Australasian Dentist Magazine May June 2021

Category 96 Australasian Dentist T he evolution of clear aligner therapy has transformed the way we can better connect and communicate with our patients. As clinicians, it also has redefined our ability to also better diagnose and treatment plan our patient’s wants and needs. We are all aware that the age of connectivity and social media means our patient’s wants has gravitated towards aesthetics. The digital workflow of clear aligners has enabled technology to arm the modern clinician with the ability to automate visual differential treatment plans. This allows the visual collaboration of orthodontics, facial aesthetics and prosthodontic principles. The principles that this author applies refers to AORTA principles amalgamating prosthodontics, aesthetic orthodontic and facial aesthetic principles to establish functional and aesthetic solutions with minimally invasive dentistry and or surgery. The principles can be grouped as: 1 Extra oral consideration 2 Peri oral consideration 3 Dentition principle here is to optimise facial aesthetic balance, not symmetry, and use clear aligners to expand the arch by non-parabolic arch expansion. CASE 1 Patient presents wanting to enhance his smile. The patient had fixed orthodontics as a child where tooth 31 was extracted. He has an inverted smile line and buccal corridor that is wider on his right side, with the maxilla vertical fifths are wider on his left side. The objective is to not only align his smile, but use the clear aligner software to broaden arches non parabolically to balance the asymmetrical buccal corridors and ensure his smile line is parallel with interpupillary line. Pushing the Boundaries of Clear Aligners – Series 2 BUCCAL CORRIDORS clinical Power of clear aligners with multidisciplinary treatment planning – Buccal Corridors By Dr John Hagiliassis In this second article in the series, we will explore how clear aligners can balance the facial aesthetics asymmetry with sequential clear aligners. The AORTA aesthetic orthodontics principles encourage our clinicians to establish extra oral, peri- oral and dental parameters. When evaluating the patient’s buccal corridors, the clinician needs to assess the patient’s extra oral vertical fifths and establish the patient’s facial midline (glabella and/or cupids bow of the upper lip). By establishing these refence points, it assists the clinician to identify buccal corridor asymmetries from a facial aesthetic balance perspective. Clear aligners can provide non-surgical alternatives and non- parabolic arch expansion to balance the buccal corridors’ negative space to appear less and improve facial balance. Based on the AORTA SAC protocols of predictable movements, buccal corridors could be improved by 2-4mm labial translation of the upper posterior teeth (SEE AORTA SAC PROTOCOL). The The key is to assess smile line and choose a reference tooth where the other teeth in the smile line are moved to balance the facial aesthetic objectives. In this case tooth 21 is our reference tooth so the other teeth are extruded to correct inverted smile line. The result was achieved within 13 months and completed with in chair whitening; and has been in retention for 5 years. Figure 1.1 – Before Alignment Figure 1.2 – After Alignment