Invisalign First – after 50 cases. Pedro Costa-Moneiro
Phase 1 6-10 years old
· 90% of upper facial growth complete by 10 years of age
Why phase 1
· Airway centric
· TMJ: if class 2 can develop TMD
· Maximal mandibular growth:
· Smile arc
Attachments
· Most teeth required, small crowns
· Cut template into quadrants
75% of 1st clinchecks are approved: should adjust based on biology and anesthetics
Class 2 case
· 1st clinheck retract upper incisors
· Modified to have mandibular advancement to improve profile
Bilateral crossbite
· RME expansion
· Wait 6 months then scan for aligners
Expansion protocols
· Simultaneous expansion
o Can result of upper incisor retraction
· Staged: 1st molars, followed by primary molars
o Maintains the AP position of upper incisors
· Clinical tip:
o To control torque on molars horizontal attachment 4mm
