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Is there a reason that clincheck software cannot account for this? It seems like a relatively predictable thing to program, so is the software really just not that advanced?
Hi from Chile,I made it using a aesthetic botton to the tooth and using a elastic to a little cut in the aligner. Was pretty easy as well
It was easy because you understand the principles and the mechanics! Well done! Thanks for the comment.
My dentist did not use any attachments on my teeth he just put simple aligners i also have diastema and open bite.
If your dentist decided to treat without attachments, he/she must have a good reason. Every case is different. Let us know how it turns out for you!
Can you clean them in hydrogen peroxide ?
If you dilute it with lumewarm water (50/50), hydrogen peroxyde can be an effective way to clean aligners and help remove stains. Let them soak for about 15-20 minutes.Make sure you brush them well after and rinse them before putting them back.
Gerry Samson brings people together all over the world. 🙏🙏🙏
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oh my god you are so annoying
I'm on my third aligner with bite ramps and I've noticed after like a day or two the bite ramps turn from a bump that stops the teeth into a literal ramp that the teeth slide back up along when I bite down. How do I stop crushing the bite ramp or is there something wrong with them?
This is unfortunately something that can happen more often when there is heavy grinding or clenching of the teeth. We suggest informing your treating dentist or orthodontist as soon as possible.
I have over bite teeth what should i do i choose IPR or removing 4 teeth which one please help?
IPR
Amazing video, thanks Stephane
Would it be a waste of time doing dental work experience if you get rejected from dental school
Learning is never a waste of time ;)
Thank you for the video Doc. What are the anchorage requirements to rotate the molar? Lock all other posterior teeth on that side until the rotation is finished?
I wanted to ask the same thing since molar rotation is challenging with clear aligners especially when we deal with an angle near to 20-25°
Great question. Rotation of round teeth (cuspids and premolars) are even more challenging. First make sure there is no friction or collision with the other teeth. Determine if it’s only rotation or a combination of movements (any tipping or torquing involved as well?). What type of rotation is it? Pure vs hinge? Where do you need to apply the force? For example if the teeth would be in soft wax, where would you apply the force with your thumbs? That will be a good indication of where to put attachments. And it is known from scientific literature that asking for a 1 degree of rotation per aligner can greatly help in the predictability of the movement. If it’s only rotation, there is no need to lock the other teeth into position. We hope this will help you :) Have fun with your rotations ;)
@@theCLEARinstitute thanks for the detailed answer :)
I do not want IPR since my bottom front teeth already have half the enamel worn down. How IPR was recommended to me for my Invisalign treatment knowing this issue is a problem, bothers me. I'd rather a longer treatment plan then making my already worn down teeth worse and unfixable.
Update?
Long term or short term-wise, Is it ever a bad idea to opt out of IPR and extractions? I told my orthodontist that I don’t want to have an IPR, the orthodontist said it’s fine but I would have just some minimal imperfections. The reason I don’t want IPR is because I like the size of my teeth how it is and I don’t like retrusion of my teeth/jaw. I want the fullest jaw as I can get basically.
Update? Do you like the result?
I'm ok with IPR when it is conservative. I prefer to use metal strips over a bur. Burs seem aggressive and it's hard to keep things even.
Not against IPR but MAN...i hate doing it 😅!!
We totally understand. But sometimes a dentist's gotta do what a dentist's gotta do 😉 Thank you for watching and commenting!
Stephane, thanks as always. Love these gems 💎 🦷
Subscribe to the channel! And take a look at our live and online courses here: learn.theclearinstitute.com/
Does Suresmile offer bite ramps to help a deep bite?
The important thing to remember with bite ramps is, as any article been published proving it helps in deep bite cases? And if so, how? By intruding the lower anterior teeth? How? From the intermittent pressure it applies on the teeth? Hhmmmm… Maybe it helps in the disclusion of posterior teeth when we want to extrude them, but it is still, at the moment, a clinical opinion rather than a scientific fact.
