Friday, October 1, 2010

Invisalign G3 as Discussed by Your Markham Orthodontist


Your Toronto Invisalign Specialist took part in the web conference call release of Invisalign G3. Being implemented October 11th, it has been touted to deliver better clinical results. It will be available on Invisalign, Invisalign Teen, and Invisalign Assist. Some of the changes do may make it unsuitable for Invisalign Express. Below is a summary of some of the changes followed by Markham Orthodontist, Dr. Tam's, opinions.

The key improvements surround Smart-Force Features. The science is that the features are customized to each tooth based on width, long axis, and the contour of the entire tooth, while measuring actual forces. These new features and changes include:

1. Torquing ridges for lower incisors. Previously only on upper incisors to help with lingual root torque

2. Lingual ridges paired with buccal ridges when retracting and requesting lingual root torque. There was a previous concern that, when retracting teeth, no lingual surface was contacting the tooth, therefore removing one of the force vectors required to achieve a moment, and a compromise in root torque.

3, Optimized rotation attachments-Some new variations to allow them to be placed at the centre of the tooth if required, so that there are fewer interferences with the bite from opposing teeth. Previously only on canines, but now also on bicuspids. The claim is that instead of predictable 30 degree rotations, 45 degrees can also be achieved predictably. These attachments are supposed to be less retentive and therefore make it easier for patients to remove aligners when compared to the use of vertical attachments.

4. IPR staging- Earlier improvement was to check the contact points of the teeth before doing IPR, but will now take into account the mesial/distal axes as well as the incisal edges. This claim is that IPR is going to be a simpler procedure. indicators in the software will change colour of the IPR from grey=done, yellow=current stage, white=later to help the clinician properly identify when IPR is to occur.

5. Precision cuts- Precuts in the aligner are now available to allow the use of buttons or elastics. Previously, clinicians would have to make cuts in the aligners with nail clipper or crown/bridge scissors.

6. Passive aligners- No movement but still get fresh trays. Especially good for patients where one arch takes far longer than the other or those wearing elastics for several months to correct A/P discrepancies.

7. Delay of IPR and attachments. Specific movements requiring attachments will start when attachments placed. IPR can be requested to not occur within the first few visits to ease patients into treatment. Allow patients to get used to aligners and also help offices with patient appointments.

8. Highlighting of unpredictable movements- The range of “predictable” movements will be shown in the ClinCheck and any “harder movements” will be indicated. Previously had to be recognized by the doctor visually. For example, large extrusions, rotations, moving certain teeth without attachments, moving teeth large distances.

How does Invisalign G3 affect me as a doctor or as a patient?
These changes are in a positive direction for Invisalign and Align Technology. There is an improvement in the clinical efficiency for doctors, aiding in the patient experience, and a show of commitment to achieving scientifically- based, excellent clinical results with aligners.

For experienced clinicians, G3 does not mark a large change in the way we plan treatment, as many of us have already been personalizing these treatment features for our patients already. The biggest plus is that the new software and features make it extremely clear to doctors that they are the ones who are directing treatment. Impressions are not to be sent to Align to allow technicians to plan treatment. Invisalign is not magic. It should be viewed as an orthodontic technique, not a product. Therefore, while these changes allow the doctor more flexibility and decision-making, it will really begin to separate the experienced doctors from those who are less experienced. Treatment planning and diagnosis will still be paramount in any successful Invisalign treatment.

For more information, please visit www.torontoinvisalign.com or visit www.markhamortho.com to learn more about Dr. Tam and MCO Invisalign Orthodontics.

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