Adjunctive Applications of Clear Aligner Orthodontic Therapy in Periodontal Plastic Surgery & Implant Therapy
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Homa H. Zadeh, DDS, PhD
Course Description
Inflammatory periodontitis results in many negative sequalae, including marginal bone loss, gingival recession, interdental tissue loss, pathologic migration of teeth. Periodontal therapy is design to arrest the progression of attachment loss. Regenerative periodontal therapy can go one step further, seeking to restore some of the lost components of the periodontal attachment apparatus.
However, periodontal therapy alone is not adequate to restore optimal esthetics and function. Adjunctive orthodontic therapy is quite useful to reposition teeth, which have drifted as a result of pathologic migration. Moreover, tooth position can potentially predispose to attachment loss. For example, crowding and facially positioned roots are examples of potential predisposing factors to attachment loss and gingival recession. Treatment of recession defects is not as effective when teeth are positioned outside of the alveolar bone. Orthodontic therapy and optimize tooth position within the alveolar bone to improve the chances of root coverage periodontal surgery.
Implants are often needed in situations where adjacent teeth have drifted and in poor position. Orthodontic therapy can improve spacing of teeth to optimize implant positioning.
Multiple clinical trials and systematic reviews have demonstrated better periodontal parameters of clear aligner orthodontic therapy, compared with conventional fixed orthodontic appliances.
Recent improvements of digital tools, have provided advantages of clear aligner therapy to reposition teeth. In particular, root torqueing aims to reposition cervical regions of roots back within the alveolar housing. Interproximal reduction can reduce the size of embrasure spaces to improve the esthetics of “black triangles” without restoration. Drifted teeth can be repositioned to open spaces which were not optimal for implant positioning.
This course will review the adjunctive value of clear aligner therapy to enhance the esthetic and functional outcomes of periodontal plastic surgery, as well as optimize teeth position in preparation for implant therapy.
Educational Objectives
How Clear Aligner Therapy works:
- Attachments
- Clear aligners material
- Digital technology: virtual planning software
Indications for Clear Aligner Therapy:
- Classification of malocclusions
- Open bite
- Deep bite
- Crowding
- Spacing
- Black triangles
Clear Aligner Treatment considerations
- Rationale
- Case selection
- Limitations of clear aligner therapy
Ancillary devices Clear Aligner Therapy
- Microscrews as Temporary anchorage devices
- Buttons
- Elastics
Biological Considerations:
- Physiology of tooth movement
Orthodontic & periodontal therapy interactions:
- Effects of orthodontic therapy on periodontal parameters
- Periodontal considerations
Surgically facilitated orthodontic therapy (SFOT)
- Corticotomy
- VISTA for SFOT
- Bone augmentation
- Soft tissue augmentation
Mucosal phenotype modification therapy (PMT)
- Rationale
- VISTA for phenotype modification therapy
- Biomaterial used for phenotype modification therapy
- Sequencing of soft tissue augmentation & clear aligner therapy
Implant and clear aligner therapy
- Clear aligner therapy for site development and optimization
- Sequencing of implant & clear aligner therapy
Risk Assessment:
- Patient and site characteristics
- Management of patient/site risks
- Anatomic considerations and risks
Evidence Based Therapy:
- Comparison of clear aligner therapy with conventional fixed appliance orthodontics
- Long-term outcomes
Limitations of Clear Aligner Therapy:
Complications:
- Prevention and management
Retention options
Hands-On Workshop Simulated Exercises
- Introduction to virtual tooth position planning software
- Tooth translation: mesial-distal, buccal-lingual
- Intrusion-extrusion
- Rotation
- Crown angulation
- Root torqueing
Educational Format
This course offers a flexible educational format to accommodate all clinicians’ needs and interests.
Participation may take place either:
- In-person or remotely (held over Zoom)
- Live (synchronous) or on-demand (asynchronous)
The hybrid education model provides some of the information in an online format, so that prior to the live presentations, participants have an opportunity to review the content and gain basic background information. This information is accessible on an on-demand basis.
Schedule for Live Session
Saturday February 19, 2022
8:00 AM to 8:00 AM …… Registration & Breakfast
9:00 AM to 11:00 AM ….. Lecture
11:00 AM to 11:30 PM ….. Break
11:30 AM to 1:00 PM ….. Lecture
1:00 PM to 2:00 PM ……. Lunch
2:00 PM to 3:15 PM ……… Lecture
3:15 PM to 3:30 PM ……… Break
3:30 PM to 5:00 PM ……… Workshop: virtual planning software
Tuition
$495 Live In-Person
$295 Remote Learning: Lecture
CE Units
- 7 hours