If I have a patient that already has braces when she was younger, has been compliant with wearing her retainer from Ortho and has shorter maxillary anterior roots, but is now having traumatic occlusion on #9 banging against #23... There is now class I mobility on #9 due to the occlusion. Would a maxillary retainer with bite ramps on #7-#10 help this patient by opening her bite slightly to prevent the traumatic occlusion? She does not wear a lower retainer due to having a lingual bar.
Thank you for reaching out with your question and providing a detailed description of the patient's situation. While specific cases like the one you mentioned involve complex decision-making, it's important to remember that providing diagnostic and treatment planning without a comprehensive examination can be highly inaccurate and potentially misleading. In general, addressing a situation involving traumatic occlusion, especially in the anterior region, requires a multifaceted approach. The primary goal is to identify and eliminate the cause of the trauma. This could involve various interventions, such as occlusal adjustment, intrusion, or proclination/retroclination of the involved teeth, among others. Simply adding bite ramps to a retainer might not address the underlying issue of traumatic occlusion effectively. While it might offer temporary relief, it does not resolve the cause of the trauma. In clinical practice, the focus should always be on a comprehensive solution that not only treats the symptoms but also addresses the root cause of the problem. Each patient's situation is unique, and treatment plans should be tailored to their specific needs, considering all factors, including previous orthodontic treatments, compliance with retainer wear, and the current condition of their dentition. Again, while we can discuss general approaches and considerations, it's crucial for the patient to consult with their dentist/orthodontist for a personalized evaluation and treatment plan. Only a professional who can assess the patient's condition firsthand can provide the most accurate and effective treatment recommendations. Thank you for understanding the limitations of online advice.
I want to be a dentist but i grew up poor and have had bad teeth and i feel sad that i want to become a dentist cause even if you put in the work and became one you would still have bad teeth and no one would respect that at all
Haha, loved this! You definitely got me
Please don't give a patient the 5th degree over not wearing their elastics like he's suggesting here. You might as well turn on the light and face it right at them while asking like you are under investigation for a crime. I've been that patient and it's really uncomfortable and embarrassing. Have some compassion. An easy resolution is to gently remind them to wear their elastics, how often they shouldbewearingthem, ask if they are having issues with using them. Especially if you as the provider can tell the patient hasn't been using them.
You are right! Communication and explanation is the best solution and should be the first thing to do. And using humour always helps, like we do in this video ;) Thank you for sharing your experience with us.
Thank you
Love it!
Thank you Adriana!
Hlo... I have missing upper two laterals with space .. Is alligners helfull for me to replacement of canine in place of lateral incisor
Always depending on your case, it may be possible. But in similar cases, aligners can be used to either to create and open spaces for implants or to close spaces and for example bringing canines to substitute the missing laterals. Each case is unique and has to be evaluated by a knowledgeable dentist or orthodontist.
Very inspirational. I loved it. Bravo Stephane
Thank you so much! Glad you enjoyed it.
Tremendous message. Exceptional delivery
I have a very wise orthodontist as a mentor!
You can read the blog article inspired by that speech here : learn.theclearinstitute.com/blogs/news/a-new-chapter-in-dentistry-embracing-our-digital-destiny
Hello Dr,,where can i download clincheck 6.0,,Thanks...
The beauty of it is there is no need to download anything. Everything is on the cloud. You just need to become an Invisalign provider and you will automatically have access to the ClinCheck software.
How about for inhouse clear aligners..
@@ravinimbal1621 Depending on the system you use, you will have a software to make your virtual setup. Every system have their own software. The one described in this video is the one used for Invisalign clear aligners. One thing to remember is that the principles and mechanics of tooth movement apply to all types of clear aligners :)
this is exxelante whats your name are you a doctor
We appreciate your positive feedback! If you found our content valuable, please feel free to share it with others. Dr. Stephane Reinhardt is a general dentist with over 30 years of experience who developed an interest in orthodontics and clear aligners. He leads our educational endeavors at The CLEAR Institute. As the Director of Education, he ensures that our range of online courses, private coaching sessions, and live in-person courses are impactful and relevant. Dive deeper into our offerings and Dr. Reinhardt’s expertise at: learn.theclearinstitute.com Your journey to clear aligner mastery starts here!
