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buttons for invisalign cases
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dsg_c1



Joined: 11 May 2005
Posts: 352
Location: mill creek, wa

PostPosted: Wed Aug 31, 2005 11:00 am    Post subject: buttons for invisalign cases Reply with quote

JK,

good morning. i have had few (too many) buttons fall off of patients that are in Tx with invisalign. my asst.'s usually do all of the buttons. i had them watch the vidoes awhile ago. my asst.'s want to try a different bonding agent - too bad for them all i have is simplicity!!!!

what would you suggest in order to get better bonds to the small comp. buttons to the enamel? typical procedure is as follows: simplicity as normal - place flow in invisalign tray - place tray in mouth - cure.

i feel that the weakness is due to the fact that i am not in real control of the flo / tooth interface. i was thinking that since simplicity is so thin that maybe i want to place another coat of simplicity, but do not cure that layer. hopefully get more integration with the button / bonding layer. what do you think?

thanks again for such a great place to learn. see you in Baltimore in Oct.

take care,
d
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darren greenhalgh dds
15130 main st suite 210
mill creek, wa. 98012
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425.357.6400

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cool kid



Joined: 12 May 2005
Posts: 818
Location: chicago

PostPosted: Wed Aug 31, 2005 1:45 pm    Post subject: Reply with quote

D,

why the flow? I'd use regualr composite. (or should i say I use regular composite)
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Rich (cool kid) Rosenblatt
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dsg_c1



Joined: 11 May 2005
Posts: 352
Location: mill creek, wa

PostPosted: Wed Aug 31, 2005 3:04 pm    Post subject: Reply with quote

cool kid wrote:
D,

why the flow? I'd use regualr composite. (or should i say I use regular composite)


i figured flow would be easier for my assistants. it has worked OK so far, i just think i could be doing things better, i don't want those ever to pop off. i don't think that wear is an issue, am i wrong?

take care,
d
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darren greenhalgh dds
15130 main st suite 210
mill creek, wa. 98012
www.pacificNWsmiles.com
425.357.6400

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frequently a blasphemer of John Kanca III, DMD
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john kanca



Joined: 14 May 2005
Posts: 6346

PostPosted: Wed Aug 31, 2005 3:41 pm    Post subject: Re: buttons for invisalign cases Reply with quote

dsg_c1 wrote:
JK,

good morning. i have had few (too many) buttons fall off of patients that are in Tx with invisalign. my asst.'s usually do all of the buttons. i had them watch the vidoes awhile ago. my asst.'s want to try a different bonding agent - too bad for them all i have is simplicity!!!!

what would you suggest in order to get better bonds to the small comp. buttons to the enamel? typical procedure is as follows: simplicity as normal - place flow in invisalign tray - place tray in mouth - cure.

i feel that the weakness is due to the fact that i am not in real control of the flo / tooth interface. i was thinking that since simplicity is so thin that maybe i want to place another coat of simplicity, but do not cure that layer. hopefully get more integration with the button / bonding layer. what do you think?

thanks again for such a great place to learn. see you in Baltimore in Oct.

take care,
d



I think your problem lies with the flowable. The modulus of the flowable is pretty low and it can pop off easily. You might want to try a regular composite as has been suggested. Smile
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dsg_c1



Joined: 11 May 2005
Posts: 352
Location: mill creek, wa

PostPosted: Wed Aug 31, 2005 4:04 pm    Post subject: Re: buttons for invisalign cases Reply with quote

john kanca wrote:
dsg_c1 wrote:
JK,

good morning. i have had few (too many) buttons fall off of patients that are in Tx with invisalign. my asst.'s usually do all of the buttons. i had them watch the vidoes awhile ago. my asst.'s want to try a different bonding agent - too bad for them all i have is simplicity!!!!

what would you suggest in order to get better bonds to the small comp. buttons to the enamel? typical procedure is as follows: simplicity as normal - place flow in invisalign tray - place tray in mouth - cure.

i feel that the weakness is due to the fact that i am not in real control of the flo / tooth interface. i was thinking that since simplicity is so thin that maybe i want to place another coat of simplicity, but do not cure that layer. hopefully get more integration with the button / bonding layer. what do you think?

thanks again for such a great place to learn. see you in Baltimore in Oct.

take care,
d



I think your problem lies with the flowable. The modulus of the flowable is pretty low and it can pop off easily. You might want to try a regular composite as has been suggested. Smile


thanks CK and JK,

i will try regular composite. any suggestion about the last layer of simplicity being un-cured?

take care,
d
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darren greenhalgh dds
15130 main st suite 210
mill creek, wa. 98012
www.pacificNWsmiles.com
425.357.6400

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frequently a blasphemer of John Kanca III, DMD
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john kanca



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PostPosted: Wed Aug 31, 2005 4:09 pm    Post subject: Reply with quote

Give it a try and let us know It ought to work. Cool
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dsg_c1



Joined: 11 May 2005
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Location: mill creek, wa

PostPosted: Wed Aug 31, 2005 4:46 pm    Post subject: Reply with quote

thanks,

will do.

take care,
d
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darren greenhalgh dds
15130 main st suite 210
mill creek, wa. 98012
www.pacificNWsmiles.com
425.357.6400

