CAD software to design clear aligners?

Discussion in 'sirona, implant planning, ortho, other software' started by denticious, Mar 23, 2015.

  1. AL

    AL New Member

    I come from Southern Italy (Napoli), but I don't own a private practice anymore. I rather work as a consultant in several offices and I am nowadays travelling much less thanks to the possibility of following cases from long-distance with intraoral scanning and in-office clever orthodontic assistants. I could call myself a tele-orthodontist:)
     
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  2. yan

    yan Member

  3. 2thm8kr

    2thm8kr ɹotɐɹʇsıuıɯqA Staff Member

  4. yan

    yan Member

    I would like to know too.
     
  5. Almine

    Almine Member

    Finally got some free time to publish my recent findings on aligners' mechanics.

    First of all I must say that thay my theory of providing only uncontrolled tipping movements works very well. I've finished 23 clear alginer patients since October and only two of them required a small refinement due to some mistracking after the initial serie of the splints. When I was moving teeth with translational movements, like everyone does, I had to make additional aligners or refinements for almost half of my patients (those who had more than 7-8 aligner per jaw). So I would recommend to everyone to try to follow such "uncontrolled tipping" philosophy for aligners' virtual setups. And to do staging of course.

    One of my new conclusions is about anglulation movements. Many times I've tried to bond double Invisaling-style attachments for improving root's positions, but had no results at all.
    [​IMG]

    The only working way to change angulation is to use the same uncontolled tipping movements in the mesial-distal direction. It only works if there is a surface on the approximal area available for pushing on a tooth. I've tried to explain my thoughts on a photo.
    [​IMG] [​IMG]

    Of course this is not a pure angulaion that we can achieve with brackets, but it's still a way to obtain more space and to improve incisial edges' positions by using very simple and predictable movements. No attachments needed, just a surface to push.

    Uncontrolled tipping is also a very powerful option for providing relative extrusion and intrusion.

    [​IMG]
    [​IMG]

    But what if we want to get pure vertical movements with clear alginers? Sometimes it's also possible.

    In the past I placed rectangular attachments on the teeth next to the one to be intruded. The value were about 0,07 mm per step.
    [​IMG]
    [​IMG]

    Then I noticed that I can control intrusion of the whole anterior area by placing attachments on the canines only.
    [​IMG]
    [​IMG]
    [​IMG]

    But rectangular attachments placed in anterior area make troubles to patients to take off the aligners. So that now I use 90-degree beveled spherical attachments with the height of 1mm. They are much more convenient for my patients and allow me to intrude anterior teeth for the same 0,07 mm per stage. And they also singificantly improve aligners' retention, that's why I bond such attachments to all of my patients even if they don't require intrusion.

    [​IMG]

    I don't experiment much on pure extrusion, but sometimes I notice that it can be obtained if there are few contidions exist:
    - Enough room
    - A straight vertical vector of the movement
    - A rectangular attachment of 1 mm height placed in the middle of the crown or closer to the incisal edge
    - 0,12 mm per step
    - Better to use for the upper incisros then for the lower

    I still belive that the only 100%-predictable way for pure extrusion is using elastics as I described previously, but sometimes I extrude up to 0,6 mm with attachments only.
    [​IMG]
    [​IMG]
    [​IMG]

    But what is more interesting, we can use rectangular attachments bonded on the upper teeth for dual simultaneous pursopes. An attachment preforms two functions - it extrudes a tooth and helps to intrude the neighboring teeth.
    [​IMG]
    [​IMG]
    [​IMG]

    One more.
    [​IMG]
    [​IMG]

    We not only tell them before starting a treament, all of my patietns sign a treatment plan, an informal consent form and a financial plan prior to any our actions inside their mouths. We don't also charge a fee for annual controls and maybe due to that reason our photographic libary includes records of more than 500 cases of super long-term observasions for 20-30 years.

    Ha-ha, "tele-orhodontist" also describes me very comprehensively :):):) I even installed a touch-screen PC in the middle of my cabinet to see my patients via Skype when I'm taveling, cuz I spend a half of my time abroad.
    [​IMG]

    By the way, I will visit the Naples region in the end of March. If you will be there we can meet up to drink campanian wine and discuss clear alginer orthodontics :coffee
     
    Last edited: Aug 27, 2017
  6. 2thm8kr

    2thm8kr ɹotɐɹʇsıuıɯqA Staff Member

    Almine, thanks for posting your findings. I have a case I am working on right now that will need intrusion and extrusion.
    I will be trying your theories.

    Can you share how you implement elastics with aligners some time?
     
  7. Almine

    Almine Member

    I've already posted some pictures of extrusion with elastic here, but here is another case.
    [​IMG]
    [​IMG]
    [​IMG]
    [​IMG]
    [​IMG]
     
  8. 2thm8kr

    2thm8kr ɹotɐɹʇsıuıɯqA Staff Member

    What are you using to anchor the elastic on the lingual side?
    I have thinking about using an attachment on the lingual on the model only and filling with acrylic or composite. Maybe after thermoforming I have enough structure on the aligner to anchor the elastic??
     
  9. Almine

    Almine Member

    Don't make it that complicated. And if you bond something to an aligner, you will not extrude a tooth. Buttons must be bonded directly to enamel.

    [​IMG]
     
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  10. megan_dental

    megan_dental New Member

    Does anyone know a link that i can use to purchase the maestro ortho studio software?
     
  11. megan_dental

    megan_dental New Member

    Can anyone tell me if attachments are required for arch expansion or distalization?
    If so which ones are most suitable?

    I use Maestro 3D Ortho Studio and for my blanks i use Dreve Biolon 0.75mm.
     
  12. 2thm8kr

    2thm8kr ɹotɐɹʇsıuıɯqA Staff Member

    For palatal expansion I use these:
    palatal expander.png

    And salt and pepper it to thermoformed 2mm PMMA.
     
  13. BukakiYourMom

    BukakiYourMom BukakiMyMom

    For software write to Italians just visit maestro page and buy it.
     
  14. Anyone2007

    Anyone2007 New Member

    3D maestro
     
  15. Anyone2007

    Anyone2007 New Member

    i have good experience working on 3D Meastro .. if somebody need help so i am ready
     
    BukakiYourMom and cadfan like this.
  16. harrydiculous

    harrydiculous Administrator Staff Member

    Maestro 3d
    Go to their website and you can download a fully functioning demo version.
    Try it out... I have used it since its conception... not bad for a couple of guys doing all the coding!

    They also have an online manual. ( search maestro 3d wiki )

    Need any help... well there are offers on this site ..
     
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  17. awesome.ely

    awesome.ely New Member

    i have maestro use occasionally but want to use more any tips on printers for aligners
     
  18. megan_dental

    megan_dental New Member

    we use Form2 Printers for printing aligners they work very well
     
  19. megan_dental

    megan_dental New Member

    Does anyone have any advice with this case?
    Tried several times to correct the 21 and 22 with several refinement aligners but there still doesn't seem to be any improvement. Is it a case of using a different composite tag?
    I use 3D Maestro Ortho software
    mcgee1.jpeg mcgee2.jpeg
     
  20. Ok so what is the overall opinion here for the best software for taking an stl scan and designing a set of aligners to be printed in house?
     

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