Dentaltown July 2018 - 66

Fig. 3: Progress and final photos.

Halfway through the treatment, it was evident that the teeth were
no longer tracking. At that point, four months into the treatment,
we treated the patient reactively with MOP and then again at month
8 (Fig. 2). We gained much better tracking and movements of teeth,
including the projected goal of better anterior coupling finishing 1mm
overjet overbite. In just under a year, he had a better smile line, and his
open bite was getting closed.
We got the anterior bite closed and landed the posterior bite, and
the patient could even close his teeth and "chew his food better." The
results were positive because MOP targets osteoclast activation, the main
rate-controlling factor in orthodontic tooth movement.4 Introduction of
a controlled microtrauma, without affecting the integrity and architecture
of hard and soft tissue, stimulates the inflammatory defense mechanism
in the body, which then creates a synergy with the effects of orthodontic
forces to accelerate the bone remodeling response.4 Temporary reductions
in bone density for 12-14 weeks allowed the difficult tooth movements
to translate, and the teeth to move as predicted and planned on the
aligner software.
After initially falling off track, this patient was thrilled to complete
treatment ahead of schedule and achieved an aesthetic final solution in
less than two years (Fig. 3). Typically this patient's treatment time would
have been 22 months, but including MOP truncated treatment time down
to 13 months. This patient would have been a candidate for orthognathic
surgery because of his maxillary deficiencies, airway and upper-vs.-lower
arch discrepancies, but we were able to avoid surgery and achieve excellent
results with the much less invasive MOPs.

HFV: Facilitating the seating of clear aligners

Fig. 4: Before high-frequency vibration treatment
(HFV), aligner does not seat properly. Malocclusion:
Class III clinical bite. Treatment plan: IPR on the
lower anterior arch region, expand and procline
upper to finish in 1mm overjet overbite on anterior
coupling.

Fig. 5: Patient used HFV for five minutes daily to
seat the aligner.

66

JULY 2018 // dentaltown.com

I have encountered aligner tracking issues that could significantly
affect patient treatment time. During aligner therapy, if teeth are not
tracking well in the aligners, teeth will stop moving or even move in an
undesired direction. In these cases, I introduce the VPro5 high-frequency
vibration aligner seater (Propel Orthodontics) to get the treatment back
on track and reduce or eliminate pain attributed to the aligner therapy.5 In
my practice, patient compliance is high because this HFV device delivers
vibration in five minutes while the patient is at home each night. A recent
study has reported a 99.6 percent daily compliance rate with at-home use
as well as a "clinically meaningful, immediate, and extended reduction
in orthodontic pain."5
Another study that evaluated the effect of HFV devices on clear
aligner exchange intervals and treatment time has shown the beneficial
aspects of HFV with clear-aligner therapy. Besides reducing pain, the
study noted that "accelerated and more predictable tooth movement was
achieved using adjunctive HFV treatment with aligner therapy." In fact,
using the HFV device allowed 64 percent faster aligner exchanges than
the control in the study. The study subjects required fewer refinements
than control subjects and fewer aligners to complete treatment than in
the control groups.6


http://www.dentaltown.com

Table of Contents for the Digital Edition of Dentaltown July 2018

Dentaltown July 2018 - Intro
Dentaltown July 2018 - Cover1
Dentaltown July 2018 - Cover2
Dentaltown July 2018 - 1
Dentaltown July 2018 - 2
Dentaltown July 2018 - 3
Dentaltown July 2018 - 4
Dentaltown July 2018 - 5
Dentaltown July 2018 - 6
Dentaltown July 2018 - 7
Dentaltown July 2018 - 8
Dentaltown July 2018 - 9
Dentaltown July 2018 - 10
Dentaltown July 2018 - 11
Dentaltown July 2018 - 12
Dentaltown July 2018 - 13
Dentaltown July 2018 - 14
Dentaltown July 2018 - 15
Dentaltown July 2018 - 16
Dentaltown July 2018 - 17
Dentaltown July 2018 - 18
Dentaltown July 2018 - 19
Dentaltown July 2018 - 20
Dentaltown July 2018 - 21
Dentaltown July 2018 - 22
Dentaltown July 2018 - 23
Dentaltown July 2018 - 24
Dentaltown July 2018 - 25
Dentaltown July 2018 - 26
Dentaltown July 2018 - 27
Dentaltown July 2018 - 28
Dentaltown July 2018 - 29
Dentaltown July 2018 - 30
Dentaltown July 2018 - 31
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Dentaltown July 2018 - 33
Dentaltown July 2018 - 34
Dentaltown July 2018 - 35
Dentaltown July 2018 - 36
Dentaltown July 2018 - 37
Dentaltown July 2018 - 38
Dentaltown July 2018 - 39
Dentaltown July 2018 - 40
Dentaltown July 2018 - 41
Dentaltown July 2018 - 42
Dentaltown July 2018 - 43
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Dentaltown July 2018 - 95
Dentaltown July 2018 - 96
Dentaltown July 2018 - Cover3
Dentaltown July 2018 - Cover4
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