Brain Teaser! How do we get this Lateral to extrude and rotate!?
Question:
Need help please! The movement on 2.2 seems unrealistic. What could I do to make it more predictable and at the same time
Answers by the Group:
Reply by Clearly Aligned Team:
If in doubt a buccal and lingual sash and space on either side either by creating it by opening it or IPR if you have OJ to allow the loss of tooth mass
Leave it open this round or put a clear stop sticker on the aligner thst initiates closure so you don’t lock yourself in
Follow up question by @Aparna Agrawal :
May be a lingual attachment as well?
Dr. Schalk’s Answer:
Introduction
This article addresses the challenge of achieving realistic and consistent 2-2 movement in orthodontic treatment. The focus is on strategies to improve the movement of teeth, particularly when significant rotation and angulation are involved.
22 Movement Analysis
The 2-2 movement involves complex dental adjustments, including 58 degrees of rotation, 10 degrees of angulation, and 4 degrees of root tip. The primary concern is often root movement, but in cases of significant rotation, emphasis may shift to rotational adjustments.
Strategies for Consistent Movement
To enhance consistency, it is crucial to create space around the tooth undergoing significant movement. This involves opening space around the tooth, which can be closed during refinement. Adjustments include increasing space up to 0.5 mm and focusing attachments on rotational components, making them larger (e.g., 5 mm) to prioritize rotation over root movement.
Implementation and Compliance
Technicians should be instructed to open space around the lateral incisor before movement begins. Additionally, patient compliance is essential for successful treatment outcomes, and patients should be informed about the importance of adhering to treatment protocols.