Cosmetic Sequential Positioners COPYRIGHT Dr Biju Krishnan 2013

Cosmetic Sequential Positioners

COPYRIGHT © Dr Biju Krishnan 2013. ALL RIGHTS RESERVED No part of this publication may be reproduced, copied, photocopied, translated or converted to any electronic or machine-readable form without the prior written consent of Dr Biju Krishnan and Cfast UK Ltd. You must not circulate this work in any form and you must impose this same condition on any acquirer. Whilst great care has been taken to ensure the accuracy, Cfast Ltd makes no claims that this document is entirely error-free and reserves the right to alter or delete anything stated or implied in them.

DISCLAIMER Advice regarding treatment planning and case support information provided by members of the CFAST team is suggestive only. Any diagnosis, prescription, treatment or advice should be the decision and sole responsibility of the treating dentist.

What is ? • A series of clear sequential positioners designed to gently move the teeth from their current, to their desired position • Removable for eating, cleaning or for certain drinks • Each positioner is worn for approx 2 weeks and around 22 hours per day When the positioner is passive, you move onto the next one in the sequence

Benefits of Clear Positioners • Discreet, virtually invisible • Removable • Gentle • Comfortable • Simple for patients to fit • No Dietary restrictions • Minimal impact on daily life

Problems with Clear Positioners • Difficult to rotate or extrude some teeth • May require more IPR than fixed appliances • Will be slower than straight wire techniques • May need attachments • Increased lab costs(? ) • Compliance!

IPR – Interproximal Reduction • Lab will instruct exactly where, when and how much IPR required • Must follow instructions closely or will not get desired results • Unlike Cfast fixed, IPR mostly carried . out at beginning of treatment • Use leaf gauge to accurately carry out IPR.

Leaf Gauge

Attachments • Tooth coloured composite shapes bonded to the surface of the tooth enamel • Can be placed labially or palatally • Can aid tooth movement or retention where there is not enough surface detail • Can be various shapes depending on their purpose • Advise patient that they may be required at the start of treatment • Attachment templates will be provided by the lab

Example Attachments Carrier Retention Angulation Rotation

Placing Attachments • Check fit - Positioners A 1 U&L • Place correct shade of composite into attachments • Place attachment matrix, hold firmly and light cure • Remove matrix and clean attachments

q Take impressions and send to lab q Lab will advise how may trays will be required to correct alignment q Lab will share post alignment image via Dropbox q If using MAC will need OPEN FLIPPER or turn on PC mode and install orthoviewer installer. q The following image will give you an idea of what you can expect to see:

q q q q q Take impressions and send to lab Lab will advise how may trays will be required to correct alignment Lab will share post alignment image via Dropbox If using MAC will need OPEN FLIPPER or turn on PC mode and install orthoviewer installer Lab will advise where and how much IPR to carry out – if required Change trays every 2 weeks until treatment complete. If any tray in sequence does not fit, take new impressions and send to lab and ensure patient wears the last tray that does fit. Patient will require a conventional removable retainer at the end of treatment Advisable for patient to also have a fixed retainer made.

COPYRIGHT © Dr Biju Krishnan 2013. ALL RIGHTS RESERVED No part of this publication may be reproduced, copied, photocopied, translated or converted to any electronic or machine-readable form without the prior written consent of Dr Biju Krishnan and Cfast UK Ltd. You must not circulate this work in any form and you must impose this same condition on any acquirer. Whilst great care has been taken to ensure the accuracy, Cfast Ltd makes no claims that this document is entirely error-free and reserves the right to alter or delete anything stated or implied in them.

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