“If you are not willing you use elastics – you are not able to get finishing like braces” Mazyar Moshiri

“We cannot have a reasonable discussion of efficacy and accuracy until we study the appliance as orthodontic clinicians, and not as scientists Mazyar Moshiri

Join me for the first summary of 2025, exploring finishing with clear aligners. Mazyar Moshiri explores overcorrection with aligners, when they should be used and his protocol. It was a lecture from last year’s AAO winter meeting..

This episode consists of overcorrection methods of 4 malocclusions: deep bite, anterior openbite, class 3, and expansion. Maz also shares his pearls on what to watch out for when using clear aligners with overcorrection.

EXTRAS: Mazyar Moshiri has kindly given permission for the summary slide of his overcorrection protocol to be included in the podcast notes, please see the podcast website https://orthoinsummary.com/

Overcorrection

Deep bite - achieve AOB

Over-intrusion lower incisors to achieve a 50-100% of total movement predicted

Favourable if proclaining teeth, unfavourable if retroclining

Use of attachments on premolars, note the hierarchy of attachment design places anchorage for anterior intrusion 5th, “Drs have to doctor the Clincheck”.

Anterior openbite

Posterior intrusion – overcorrect with occlusal bite blocks

class 3 triangular elastics canine and premolars

Force down on posterior bite blocks

May require controlled relapse following overcorrection, done in refinement

NOTE – aligners continuous force system, reciprocal extrusion of anterior teeth is expected

Class 3 case

Retract lower incisors with retromolar tads and 6 Oz 3’16th

Side effect – increase in curve of spee – similar to retraction on a NiTi wire, aligner is not stiff enough to resist

Correction in refinement with anterior intrusion to eliminate premature contacts, DO NOT EXTRUDE POSTERIOR TEETH, as aetilogy is anterior iatrogenic extrusion

Expansion

Overcorrection of 1-2 mm, greater the further posterior

Attachments, plan buccal attachments +/- palatal attachments, to account for likely buccal tipping, ensuring buccal root torque and preventing palatal cusp dropping

Tip: for palatal cusp dropping place occlusal attachment on the palatal cusp to prevent extrusion during expansion

Caution – if already in buccal version, consider limited correction