December 07, 2022

3D TECHNOLOGY IN ROUTINE ORTHODONTIC PRACTICE BJÖRN LUDWIG

8 minutes

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

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

...more

View all episodes

By Farooq Ahmed

77 ratings

December 07, 2022

3D TECHNOLOGY IN ROUTINE ORTHODONTIC PRACTICE BJÖRN LUDWIG

8 minutes

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

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

...more

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3D TECHNOLOGY IN ROUTINE ORTHODONTIC PRACTICE BJÖRN LUDWIG

3D TECHNOLOGY IN ROUTINE ORTHODONTIC PRACTICE BJÖRN LUDWIG

More shows like orthodontics In summary

The School of Greatness

The Skinny Confidential Him & Her Podcast

The Diary Of A CEO with Steven Bartlett

The Orthopreneurs Podcast with Dr. Glenn Krieger

Well with Arielle Lorre

All-In with Chamath, Jason, Sacks & Friedberg

Huberman Lab

Meditación para dormir

ZOE Science & Nutrition

Hey Docs!

Morning Microdose

Motivación Diaria por Motiversity

Pursuit of Wellness

The DOC Podcast

Orthodontic Pearls Podcast