Orthotown October 2017 - 32
4. The big one (to me): Modifying your ClinCheck.
ClinChecks are derived from a program called Treat, which Align
Technology trained my techs to use. But they're not orthodontists, of course,
and the Treat program is like so many other computer programs and goes by
default values. Cut-offs need to be made and hierarchies developed.
Let me explain: Suppose UR1 needs to be extruded 0.51 millimeters.
Because the cutoff is 0.5mm, the extrusion would be classified as a "moderately
difficult" movement and there would be an attachment placed. But if UL1
needed extrusion of 0.49mm, that would be below the 0.5mm cutoff-no
attachment would be placed and the tooth would be assigned as an "expected"
movement. However, we know that the difference between the two is not
clinically distinguishable.
This goes for optimized attachments, also: If a tooth needs rotation and
extrusion, which attachment should be assigned to it? You must determine
which is more important, and can place an attachment that you believe will
work best. IPR, tooth positions, order of movement, timing of movement, arch
form, arch width, unwanted movements, size and shape of attachments-all
these require doctor input. I've found that most orthodontists are
comfortable changing final tooth positions and add a few degrees
of torque or rotation. That is simply not enough and doesn't make
you much better than a GP using the appliance. So how are you
going to get better?
5. These are not braces!
Just because you've been trained in orthodontics doesn't mean
you can easily shift into clear aligners. Although biomechanics
is biomechanics, they don't work the same and each has its own
strengths and weaknesses. Having a driver's license doesn't mean
I can drive an 18-wheeler, even if it's a "transportation mode" just
like an automobile. Change your thinking to adapt to clear aligners!
I have fun with these now, and the appointments are usually five
minutes or less spread sometimes over three months. (That's why I
have time to post cases on Orthotown and write this article.)
6. Spend the time to learn this system.
Expect the unexpected. I've found that when unusual things
happen in fi xed, most times docs don't even notice because such
things occur all the time and they're used to it. But the first time
you have a posterior open bite or a tooth intrudes in a clear-aligner
case, this becomes a big deal.
32
OCTOBER 2017 // orthotown.com
http://www.orthotown.com
Table of Contents for the Digital Edition of Orthotown October 2017
Orthotown October 2017 - Intro
Orthotown October 2017 - Cover1
Orthotown October 2017 - Cover2
Orthotown October 2017 - 1
Orthotown October 2017 - 2
Orthotown October 2017 - 3
Orthotown October 2017 - 4
Orthotown October 2017 - 5
Orthotown October 2017 - 6
Orthotown October 2017 - 7
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Orthotown October 2017 - Cover3
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