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CLINICAL
CONSIDERATIONS
SPACING
SPACING
SPACING CASES TREAT MOST PREDICTABLY WHEN:
1. Anterior teeth are flared.
2. Both arches are matching
(e.g., have spacing present)
3. The arches are wide and u-shaped
(not omega- or v-shaped)
GENERAL TREATMENT PLANNING CONSIDERATIONS
Tongue thrust
If there is anterior spacing caused by tongue thrust, aligners may serve as a block for the tongue during
treatment, but the patient must also change their habit to avoid relapse after treatment is complete. A
robust retention protocol will be essential to keep teeth in their place.
Tooth size discrepancy
If there is tooth size discrepancy (teeth too small for the size of the arch), restorative options such as
veneers might be suggested. If there are missing teeth, Invisalign treatment options can include pontics
when there is sufficient space so that the patient’s appearance can be improved during treatment. In
treatments where there is spacing on one arch caused by tooth size discrepancy and crowding on the other,
IPR in the arch with crowding may be required.
Patient’s profile
The patient’s profile must be considered when treatment planning for cases. Simply closing all space by
retracting the teeth may have a detrimental effect on an already flat profile. Sometimes a better alternative
is to maintain the existing profile and reallocate space (e.g. leave residual spacing distal to the second
premolars).
SPACING
INVISALIGN SPECIFICS
Default protocols for space closure
On spacing treatments with flared teeth, the spaces will be closed by retroclining (via lingual crown
tipping movements) the anterior teeth; note that this will create relative extrusion and increase the overbite
unless the teeth are intruded at the same time. This can be very helpful to address spacing/open bite due
to tongue thrust or other habits.
On spacing treatments with more upright teeth, retraction with bodily movement will be employed to
maintain the current anterior teeth inclination. To ensure that the Power Ridge feature is applied to the
ClinCheck treatment plan, you may want to consider requesting additional lingual root torque.
Virtual C-Chain
Consider requesting Virtual C-Chain overcorrection at the end of treatment to ensure full space closure.
Using Virtual C-Chain requires careful monitoring to ensure the contacts don’t get so tight that the teeth
start crowding. These overcorrection stages are optional.
Active aligners are
displayed in blue.
Passive aligners are
displayed in grey.
Overcorrection aligners
are displayed in brown.
For more information and treatment planning help
Learn more from your peers who are successfully treating patients with both mild and severe spacing:
https://learn.invisalign.com/spacing#tips
Align Technology, Inc.
2560 Orchard Parkway
San Jose, CA 95131
Customer Care Toll Free
(888) 822-5446
https://learn.invisalign.com
© 2013 Align Technology, Inc. All Rights Reserved.
Invisalign®, ClinCheck® and SmartTrack®, among others, are trademarks and/or service marks of Align Technology, Inc.
or one of its subsidiaries or affiliated companies and may be registered in the U.S. and/or other countries.
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