SMART PATH FROM SCIENCE TO SMILES
2014
K LINE Training Manual for
Practitioners
K LINE Manual For Practitioners
2014
What are K Line Clear Aligners?
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Diagnosis and Case selection
1- Indicated Cases
After
Before
Crowded Teeth (up to 6 mm discrepancy)
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After
Before
Spaced Teeth up to [6 mm discrepancy]
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After
Before
C r o s s bites (simple, mild and moderate)
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After
Before
Protrusions
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After
Before
Deep Bites
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Not Indicated Cases
The following figures represent severe cases, with no treatment option with K Line aligners (these are only examples, certification and further clear aligner education is recommended for best case selection)
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How to identify indicated cases if you aren’t an expert??
We will make it easy and simple for you, as follows:
Just gather up simple rough data for your case to be submitted ,to be
mentioned within, clinical photos, impression or models and panoramic radiograph wherever possible .We will assess the case data and
revert back to you with a predicted treatment plan.
Please find below the case flow Chart
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Insuring best quality through impression taking:
A good impression helps to ensure proper identification of tooth
anatomy and the manufacture of aligners that fit and deliver better
force on the teeth desired to be moved.
That's through the following:
1- Take accurate impression
a) We need the arch captured perfectly in your impressions
to reach at least the 2nd permanent molars.
b) The impression should extend more than 2mm beyond
the free gingival margin on the buccal and lingual surfaces.
c) Using polyvinyl siloxane two phase technique or polyether
are recommended.
1
4
2
3
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2-Take opposing arch impression
Checking the impressions for:
a. All teeth are included in both impressions
b.Gingival margins can be clearly identified
NB:
*If any of the aspects are not visible in you impression, we highly recommend taking a new im-
pression
*If it is your first time to send K Line impressions, kindly take 2 impressions per arch, we will pick the better one.
3-Take Bite registration
a. Wax bite horse shoe bites (more preferable.)
b. Rubber bite used in overseas cases
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Good impressions
Good capture of
the anatomy
The gingival margins are clearly demarcated
Bad impressions
Bad capture of
the anatomy
The gingival margins are deteriorated, with no
Light wash
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4-Radiographic requirements
*Panoramic x-ray
*Lateral cephalometric X-ray
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5-Clinical Photos
*Intraoral photos
1-Frontal
2-Lateral
4-Occlusal upper
3-Lateral
5-Occlual lower
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*Extraoral photos
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Tips and Tricks
to achieve ideal outcomes
Before discussing the problems you may face during and after treatment, you
should put in mind the following:
Teeth movement = Space + Force+ Time
Insufficient Space may be due to:
Insufficient IPR
Effect of insufficient force system/points of contact in the aligner
and/or attachment
Treatment plan that limits the success of creating space required
That will cause:

Tooth will not move

Incomplete seating of the aligner will occur

Active Forces increase
That can be prevented by correct IPR (Interproximal reshaping)
1-Check the Interproximal Contacts
2-If the contact is tight; relieve it by
stripping.
K LINE Manual For Practitioners
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Insufficient force may be due to:

Lack of correct engager to aligner contact

Insufficient time for the movement
That will cause:

No case Progress

Incorrect teeth movements
Engagers
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Cases Management Considerations
During treatment considerations
 Aligner fitting
Aligner popping off
Causes
Solutions
-Inaccurate impression
at the start of the case
-Take new impression
-Expansion movements at the
beginning of treatment
Not occurred
-Ask the patient to frequently
bite to help seating the aligner
-Ask patient for patience till
aligner is seated normally
Aligner too retentive
Causes
Solutions
-Severely tipped, crowded or
flared teeth
-Trim away the aligner in undercut
regions
-Too many engagers
-Smooth the engager edges
Aligner not retentive
Causes
-Short clinical crowns
Solutions
-Create retentive dimples by pliers
-Ask K Line for more engagers on
teeth or more gingival
coverage
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Teeth movement
Tooth not rotating
Causes
Solutions
-Insufficient Space
-Check tight contacts on teeth trying
to rotate and relieve with finishing
strips
-Difficult tooth anatomy
(i.e canines and premolars )
-Use thermoforming pliers for
more
Controlled and optimized
Coupling force.
Tooth not extruding
Causes
Solutions
-Engager not optimally
tached
-Ask the patient to bite on cotton atfitting to help seating
Unplanned intrusion
Causes
-Insufficient space causing aligner to
squeeze tooth apically
Solutions
-Relieve contacts with
finishing strips
-Buttons & elastics to
extrude the tooth back
-If significantly not attached,
take new impression
-Insufficient aligner
wearing time or
elastic wearing
-Extend wear time
-Schedule patient for more visits
-Patient should understand that
additional costs may be needed for
extensions
Due to the treatment duration
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Post- treatment considerations
Black triangles
Causes
Solutions
-Unwanted tipping between
two teeth causing contact
point to be occlusal
-Due to the teeth shape and position
-Upright the teeth with
buttons
& elastics or fixed
appliances
-Move contact point
gingivally through IPR
and then close the space
with Refinement or
detail plier
-Then Connective tissue graft
Black triangle
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Posterior open bite
Causes
Solutions
-Anterior interference
-Refinement to relieve
interference by additional
Leveling. IPR may be
needed
-Transient intrusion of
-Cut out premolar to molar
material on the occlusal surface
region of aligners to allow
of the posterior teeth
for settling of the posterior
-Sometimes expressed more in
Patients with bruxism
-Treat bruxism
Posterior open bite
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Root tipping
Causes
-Roots not moving
Solutions
-Use buttons and elastics
request Ball indentations to
control the torquing much
better
Premature occlusal contact
Residual spacing
Causes
Solutions
-Not enough time for
-Extend wear time
movement to express due
-Refinement
bone biology or patient
compliance
-IPR ledge makes contact
appears open
-Remove ledge with IPR, close
space with Refinement
Residual spacing
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K Line® Portal
We always recommend our clients t establish use their accounts on our website portal for a better professional data
collection ,better treatment planning and communication
between the dentists and our professional support
To access K Line portal, kindly follow these simple steps:
1. Visit www.klineinternational.net and login using your
K Line login account.
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2. Click here to add a new case
3. Filling out the general information for the patient and save afterwards
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4. Uploading Radiographs, Pictures and any other documents
NB: Please don’t forget to save the uploaded files.
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Finally, don't forget
To prevent relapse
Traditional orthodontic treatment isn't over when the braces come off, and
clear aligner treatment is no different.
After straightening their teeth, patients need to wear a retainer to prevent
them from relapsing.
There are a lot of retention protocols.
Generally; we recommend long term retention.
We start with full time wear of removable retainer for about one year and then
night wear for the following years. Additional fixed retention through lingual
wire will be preferable
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K Line clear Aligners
K Line Europe
Karl-Zahn-Str. 11, 44141 Dortmund Germany
Landline: +49 (0) 23153370600
Fax: +49 (0) 23195095585
info @kline-europe.de
www.kline-europe.de
www.facebook.com/klineeurope
K Line Team
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