joel m. eichen d.d.s.

http://www.invisalign.com/US/index.html


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--
Joel M. Eichen, D.D.S.
Philadelphia PA

http://www.phillyducks.com
We’re Just A Duck Call Away!


STANDARD DISCLAIMER applies ~
meaning no one IN PENNSYLVANIA
has seen the tooth or teeth in
question so take this advice in
proper context ~ its the internet!

We is guessin'!

joel m. eichen d.d.s.

Why pretend that these guys (who are not to my liking either) do not
exist?

Why would de-NILE help?


Joel

--
Joel M. Eichen, D.D.S.
Philadelphia PA

http://www.phillyducks.com
We’re Just A Duck Call Away!


STANDARD DISCLAIMER applies ~
meaning no one IN PENNSYLVANIA
has seen the tooth or teeth in
question so take this advice in
proper context ~ its the internet!

We is guessin'!

carabelli

I will respond anyway. As far as I am concerned this is not a proven
technique *yet*. As I have said before, I will sit on the sidelines until I
am convinced it is an effective long term technique. In theory it should
work, however there are times I have a hard enough time moving teeth with
pretty stout alloy wires let alone a peice of "strong medical grade
plastic". Charlie may have more to say with some hands-on experience.


carabelli (certified in 6 hours)

wb

Don't worry, you will never be replaced.
I appreciate the orthodontist as I do not
enjoy bending wire.

jgenecov@aol.comnojunk (jeff

OK Joel - Here Goes...

I've been working with Invisalign for about 3 years,It generally works pretty
well, although it's not a panacea.

Maybe my success with it has been that I do not try it on patients for whom
I'm not sure it will work. For example, an Invisalign candidate in my office is
not one who would need extractions, not one who would need orthopedic/surgical
jaw changes, not one who would be a compliance problem.

One who would be a candidate would be one who has mild to moderate anterior
crowding, one who has an anterior crossbite that can be solved non surgically
or one who has excessive spacing.

If the patient understands that Class 2 skeletal/dental correction is not
doable, then we can leave that alone and resolve other issues. we try to
provide reasonable expectations, and therefore can meet them and often exceed
them. When that happens it's a win - win.

As for long term stability, teeth moved by Invisalign are as stable as any
other modality - it's all in the original diagnosis.

That's where the treatment planning and interaction with Invisalign comes into
play. It's crucial to understand the movement of the teeth and whether or not
how the Invisalign people interpret what you've requested. we spend a lot of
time getting their treatment predictions to fit within biologically predictable
limits.

<< Subject: Re: Invisalign
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From: Joel M. Eichen D.D.S. joeleichen@yahoo.com
Newsgroups: sci.med.dentistry
Date: Tue, 08 Jul 2003 08:27:06 -0400
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We need some professional opinions about if this is effective and
where it is effective ........

Professional ... as in "orthodontist."


Joel


--
Joel M. Eichen, D.D.S.
Philadelphia PA

http://www.phillyducks.com
We’re Just A Duck Call Away!


STANDARD DISCLAIMER applies ~
meaning no one IN PENNSYLVANIA
has seen the tooth or teeth in
question so take this advice in
proper context ~ its the internet!

We is guessin'!


Regards,

Jeff Genecov, DDS, MSD, FICD
Diplomate, American Board of Orthodontics

fmn

With the new IP appliance design, very little wire bending is necessary, yet
full control is achieved. Jeff, have you heard about the "Individual
Patient" appliance system that adds overcorrection of rotations directly in
the bracket and adds labial and lingual root torque directly in the bracket?
fmn

jgenecov@aol.comnojunk (jeff

NNTP-Posting-Date: Tue, 08 Jul 2003 16:57:17 GMT
Date: Tue, 08 Jul 2003 16:57:17 GMT

I think if the limits are clear, as Jeff points out, this has a use. I
noticed a guy named Hilliard has developed "thermopliers" and has developed
a system of altering the invisalign type appliance using the "Essix"
appliance. It seems this would perhaps help, but takes away from the
simplicity.
I appreciate your point, Jeff, about the predictions vs skeltal limits and
could see this being a major issue if we overpromise the patient.
fmn

I think that's the point, that's orthodontics is not just a matter of putting
the brackets on, or placing an aligner and "VOILA" the teeth straighten
themselves out. There are a myriad of other factors to consider, and if you
consider Invisalign, or Essix retainers or even a Crozat appliance ,
appliances, then you have to understand the nuances of that appliance,
including how to achieve your goals when the appliance doesn't appear to be
working.

The thermopliers, or the other auxillaries that are necessary for Invisalign to
do it's job require clinical experience & education, as well as ingenuity and
luck!

simplicity is good, but you have to know what to do when things get
complicated!
Regards,

Jeff Genecov, DDS, MSD, FICD
Diplomate, American Board of Orthodontics

jgenecov@aol.comnojunk (jeff

Sounds like andrew's original Strait Wire Appliance to me!

<< With the new IP appliance design, very little wire bending is necessary, yet
full control is achieved. Jeff, have you heard about the "Individual
Patient" appliance system that adds overcorrection of rotations directly in
the bracket and adds labial and lingual root torque directly in the bracket?
fmn >>

Regards,

Jeff Genecov, DDS, MSD, FICD
Diplomate, American Board of Orthodontics

fmn

That was the original promise of the Andrews appliance in the major shift
from putting the same type of bracket on all teeth and requiring the
operator to place them at the right angle and then rely on wire manipulation
for complete alignment. These were the days when orthodontics was truly an
art and required a great deal of operator participation. Like other
technological advances have help other dental procedures become simpler
freeing us consciencious dentist to provide BETTER more complete service,
the straight wire appliances simplified the alignment and leveling part of
ortho and can truly me a mostly auxiliary procedure. This allows the
consciencious orthodontist to then spend more time seeing the nuances of
skeltal resistance, maxilla shape, tooth size discrepancies and all the
other subtleties that were hard to pay attention to in the early days.
I know you have been bombarded with every "new" bracket there is, but this
seems to be different. It starts with a basic Roth prescription straight
wire, 022 slot bracket. What is unique is there are variations that add
ADDITIONAL m or d rotation in the bracket slot itself as well as torques for
additional labial root torque or lingual root torque. The Individual
appliance feature is that you do not have to carry a big inventory of
brackets, but you order the individual appliance with their software with
guaranteed deliver in 7 days. It is sort of the same concept as Invisilign
in that we use modern technology to design the case in the beginning to
anticipate finishing problems, thus less wire bending. The difference is,
of course, there are few limits that invisalign has. If there is a surgery
case, the appliance is planned accordingly and you order basic brackets that
fit that case. If you extract, it automatically suggests brackets designed
to compensate for unwanted rotations as you close the extraction space. If
you have a TPA it automatically adds lingual sleeves to the bands, if you
have a Class III tendency, it automatically changed the lower anterior
brackets to more labial root torque, if you have a skeletal class II, it
automatically prescribes a lingual root torque bracket, etc. You of course
have the ability to review the reasoning and change what you want, but now
you just evaluate a suggested appliance rather than create it from scratch,
or worse, prescribe the same appliance for all cases.
fmn

carabelli

I understand this was not addressed to me - however. I am not familiar with
this one. Does this mean overcorrection was built into the brackets? What
does the case look like at removal? Are the overcorrections still present
then?

carabelli