Clear Aligners in Orthognathic Surgery Flavio Uribe. AAO June 2021. Episode 106

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Farooq Ahmed

Clear Aligners in Orthognathic Surgery Flavio Uribe


Use of aligners

·      57% – questionnaire from JCO Keim 2020

o   Previously 2014 22%, 2008 12%

·      90% of orthodontists satisfied with outcomes of aligners

·      Type of case

o   Most malocclusions



Challenges with aligners and orthognathic surgery

·      Intermaxillary fixation

o   Conventional IMF In surgery = brackets

o   Aligners – difficult as no fixed dental component

§  Use TADs for IMF Potential root damage – can be prevented using a stent

§  Positioner type surgical splint / wafer – Caminiti 2019

·      Transitioning into and out of surgery

o   Scan 2 weeks prior to surgery

§  Fit 2 weeks after surgery

o   Segmental maxillary procedure

§  Scan 4-5 weeks after surgical splint removed / Hawley type retainer

§  Wait 4 weeks to deliver aligners


Occlusal outcomes in orthognathic surgery and aligners

·      ABO-OGS: Invisalign = 41 Vs 28 with conventional  Robitaille 2016

·      Flavio study

o   PAR: 89% reduction to 3.5

o   ABO-OGS: Average 33 (failure of ABO-OGS)

§  Cases – mainly issue with rotations on 7s



·      AOB case

o   3 part maxilla

o   5 clinic appointments



·      Surgery 1st is amenable to aligner treatment



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