2014 K LINE Training Manual for Practitioners
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? 2 2014 K LINE Manual For Practitioners Diagnosis and Case selection 1- Indicated Cases After Before Crowded Teeth (up to 6 mm discrepancy) 3 2014 K LINE Manual For Practitioners After Before Spaced Teeth up to [6 mm discrepancy] 4 2014 K LINE Manual For Practitioners After Before C r o s s bites (simple, mild and moderate) 5 2014 K LINE Manual For Practitioners After Before Protrusions 6 2014 K LINE Manual For Practitioners After Before Deep Bites 7 K LINE Manual For Practitioners 2014 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) 8 K LINE Manual For Practitioners 2014 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 9 2014 K LINE Manual For Practitioners 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 10 K LINE Manual For Practitioners 2014 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 11 2014 K LINE Manual For Practitioners 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 12 2014 K LINE Manual For Practitioners 4-Radiographic requirements *Panoramic x-ray *Lateral cephalometric X-ray 13 2014 K LINE Manual For Practitioners 5-Clinical Photos *Intraoral photos 1-Frontal 2-Lateral 4-Occlusal upper 3-Lateral 5-Occlual lower 14 2014 K LINE Manual For Practitioners *Extraoral photos 15 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 2014 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 17 2014 K LINE Manual For Practitioners 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 18 2014 K LINE Manual For Practitioners 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 19 2014 K LINE Manual For Practitioners 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 20 2014 K LINE Manual For Practitioners 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 21 2014 K LINE Manual For Practitioners 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 22 2014 K LINE Manual For Practitioners 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. 23 K LINE Manual For Practitioners 2014 2. Click here to add a new case 3. Filling out the general information for the patient and save afterwards 24 K LINE Manual For Practitioners 2014 4. Uploading Radiographs, Pictures and any other documents NB: Please don’t forget to save the uploaded files. 25 K LINE Manual For Practitioners 2014 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 26 2014 K LINE Manual For Practitioners 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 27
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