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Aligner orthodontics. in growing patients. a research based approach. Tommaso Castroflorio Episode 69 December 17th 2020

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Farooq Ahmed

 

Aligner orthodontics. in growing patients. a research based approach. Tommaso Castroflorio

 

·      Expansion ideal prior to lateral incisor eruption: Bjorn Zachrison and Marco Rosa

 

Cause of maxillary retraction

 

·      Increasing malocclusion in the population Corruccini 1985

·      Higher prevalence of reduced intermolar width in recent generations Defraia 2006

 

Timing of expansion

·      Transverse changes of maxilla between 7-11mm Nanda 2012

·      Little force required to separate palatal suture in 7-9 year olds Hugo De Clerk and Proffit 2015

 

Invisalign first

·      Attachments on primary and secondary teeth – optimised

·      Staging of expansion:  1st molar first

·      Simultaneous expansion: anchorage strained.

 

Research of Invisalign first

1.     43 cases retrospective

2.     Average age 8.1

3.     Treatment 9.7 months

4.     Area increased 19%, volume increase 38%

 

Mandibular advancement

·      Active / optimised wings, similar to twinblock, but laterally placed

·      Active plane interact and postures the jaw forwards

·      Timing of functional appliances, predictor of timing

o   CVM, however validity questioned  McNamara and Baccetti

o   Females pubertal growth CVM2-3 Oyonarte 2020

o   Males pubertal growth CVM3-CVM4 Oyonarte 2020

·      New predictor of pubertal growth :

o   Stage of 2nd  lower molar root development Oyonarte 2020

 

 

Case selection for MA

·      ANB 5 degrees

·      Class 2 molars

·      Convex profile

·      Average angle

·      2nd molar development

 

Unpublished research

 

·      45 treated MA Vs control (no treatment)

o   0.48mm of advancement per month

o   Reduction of Witts 2.6mm

o   Co-Gn +8mm

o   Similar changes to twinblock

 

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