Predictable extrusion of a tooth with Invisalign

Raman Aulakh describes clinical logic, design approach and practical techniques that allow a more reliable extrusion of a single tooth using Invisalign.

The discussion is based on methods based on evidence and real experience and must serve both GDPs and orthodontists trying for a more predictable method for this movement with alignrs.

Because the extrusion remains a challenge

The concept of the combination of vertical and horizontal forces to guide the extrusion more predictably was introduced by Dr. Jonathan Nicozisis (2010). He supported the synchronization of extrusion with withdrawal movements, using the power direction to optimize industrial alignment – a fundamental idea we now refer to as disconnecting and extrusion of engineering.

The aligners are pushing – they do not pull. This fundamental truth is the reason why teeth extrusion is classified among the less predictable movement of alignment (Rossini et al, 2015). The challenge is the industrial: When Aligner tries to pull a tooth down, plastic often slips over the tip of the notch, creating unintentional overturn or no movement (Upadhyay et al, 2022).

Strategies to success

A power approach begins with the understanding that clear aligners need help to express vertical movements. Here are the clinical tools that improve extrusion efficiency:

Attachment design

Extrusion cannot occur without proper traction. The welding of a vertical rectangular or optimized extrusion creates a submarine for alignment to promote (Simon et al, 2014). For the cutters, the ulcers found in horizontal adhesives increase surface involvement and minimize lifting of alignment.

Relative extrusion through overthrow

The relative extrusion refers to changing the vertical position of a tooth not by moving it straight downwards, but by overthrowing it, so that the tip of the cutting appears lower. This movement is easier for alignrs to express a more predictable method than the attempt of a pure vertical movement (Haouili et al, 2020).

Schedule hypertension

Due to low surveillance rates, digital settings must include excessive mechanics. For example, if 1mm extrusion is required, consider 1.5-2mm. This ensures that even if the move is relegated, the clinical result still meets the target.

Swirling

A strong industrial concept combines slightly linguistic extrusion. This creates a vector This allows the aligner to push the tooth down as it withdraws – by improving the involvement of alignment and vertical motion performance. I am referring to this as withdraw and blast mechanics.

Auxiliary support for persistent cases

When attachments and excessive mechanics fail or are inadequate, aids such as tires can provide a direct vertical force. Buttons on the tooth with tires in a cut off or opposing attachment offer the missing attraction. In severe deviations, the cross sections or engineers supported by TAD can be justified.

Example cases: Industrial application in practice

This 30 -year -old man wanted to align the UL3 to improve his aesthetic smile and operation. The initial, projected and real results are presented in Figure 1.

In Figures 2A, 2B and 2C, we can see the clinician planning, each move was designed with control to achieve the scheduled movement presented in red:

1. Create a visible space between teeth during alignment, so there is no endopoxmic commitment and serves as a starting position as we can see in Figure 2a
2. The Procline tooth (as shown by the green arrow in Fig.
3. Use equal amounts of extrusion for each increase in withdrawal. The resulting is the push vector of the slope (as shown in the blue arrow in Figure 2C)
4. Address design: Position in a lower notch Tuesday to maximize tail adhesion with alignment interface.
5. Optional linguistic tires then oral to help scheduled movements.

Final thoughts

Clear aligners have gone a long way, but vertical control remains borders that requires respect for industrial. Predictable extrusion is not a software trick – it is a method of treatment. Use of design with force using withdraw and blast mechanicsThe exact attachment selection and preventive staging convert the extrusion from unreliable routine.

To find out more about achieving this level of clinical accuracy and predictability, consider enrollment in Postgraduate Diploma in the treatment with clearWhere we are deeply immersed in power systems, advanced clinical design and complex industrial.

References

• Boyd, R (2017). Clinical advances in Invisalign Aligner technology. J World Orthodontic Federation6 (2), 81-89.
• (2020). Has Invisalign improved? A future monitoring study on the effectiveness of tooth movement with Invisalign. American Journal of Orthodontics and Dentofacial Orthopedics158 (3), pp. 420-425.
• Nicozisis, JL, (2010). Invisalign case report: Anterior cross correction and extrusion mechanics. Orthotown MagazineOctober 2010.
• (2015). Effectiveness of clear alignrs in controlling orthodontic tooth movement: a systematic review. The corner orthodontist85 (5), pp. 881-889.
• Simon, M, Keilig, L, Schwarze, J, Jung, NE and Bourauel, C, (2014). The outcome of treatment and the effectiveness of a technical alignment – in terms of torque of the cutter, premature frustration and molecular remote. Bmc oral health14 (1), pp. 1-9.
• Upadhyay, M, Yadav, S, Nela, PK and Nanda, R, (2022). Industrial of clear alignment Therapy: Is there a standard protocol? Newspaper of clinical orthodontics56 (5), pp. 259-269.

This article is funded by the Aligner Dental Academy.