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brad



Joined: 13 May 2005
Posts: 346
Location: Cincinnati, Ohio

PostPosted: Wed Aug 31, 2005 8:08 pm    Post subject: Reply with quote

unrelated to the button issue-

how do you and your patients like Invisalign?
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Bradley A Dorsch, DDS
Forest Hills Family Denitstry
1055 Nimitzview Dr
Cincinnati, OH 45244
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john kanca



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PostPosted: Wed Aug 31, 2005 8:34 pm    Post subject: Reply with quote

Darren

Have you watched your assistants actually place the adhesive? Question
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cool kid



Joined: 12 May 2005
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Location: chicago

PostPosted: Wed Aug 31, 2005 9:26 pm    Post subject: Reply with quote

brad,

allow me to steal the question posed to darren. We started doing invisalign about 2 months ago, so no cases completed, but pts are amazingly receptive to it. we have about 12 cases going in about 7 weeks. there are so many of those lower lingual crowding issues with the heavy plaque retention that I show photos of it to the pts and they want to know how to fix it. when I show them the models and then a computer demo of the case from start to finish, they are really impressed. I'll give more feedback as I get further along with cases. Definitely a nice tool to have in the office tool chest for some of those simple lower crowding or small diasthema cases.
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dsg_c1



Joined: 11 May 2005
Posts: 352
Location: mill creek, wa

PostPosted: Thu Sep 01, 2005 1:07 am    Post subject: Reply with quote

brad wrote:
unrelated to the button issue-

how do you and your patients like Invisalign?


brad,

i love the technology. it has made ortho quite enjoyable.

right out of school i was taking some CE in ortho. it was every saturday, it was difficult to stay awake - seriously! i bailed half way through the course - sphyllis was looking more enjoyable at that point.

awhile back i got certified with invisalign. it was the ONLY thing that seemed up my alley when considering this benefit/treatment for my patients. it has been great. i don't really have to talk it up - like CK said, just show them the benefits and a lot find it a great alternative to placing metal back on their teeth. most of my patients that have or are in invisalign aligners are either young (teenagers who DO NOT want traditional brackets/wires) or middle aged women (who have had braces before and don't want to go back)!!!! honestly most who have been in or are in treatment probably wouldn't have gone for the traditional braces (for the first time or for a second time), they would have rather remained in their crooked state. most are really excited to get them. i think a lot different than most who are going into metal.

i have referred a lot to the orthodontist - there are limitations and i find those difficult cases should remain with the wire benders!

anything specific and i / CK would love to answer.

take care,
d
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darren greenhalgh dds
15130 main st suite 210
mill creek, wa. 98012
www.pacificNWsmiles.com
425.357.6400

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frequently a blasphemer of John Kanca III, DMD
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dsg_c1



Joined: 11 May 2005
Posts: 352
Location: mill creek, wa

PostPosted: Thu Sep 01, 2005 1:17 am    Post subject: Reply with quote

john kanca wrote:
Darren

Have you watched your assistants actually place the adhesive? Question


very briefly once - just popped into the room to see how things were going. i have gone over the protocol with them multiple times and they have seen the video. my assistant did say that after watching me place simplicity that she didn't think she was thinning the material enough. the biggest reason why things go wrong - i read that from one of your posts.

i have only had simplicity for a little while - i love the stuff, so i'm not going to change for my assistants - i just need to get everything down pat with them. difficult to really get a grip as to why this is happening more than usual, it hasn't happened for a couple of weeks. i will start to use regular composite though.

seriously, ever since i have changed to simplicity / pulse curing / and beveling - EVERYTHNG looks better. i'm really happy with the results.

thanks and take care,
d
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darren greenhalgh dds
15130 main st suite 210
mill creek, wa. 98012
www.pacificNWsmiles.com
425.357.6400

friend of flem
frequently a blasphemer of John Kanca III, DMD
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brad



Joined: 13 May 2005
Posts: 346
Location: Cincinnati, Ohio

PostPosted: Thu Sep 01, 2005 7:08 am    Post subject: Reply with quote

Thanks fellas-
CK keep me posted on your results. i think I may do the invisalign CE thing next year-- a lot of our pts have been clamoring about it-- almost as much as they ask for simplicity Wink
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Bradley A Dorsch, DDS
Forest Hills Family Denitstry
1055 Nimitzview Dr
Cincinnati, OH 45244
513-231-5353
www.cincytoothdoc.com
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john kanca



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PostPosted: Thu Sep 01, 2005 7:08 am    Post subject: Reply with quote

Darren

Spend a few minutes and watch them. I can tell you from experience that at times people stray from protocol, no matter what they say they do. Confused
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cool kid



Joined: 12 May 2005
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Location: chicago

PostPosted: Thu Sep 01, 2005 8:19 am    Post subject: Reply with quote

brad wrote:
Thanks fellas-
CK keep me posted on your results. i think I may do the invisalign CE thing next year-- a lot of our pts have been clamoring about it-- almost as much as they ask for simplicity Wink


If you are going to do it brad, then just jump on it. If you already have pts asking for it, then get certified. When you do get certified, make sure that you bring any person in your office who will be discussing it to the patient. They have lectures specifically for staff and it really gets everyone on board. As darren stated, be selective with the cases. pick the easy ones. We have an othodontist here at our office once a month so if it is even remotely over our head, we can try it and punt it if it seems too much to handle.
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