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In July 2015, Dr. Joe Gaudio presented "Using BiteFX to Present Invisalign for Occlusal Correction to Patients". Dr. Haakon Andersen, from Norway, recently watched the recording and asked if Dr. Gaudio would answer some related questions. Dr. Gaudio kindly provided very helpful responses. As the questions and answers are likely to be of general interest both Dr. Andersen and Dr. Gaudio gave their permission for us to publish them. |
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The questions cover:
- Using centric relation with a ClinCheck (Q1)
- Use of Best Bite splints with Invisalign (Q2, Q3) and handling aspiration danger (Q4)
- Use of the QuickSplint with Invisalign(Q5)
Q1 (Dr. Andersen): Do you send CR index along with the impressions to have the ClinCheck (CC) made in centric relation in all your cases or do you have another way you recommend?
A1 (Dr. Gaudio): If I have a patient that is symptomatic with regards to TMD issues but there is no problem with load testing the patient then I do take a centric bite registration in centric relation and then you want to be clear in your ClinCheck comments that the patient needs to be treated to centric relation.
Q2 (Dr. Andersen): When using Best Bite splints for facilitating cross bite corrections, do you make them over the aligners?
A2 (Dr. Gaudio): Best Bite splints are used over the Invisalign trays and usually will be retentive over the course of at least 3 to 5 trays unless, of course, you are repositioning the anterior so dramatically. Use common sense as to how long to use with a set of trays and then simply remove the PVS material and redo the PVS. Also alert the patient that if the fit becomes poor then they should come in sooner.
Q3 (Dr. Andersen): Do the patients wear the Best Bite 24-7 or just at night?
A3 (Dr. Gaudio): The Best Bite is to be worn at night time or, if they need to resolve some muscular tension while in transition, then they can take a break during the day and place it as needed.
Q4 (Dr. Andersen): How do you cope with the aspiration danger when using at night time?
A4 (Dr. Gaudio): The Best Bite comes with a lanyard that is threaded through the hole in the small handle, tied off to secure the knot and then placed over the head as a "necklace" but I have not had a patient even come close to having an "incident" with it.
Q5 (Dr. Andersen): Do you also make the Quick bite over the aligner or is there another procedure to it?
A5 (Dr. Gaudio): The QuickSplint can be used in the same way and covers a larger surface (usually 1st Premolar to Premolar) vs the Best Bite (usually Lateral Incisor to Lateral Incisor).