WHAT IS THE WORK FLOW FOR ALIGNERS?
It starts with a good examination, scanning and taking all records to have a complete diagnostic. Informed consent is crucial. Then treatment planning using virtual software like the ClinCheck. Once the aligners are ordered, we see the patient and deliver the aligners. Depending on the case and your level of knowledge and confidence, you decide how often you want to see the patient to monitor and follow up on the results. Once treatment is finished and patient is satisfied we start the retention protocol that will last until the patient wants to keep the teeth straight :) You will find everything you need to know in the MOCA 101 online program here: learn.theclearinstitute.com/collections/bundles/products/m-o-c-a-101-the-foundation-basic-clear-aligner-principles
Just noticed these on my next set of trays, was wondering if my dentist just forgot schedule for attachments now I know. But now I am just curious why they aren’t filled in with plastic
We are wondering the same and Dr. Reinhardt has been saying for many years that the bite ramps should be filled by plastic. Then we would have the benefit of the bite ramps combined with the benefit of an active push by the plastic covering the lingual surface of the teeth.
Visit our website to learn more about clear aligner principles: learn.theclearinstitute.com/
What do you think of sure smile aligners and the fact that I will not be getting buttons placed on my teeth also the aligners feel a little loose on the top thank you😊
Studies and scientific literature proves that having the right attachments will increase the predictability of tooth movement and success, whatever system you use. It’s scientific evidence… Even better than what we think ;)
Please fix your website It’s too slow
We will check that. Thank you for sharing.
Invisalign has over ten million cases. Why, after all these years, do we have to second-guess the results? Why should we even have to add overcorrection? THIS SHOULD BE AN INTEGRAL PART OF THE INITIAL INVISALIGN SETUP!!!! Experienced and knowledgeable clinicians such as Stephanie must be the force behind the Clincheck algorithms. When a case requires a specific setup to achieve the result, that should be a part of the initial setup. It is frustrating for patients to undergo multiple refinements over an extended period to achieve the planned result.
Thank you for your comment Richard. We dream of the day when the virtual setup softwares will reproduce the real movements of the teeth and also adat them to the type of attachments and mechanics we place on the teeth. We’re just not there yet. What we see on the ClinCheck is the shapes of the aligners, a force system. How the force will be applied on the teeth. But we have to figure out and visualize how this will translate in the patient’s mouth. There is a difference between a ClinCheck and a RealityCheck ;)
@@theCLEARinstitute Hi Stephane. Thank you for taking the time to provide your thoughts. The ClinCheck and the RealityCheck should be the same. The technician must point out that certain teeth are precisely positioned to compensate for the flexible trays. Doing so will reduce the number of refinement trays. After ten million plus cases, the proper setup by Invisalign must be done according to what you are teaching and what is required for the appliance to achieve the desired movements. After all these years, I am trying to understand why this is not being done. It makes working with the appliance extremely frustrating. In many cases, brackets and wires are just faster and more predictable.
To know more about ClinCheck Pro modifications, take a look at our online course here: learn.theclearinstitute.com/collections/online-courses/products/clincheck®-pro
Excellent as always!!
