Dr Amanda with straight smile Solutions straightsmilesolutions.com and I wanted
to make a new video on this topic should you remove your Invisalign or clearcorrect
or any clear aligner attachments before doing a refinement before re-scanning before taking
a new impression I'm hoping you're not using Impressions still but before rescanning or
should you leave them on and ultimately that my opinion on this has changed since I made
the other video a few years ago so this is kind of my opinion right now so answer is it depends
unless you know the reason for why it went off track you absolutely should take them all off
you need to dig into it and figure it out and I've done a lot of videos on why things go off track
um two I mean there's a few small reasons but the two major reasons is one you did not create
a proper treatment plan or stage it correctly you just relied on the technicians which is rarely
accurate an orthodontist takes two three four five six seven eight times to get a clincheck or clear
pilot set up right and that's with really good preferences and good submission it takes time it
just it is a very time consuming process and once you learn how to do it right you can do it pretty
quickly but you still have a lot of iterations to get it right so unless you've you've staged
it right you've done the right speed you've done the right movement it's a proper movement you know
that's one thing the other thing is creating an accountability Loop an accountability Loops is not
just relying on your patient to say yeah I wore it not just relying on those little compliance tabs
not just having them show up every four five six seven weeks and checking him in on the office that
just doesn't work that's that works very rarely let's put it that way you have to have an actual
weekly accountability Loop it's it's it's night and day in terms of your refinement rate if you
have an if you have a proper treatment plan of course if you have a weekly accountability
Loop and now this line has made this free with Invisalign virtual it's decent enough
um you know there are better programs out there but there you have to pay for them
um Dental monitoring is one in on Dental is one there are some other ones everyone's suing
everybody so I'm always cautious I don't you know you should definitely check them all out
see which one's the best for you if you're only doing Invisalign and no other aligners
and you feel comfortable having all of that going into a portal that you don't control
be my guest use it but I'd rather use that than nothing so anyways
um if you have the accountability Loop and if you have an orthodontist take a look at your
treatment plan and realize that it is predictable and makes sense then you'll know what went wrong
once you know what went wrong then you can decide whether or not you need to take the
attachments off so if you're doing Invisalign if your treatment plan is ideal it makes sense it was
stage rate the speed is right the attachments are right the mechanics are right for the face
for the bone okay that's great check you did that right you also had an accountability Loop maybe
you dropped the ball a little bit there maybe you weren't doing the weekly check-ins with
the aligners on and it got a little off track but the mechanics were good you didn't have any
weird interferences the patient's not grinding or clenching the patient doesn't have tongue thrust
or any other oral myofunctional habits you know something that made something happen unpredictable
um it's just a tiny little off-tracky thing then by all means leave those attachments on it's fine
it's totally fine now here's the issue is that and I don't know which aligner companies can do this
and which ones can at this point Invisalign is really good if they needed to swap an attachment
out they can virtually do that and put a new one on they can also add additional attachments as
needed to other sites that you can just put on one or two extra ones and quite commonly if a
little posterior open bite opens I'll ask for additional attachments I'll leave the ones on
scan It'll ask for you know one or two new ones as needed to help close a posterior open bite
very easy with Invisalign works out great with other companies the virtual thing doesn't work
that well you tend to have more fit issues and by other companies I mean pretty much all the rest
of them I for me I haven't seen a lot of success in doing this so you have to be really sure that
you don't have a posterior open by and that you don't have habits and you're not having tongue
thrust and other issues if you're to leave the attachments on so double check your bite double
check your articulation before you do this make sure that's not an issue and like I said if you're
sure it's just a super modern tracking issue the plan is solid you've had an orthodontist check
it then finally the attachments on for everyone else take them off put them back on again that
would be my suggestion so this opinion is subject to change of course as new technology comes out
new AI comes out um and definitely look forward to seeing your cases if you haven't taken it off
to see if it's working but um I think it's for most situations it's probably safer to take them
off I know it takes extra time but yeah there's a few one-offs so hopefully that was helpful thanks