Search

3D TECHNOLOGY IN ROUTINE ORTHODONTIC PRACTICE BJÖRN LUDWIG

Play episode
Hosted by
Farooq Ahmed

3D TECHNOLOGY IN ROUTINE ORTHODONTIC PRACTICE BJÖRN LUDWIG

Lower arch missing lower 2nd premolars

  • Hemisection lower E – distal half – Old school
  • Allow mesial drift of 6s, L4s do not distally tip, important in class 2 cases
  • Use mesial aspect for anchorage if ankylosed
  • Remove remaining 

Other options

  • TADs 30% failure in the mandible in Caucasian
  • Herbst 
  • Mini-plates – very evasive
    • But hemisection is simple

Gingivectomy

After extrusion of impacted tooth,  need for gingivectomy 

  • Orthodontists should learn as common need
  • Process
    • Scan
    • Plan a gingivectomy guide
    • Laser or electrosurgery for gingivectomy

Cant and TADs

  • adult cases are the future of orthodontics, more challenging
  • RHS>> Gincevectomy
  • LHS>> extrusion using TADs TAD – opencoil to bracket on the tooth, and aligner to guide the tooth, cover incisal edges only
  • And few aligners
  • Patient did not want perfect result

 

Space closure and TADs Georgios Kanavakis 2014

    • Space closure and mesial slider
    • 2 x palatal tads
    • SS spring close 
  • Mesialization of molars
  • High tech
  • But Space closure can be achieved with timely extractions, such a smissing UEs and extractions with mesial drift.. 
  • Less likely lower arch, miniplates used to mesialise

 

Expansion

Digital planning

  • Digitally decompensate the lower arch.

 

MARPE

  • Changes to the midface through MARPE
    • Hard tissue changes to the midface and nasal complex
  • Caution in use, for selective cases only, and critical in use

SARPE

  • Indicated due to resistance for Maxillary expansion in adults from 3 potential structures 
  • Zygomatic buttress, Pterygoid plates, Sutures from the mid face Published 1984 by Andrew Glassman 
  • Using a finite element analysis programme,  fusion 360,  identify the resistance individual to patient
  • Case: Surgical guide to do a small lateral osteotomy under local = future as it is individualized to each patient

 

CBCT guided autotransplantation

  • CBCT assess site
  • guided donor site preparation
  • Guided restorative management  of premolar as central incisor

Hybrid treatment brackets Vs aligners

  • Class 2 correction
  • Change from fixed to aligners with Onyx Ceph planned wings for class 2 correction – like functional appliance

 

Problems

  • Distalisation with Miniscrews 
    • Later on posterior crowding of 2nd molars and risk anterior recession
  • Fracture of palatal appliance
  • Failure at welding point between expander and abutment
  • Can stop people using designs
  • Solution
    • print 1 piece appliance CADCAM
  • Overuse

TAKE HOME MESSAGE BY ME FROM THE LECTURE

  • Sometimes effort is not equal the benefit so always evaluate your benefit
  • Always assess your outcome and see if technology you invested in worth it
  • Orthodontists are Dentists and should do some gingival contouring and temporaries ..etc
  • Always match arch before and after treatment and maintain your arch form 
  • Future is Hybrid Therapy … using strength of both aligners and fixed braces

 

Join the discussion

More from this show