CATEGORY 50 AUSTRALASIAN DENTIST Aligner Cases: Chairside Checklist 1. Patient selection u Proper case selection – Proper diagnosis and suitability for aligners. u Review crowding, rotations, torque needs, deep bite/open bite, and anchorage. u Check the periodontal status, caries risk, restorations, and enamel quality. u Assess the compliance potential and expected wear time. 2. Treatment planning u Stage the movements conservatively. u Create sufficient space for tooth movement before starting the tooth movement. u Avoid combining too many difficult movements in one phase. u Decide early if attachments or auxiliaries are needed. 3. IPR decision u Confirm a real space need before planning IPR. u Do IPR only when the contact is clearly accessible. u Prefer IPR after teeth are aligned enough to visualize and reach the contact. u Reconfirm the amount needed for each contact before starting. 4. IPR execution u Measure planned reduction before starting. u Use the least invasive controlled method. u Protect soft tissues and adjacent teeth. u Keep reduction conservative and symmetrical. u Finish and polish enamel thoroughly. u Recheck contact tightness after IPR. 5. Aligner monitoring u Confirm tray fit at every visit. u Look for poor tracking, gaps, or tray distortion. u Do not advance trays automatically if tracking is off. u Reassess staging before adding more IPR. 6. Oral health u Reinforce brushing, interdental cleaning, and fluoride use. u Watch for gingival inflammation and demineralization. u Check for sore spots, ulceration, and tray-edge irritation. 7. Follow-up u Compare actual movement with the planned setup. u Document all IPR: site, amount, and date. u Delay extra IPR unless the contact is accessible and still needed. u Consider refinement aligners if movement is incomplete. Conventional Orthodontics: Chairside Checklist Before bonding u Confirm the diagnosis and treatment goals. u Review medical history, allergies, periodontal status, caries risk, and oral hygiene. u Take baseline records: photos, scans/models, radiographs, and cephalometric records if needed. u Check for enamel defects, restorations, and compromised teeth. u Explain treatment duration, risks, diet limits, hygiene requirements, and retention. Bonding phase u Verify bracket prescription and slot size. u Check bracket position before curing. u Remove moisture and isolate properly. u Confirm archwire sequence and ligation method. u Trim wire ends and ensure there is no tissue impingement. Appointment checklist u Check for loose brackets, broken wires, or ulceration. u Check the oral hygiene and reinforce brushing and interdental cleaning. u Assess the periodontal inflammation and demineralization. u Review progress against the treatment plan. u Compare current tooth movement with expected staging. u Adjust archwire, elastics, or auxiliaries as planned. u Document any emergencies or appliance damage. Prevention u Use good bonding technique and accurate bracket placement. u Stage forces lightly and progressively. u Monitor oral hygiene at every visit. u Give diet advice: avoid hard, sticky, and very sugary foods. u Use fluoride and remineralizing support when indicated. u Respond early to loose brackets, poking wires, or broken appliances. u Take radiographs and records when root resorption or other problems are suspected. Debonding and retention u Remove residual adhesive completely. u Check the enamel surface after debonding. u Provide a retention plan clearly. u Explain retainer wear schedule and long-term follow-up. u Record treatment outcome and any complications. Conclusion Orthodontic treatment can produce complications such as root resorption, periodontal damage, and enamel lesions, but these risks can be minimized through careful diagnosis, controlled forces, good oral hygiene, and regular monitoring. Though no treatment is fully free from iatrogenic effects, consistent monitoring and proper follow-up can reduce the adverse effects and yield a positive outcome. u Contact gapmagazines@gmail.com for a complete list of references CLINICAL
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