When considering ethics in dentistry, is it ethical to remove four healthy teeth in children with the consent of their parents but without informed consent of the possible side effects mentioned in the article written by Dr Larry and Dr Zubad, “Does having had premolar extractions affect how orthodontists treat their patients? Apilot study” (Smaller airway, narrow arch forms, apnea and Tmd to name a few of the possible complications…)
Wrong that TMD is not correlated with extraction orthodontics. See 2022 research study: Londoño A, Assis M, Fornai C, Greven M. Premolar Extraction Affects Mandibular Kinematics. Eur J Dent. 2023 Jul;17(3):756-764. doi: 10.1055/s-0042-1755629. Epub 2022 Sep 27. PMID: 36167318; PMCID: PMC10569881. All previous articles denying the correlation were commissioned by the AAO in response to the Brimm vs Malloy lawsuit, which threatened the industry since the jury verdict was that extraction/retraction "severely mutilated" the patient's jaws. See as well the Brazilian survey of 200 plus orthodontists (2015) which established that 405 of orthodontists with seniority, believed, according to clinical experience, that orthodontic treatment can and does cause TMD. See as well these patient reports (soon to be published) own their experience of extraction orthodontics: Ruined my face, and face/jaw pain Narrow smile, TMJ and ear pain, breathing and sleeping at night problems i think they made my temples hurt Constant jaw pain from tmj My jaws get tires and sore most days. Pain every day in my jaw, teeth that never feel they belong in my mouth, sleep disorder Constant tension in jaw, both sides My jaw gets tired rather quickly. Recessed Jaw which has affected confidence, also jaw feels tight and unnatural when teeth are fully closed. I cannot open my mouth wide open Extractions and braces at 13 significantly contributed to my TMD. I had severe pain and by 18 (freshman year of college) I had surgery- cut and move down the condyles and wired shut for 6 weeks. The whole thing was traumatizing. I have psychological issues eating because I’ve had so many oral surgeries and such severe pain that eating wasn’t worth the pain at one point. It’s a lot of conditioning to unlearn. I have an underbite which has contributed to TMJ issues Jaw click Instability of the mandibular joint, audible and painful popping and clicking, fatigue when talking for long periods. Negative overall health, TMJ disorder, class III occlusion due to retracting maxilla. Only upper, currently smaller than lower jaw. Lower jaw is cramped and to bite properly, must be shoved back into the socket. I’ve had surgery to move the condyles down to make space for my non existent discs (scar tissue) to rest Mainly TMJ issues, I have a dislocated disk on my left side of the jaw and had to go to physical therapy to help with tension release and opening the jaw easier. I developed a huge open bite due to a NTI appliance prescribed for my TMJ and am now wearing braces again to correct the open bite and symptoms. I'm in my 4th year and it's definitely no fun... My bite is off resulting in severe TMJ pain, muscle tension and headaches. It has diminished my jawline - looking at pictures before and after it is evident - As well, I suffer from TMJ and had arthroscopic TMJ surgery as a result Extreme pain in TMJ and lower jaw bone. Severe bone loss in tmj joints, difficult breathing through nose and throat, face appearance, no remaining tmj discs I am having TMJ replacement with Lefort Clicking sound in jaws, at times painful, difficulty in breathing Severe TMJ, likely caused by orthodontic actions as child. Premolar extraction gave TMD, wisdom teeth extraction gave airway issues. I have developed TMJ disorder, grinding which has led to lost teeth. Now have a worse overbite than I did before braces. I have arthritis in my tmj, I'm currently under treatment as the inflammation is too much Idiopathic Condylar Resorption, relapsed to open bite from braces twice. I had horrible TMJ pain within 2 months of getting my braces off. I grind my teeth really bad now. I get headaches often, but I’m not sure if that’s caused by my jaw. I hate my side profile. My chin is recessed, my lips are weirdly uneven, and I have no jawline whatsoever. I prefer to lie down as maybe this is more comfortable for my TMJ and the tension I feel in my face. Now that the mask mandate is over I continue to wear it even though it makes my teeth feel more sore because I'm so ashamed of my face. I think my right side TMJ got worse after two years of constant mask wearing. My teeth are in terrible shape with painful abfractions, gum recession and bone loss between teeth leading to many black triangles. Every tooth has weakened enamel and is sensitive to temperature. I am ashamed of my smile as it makes me look old. It feels like my teeth are too far back, I have to stretch my face to show them when I smile. Severe TMJ pain for over 20 years. Constant regret and depression from losing permanent teeth. Constant tmj pain