hey it's dr amanda with straight smile solutions straightsmilesolutions.com and today we're going
to talk about getting ready um to build up laterals or to do restorations on on sizers
be it whether you want to do them on 7 and 10 or upper two's you wanna do it on seven through ten
top front four teeth two to two or you wanna do it on three to three or six through eleven
so ultimately anytime i have a bolton discrepancy and if you don't know what a bolton discrepancy
is that is the foundation for this video so you need to take a pause on this video and go back
and learn what a bolton discrepancy is how to find it how to know it exists and what the options are
not going to go into that here because i've made tons of videos on that to access that you need
to pause this go into your youtube put up in the space bar straight smile solutions
from there that'll take you to my youtube channel from there you can type there's a small magnifying
glass at the tabs at the top towards the right not top right hand corner but top right ish put in
the word right here bolton just put that word in b-o-l-t-o-n watch all those videos and you'll be
ready to come back to this video okay good now i'm assuming you know what a bolton is so i'm going to
go ahead and move on we know we have a molten discrepancy pretty common runs in families runs
in my family for sure i have small laterals i have a bolton and i have spaces left around my laterals
no one ever gave me an option when i went to ortho as a kid um they just left space
around my laterals now i would have liked to have options um but that's what we decided to do but
a lot of patients don't want spaces left around their laterals and maybe they don't want ipr on
the bottom maybe they're too young for ipr maybe it's too too severe for ipr maybe they don't want
a lower incisor extraction and so they want to get restorations on their laterals to make it
look more square and more nice and more normal and that's totally fine obviously i'm not a
restorative dentist so i'm not going to go into the weeds about restorations that's y'all's job
it's not my job i'm an orthodontist all i do is do what you tell me to do so when a patient comes to
me with this first thing i'm gonna do is go back to the restorative dentist and i'm gonna say hey
what do you want me to do do you want to do risk you know do you want me to do ipr
do you want me to pull a tooth out or do you want to do restorations if they if you know if
restorative dentist says restorations and parents says restorations restorations it is next step is
i want this treatment plan locked in stone okay so that means what i'm gonna do is i'm going to work
with the dentist and ask about space distribution how do you want me to set up this case so that
you have really nice setups alright again are we doing three to three are we doing two to two are
we doing one to just twos are we doing six veneers four veneers or two veneers that's the answer
our first thing i'm going to ask the dentist so patient may have to go back so before i can even
work up this invisalign treatment plan or a liner treatment plan um if it's braces it's a little
less urgent because we're going to deal with this at the end if it's aligners we're going to deal
with it at the beginning so we can't even approve this clint check i'm just going to act like we're
using invisalign because i think honestly if you're going to do this i think you should only
do invisalign because they have the resources that you need to make this look really really
good and you're not going to have this in other aligner companies i mean it's just my experience
and to be really honest i'm not going to get too into the weeds with it in braces because i
think it's a nightmare to do embraces after having done it for 15 years or so in braces
and then i found out i can do it much better and invisalign i just don't treat these cases
with braces anymore because it's too much hassle with springs closed coil springs open coil springs
you fiddle around for months trying to get the space distribution right whereas with invisalign
i can just program it on the front end and be done set it and forget it right so when patients come
to me like this they get invisalign there's no option if they want braces they can go down the
street i don't really care so then what we do is once they've told me how many videos they
want i want it set in stone i want a signature from the treat from the restorative dentist
i want a signature from the parent that we're doing too you know and exactly how we're doing
the space so i'm gonna really make everyone lock it in because what i don't want and this is this
is where i learned the hard way many many times when i first got started yeah yeah yeah i'm gonna
do restorations guess what we'll get to the end we set up the space you know what actually we changed
our mind can we just have the space closed we'll take the ipr we'll take the extraction
what now i got to spend another year on this case that makes me mad right so i want everyone to be
locked in stone now most of you who are watching my videos are probably restorative dentists who
also do ortho so you get the added bonus of being able to bundle the fees into one big treatment
plan that way the patient is locked in 100 you want to grab the signature just like i said to do
and you want to take a deposit of at least 25 to 50 up front for the restorations why because i
want you to do a virtual waxa now how to export stls to do a virtual wax of what that means how
to do it again i got videos on that already so all you have to do same thing i told you before go in
the search bar put in straight smile solutions get to my channel go to the little magnifying glass
put in virtual wax up or just wax up and it'll tell you or export stl it's going to tell you
how to do that with invisalign crazy super easy so all you're going to do is you need to check
with your lab to find out if your lab accepts invisaligns clinchex export stl for virtual wax
ups not all labs do many labs do the bigger ones do so if they do not well then you won't be using
that lab for the restorations so you need to or at least for the virtual whack yeah i would just
for the virtual wax up you want to get the virtual wax up before i even approve the clinchack i want
to know that you have your patient has accepted it virtual wax up cost varies i've heard anywhere
from 100 to 300. you can do an actual wax up i know my husband does it he actually exports it
and he does a physical wax up the price point was not all that different to be honest they
print the model they do the wax up oh like old school on the model he gets the physical model
he shows the patient patient can look at it touch it feel it it's not just a you know an nft it's
not just a visual thing a digital thing but you know whatever floats your boat you can do that yes
it's a couple hundred dollars but guess what you built that into the feed it's part of the process
you already took the deposit down okay so you 100 how to do it because i don't know how you
want me to distribute the space that's your job and if you don't know that's why we do the wax up
how do i normally do it when i work with people i usually do one third two thirds space distribution
but that's if i'm doing laterals only okay that means i'm gonna close the space here and
all the space is gonna be around here and here okay this is not done this is just a picture
so one third two thirds is probably more like this we're gonna have a tiny bit here
and more back here okay but a lot of it's gonna depend on the shape of the tooth too
and plus if you're doing crowns you maybe want it more centered you may want one half one half
so you have to tell me what you want if we're doing you know veneers on fret four then we're
going to want over all the space equidistant it's very easy for me to program this into clinchack i
just have to know what you want okay so this is a lot of back and forth between patient restorative
dentists and orthodontists and it's a triangle and we might go in the triangle for a few weeks
trying to figure this out as you're going to do various virtual wax ups now the key to the
virtual wax up within the clinch program is that if you do not approve this treatment plan again
this is why you take the deposit they're going to charge you something i don't know what it is it's
only a free service if you approve the treatment plan if not they're going to charge you a fee for
dealing with the setup and all you know doing the work on their end so you need to make sure you've
taken a deposit and the patient understands that once you start using these services
they are committed one way or another to some type of orthodontics it doesn't mean that you
have to do that treatment plan but you need to do some type of invisalign so of course
you yeah i mean that's the only way that you can do it there's no other way to do this you know to
do the virtual wax up without using invisalign feature as far as i know no other aligner
company has this functionality if i'm wrong great contact me i have no problem updating this video
contact me at info street smile solutions street smart solutions dot com send me a message tell me
hey my aligner company has virtual wax ups export sdl here's how we do it great send me a sample
send me an example show me how to do it i'll make a video on that and i'll update this but for now
all i know is that invisalign align technology has it so anyways that's it that's how you set up
this for restorations and if you do it my way it's going to save a lot of headaches
i can 100 guarantee all right thanks so much and hey if you're a consumer or a prospective
patient who's watching this video just educating yourself take this information to your dentist
if your patient is a general or a pediatric dentist that doesn't know what this means
they're welcome to contact me we talk to dentists all the time and it's a free surface so just tell
them to contact straight smile solutions to learn more about it if you're an orthodontist and you're
not already doing this you should and you're welcome to contact us as well all right thanks