fig. 20.224 Initial cone beam computed tomography and panoramic X‐ray.Fig. 20.225 Initial lateral X‐ray and cephalometric analysis.Fig. 20.226 Initial ClinChecks.Fig. 20.227 Refinement: intraoral views.Fig. 20.228 Refinement: extraoral views.Fig. 20.229 Current intraoral views.Fig. 20.230 Current smile.Fig. 20.231 Current cephalometric measurements.Fig. 20.232 Cone beam computed tomography measurements, before and after tre...Fig. 20.233 Final smile.Fig. 20.234 Initial intraoral view.Fig. 20.235 Initial smile.Fig. 20.236 Initial panoramic and lateral X‐rays.Fig. 20.237 Refinement: initial views after 6 months, when the patient decid...Fig. 20.238 The palatal suture is broken with the same anaesthesia that that...Fig. 20.239 The palatal suture is broken with the same anaesthesia that will...Fig. 20.240 After 2 weeks, the 8 mm screw is fully opened. The palatal surfa...Fig. 20.241 Refinement ClinChecks.Fig. 20.242 Second refinement: intraoral views.Fig. 20.243 Second refinement Clinchecks.Fig. 20.244 Final Intraoral views.Fig. 20.245 Final smile.Fig. 20.246 Final cephalometric examination.Fig. 20.247 Final panoramic X‐ray. Fig. 20.248 Initial frontal intraoral view.Fig. 20.249 Initial intraoral views.Fig. 20.250 Initial panoramic and lateral and X‐rays and cephalometry.Fig. 20.251 Initial extraoral view.Fig. 20.252 Initial Clinchecks.Fig. 20.253 Refinement: intraoral views.Fig. 20.254 Refinement ClinChecks.Fig. 20.255 Extraoral view after refinement.Fig. 20.256 Final intraoral views.Fig. 20.257 Final smile.Fig. 20.258 Initial and post‐treatment cephalometric analysis.Fig. 20.259 Initial intraoral view.Fig. 20.260 Pretreatment extraoral and intraoral views.Fig. 20.261 Initial panoramic X‐ray, teleradiograph and cephalometry.Fig. 20.262 Simultaneous distalization pattern in upper and lower arches.Fig. 20.263 Upper and lower ClinCheck views.Fig. 20.264 interproximal reduction necessary in order not to procline lower...Fig. 20.265 Lateral ClinCheck views.Fig. 20.266 Rein horse with Powerchain to temporary anchorage devices in the...Fig. 20.267 Simultaneous upper distalization using temporary anchorage devic...Fig. 20.268 Simultaneous lower distalization using temporary anchorage devic...Fig. 20.269 Initial occlusion (upper) and situation at month 17 of treatment...Fig. 20.270 Arch development in 23 months. Powerchain from first upper and l...Fig. 20.271 Pretreatment and final smile and overjet.Fig. 20.272 Final panoramic and lateral X‐rays.