and pain in teeth my lower receeding jaw has been exacerbated, lower face pulled backwards, tmj issues Severe TMJ became so swollen at age 30 that jaw was pushed into a severe crossbite, had to be manually pushed back into place by oral surgeon. Now wearing a jaw splint. I clench my jaw all night. I’ve tried several different mouth guards but they don’t help. I am constantly sore in the muscles around the TMJ. My jaw naturally wants to open more to the right side, which they “corrected” with my orthodontic treatment. If I spend some time massaging and loosening the muscles around my jaw it will allow my natural opening and it feels great. Trying to open straight down doesn’t work. Severe tmjd and trigeminal neuralgia. Whole body aches. Poor sleep. Tongue too wide for my mouth. Sought treatment through an LVI trained dentist but it did not help. I used to have a great looking jaw when I was younger. I started mewing before my extractions, and I was even seeing improvements of my facial structure. Since I got my extractions, I don't see any improvements and I feel like my palate got a little narrower and my bone volume has decreased. + more jaw clicking Clicking jaw. With only the upper premolars extracted, I've had to compensate to have a Class I occlusion by pulling my mandible backwards to fit the smaller upper arch, this has caused displaced articular discs in both joints, along with a range of associated symptoms such as headache contribution, feeling weaker and a compromised airway. After removing my braces, my jaw was completely out of line. Ortho told me it would “get better”. years later, it has not. My 3rd molars also came in sideways after braces were removed. my lower receeding jaw has been exacerbated, lower face pulled backwards, tmj issues not being able to sleep and breathe properly Bad TMJ- headaches- teeth grinding/chewing It was very painful and embarrassing to have the missing space there and jam a fake invisalign tooth down ln it for months as the gap was closed. 15 years later and I have been diagnosed with TMD and OSA. Severe TMD treated with botox, stiff neck, dizziness, postural issues. It has caused me to not be able to sleep correctly. I had 4 premolars removed at age 12 and had my wisdom teeth removed at age 18. I have had TMJ disorder since I was 30 years old and wore a night guard for 17 years that I chewed through. I got a new one and my sleep got so much worse because the new night guard was bigger and my mouth is so small. I tried CPAP and never went to sleep. I am thin and not overweight. I used a TAP Mandibular Advancement device for 2 years and I would wake up in the middle of the night with my teeth hurting and could not go back to sleep. I now just tape my mouth when I sleep. I am looking for a solution to fix the root cause of my problem. I don't get enough quality sleep and I am always tired and have TMJ pain and get frequent headaches. Short face, Tmd issues facial asymmetry from TMD Extreme regret over aesthetic changes and loss of my facial shape and lips I used to have. Upset that my teeth have worn down due to clenching, and my mouth breathing leading to an exasperation of my facial features. Upset that my TMJs are not in great health. My tmd didn't start for more than 20 yrs after ortho was completed and I attribute its onset to reconstructive dental work as the symptoms started within a few days of its placement; however, its possible the ortho increased the risk of the loss of my upper and lower incisors which is why the reconstructive dental work became necessary. Chronic migraines, TMJ (1230 verbatims total)
Very true!! Love it!
Looks like you added a slight occlusal bevel in the video?
It's more of a gingival bevel, but it depends on how you look at the bevel 😊. We consider the bevelled surface to be the one where the force will be applied.
@@theCLEARinstitute good definition. Thanks for the great videos!
Amazing and engaging video, thank you, I learned so much, keep it up! 👌
With compliments to the (g)new Dr. Stubble.
Take a look at our courses and programs here: learn.theclearinstitute.com/
Hey there! I had braces for a year now and after getting them off I have a 7mm overjet in my front upper 4 teeth. I had an appointment with another orthodontist and she suggested to do 4 premolars 3xtraction or simply an IPR if I want to extract my teeth. My question is what's your advice? Should I have to do extraction or 7mm overjet/flared teeth can be fixed with ipr.
Thank you for your question. Even if we would like to help, and 7mm of OJ seems a lot to correct with IPR only, we can't provide any diagnostic here. We recommend you get a second opinion if you are uncomfortable with what your dentist/orthodontist told you. You must trust the person who will provide the treatment and be comfortable with the treatment plan proposed. Good luck with your treatment.
Hi guys ! loved this video. Do have something about IPA and Virtual Care ? I'd like to learn more about it. Thanks
Not yet, but coming soon ;)