hey it's dr amanda with straight smile solutions street smile solutions.com and
today we're going to talk about class 2 and class 3 elastics i know this
um infographics is class 2 but either way same thing
um well not the same thing but same thing in this context um we're going to talk about if
you should use buttons or slots and how that works and what things you need to adjust accordingly and
the feedback i'm giving you today is really just based on my own experience what i've seen work
what i've seen not work and i never learned it in any invisalign class i mean definitely in
talking to my colleagues you know you always get little tips and see how other people do things
and then i've kind of extrapolated um and had the i guess the fortunate experience of being able to
take things that i did and extrapolate it to all my doctor clients you know so almost um
exponentially you get to see more outcomes that you'd ever see in your own lifetime with just your
own patients right so i've found this and a lot of times i come up with things on invisalign or
about invisalign and invisalign steals the ideas and then i've never heard them say it and all of
a sudden they say it and they don't even give me credit for it so i'm saying it now before someone
else says it's um i feel like i'll throw it in a blog too this is my idea maybe other people do it
but i've never heard anyone else say they do it but anyways so the standard kind of turnkey model
if you ask for class to elastics with invisalign if you ask for that you're going to get upper
slots which are built into the liner and lower buttons which you're going to have to glue on the
teeth so the elastics are going to hook from the lower button that you glue on the teeth with the
template to the upper slots which are punched into the aligner nothing special you have to do there
okay so that's your standard class two the flip or the reverse you get for class three so class three
the standard that you get unless you ask for something it's kind of going to starbucks
you ask for a psl you're going to get the standard psl but you can have all kinds of modifications
put into your psl right you can have it with this this phone this other stuff and everyone has
their preference right but if you don't ask for something you're just going to get the standard
right which is a tall with one shot blah blah blah you get the idea same thing with aligners so
standard i explained standard class 2 standard class 3 is the flip you're going to have buttons
on the upper 6's which are 3 and 14 and you're going to have slots on the lower 3s which is 22
and 27 right the it's kind of a hybrid thing so you can you use um moderate elastics or medium
elastics which are four to four and a half ounces three sixteenths usually sometimes one quarter um
the problem that i have with that is most of the tracking issues that i see in most patients unless
you're really good at making an awesome clincher are going to be right around in this area which
is usually around where the buttons are right so what happens when you have the button hooked to
the tray and the patient's compliant is you end up having more tracking issues and more unseats
um which is why i don't like to have any slots for my patients at all the only time i would do slots
is if my patient had already finished their aligners and we were just working on the bite
then i'm fine with slots i don't care if you know i don't have to bond buttons but if we're
if we're aligning at the same time it's really important to me that i don't have a counter force
trying to pull it off you know all day long 24 hours a day because that's going to affect
my aligner seating right can you kind of get what i'm talking about so for that reason i prefer all
buttons button button button button no slots and then i can use a heavier elastic which is the 316
heavy which is six to six and a half six to six and a half ounces that's the elastic that you
would use with braces so obviously i was trained to do braces before i was trying to do a liners
so in my mind i'm trying to do things similar and i know that they work right i know this
mechanics work in braces so let me extrapolate what i learned from braces to what works for
me and aligners so this is what works i ask for all buttons no slots on all my aligners unless
unless and less i've already finished all the alignment and we're just wearing a consistent
tray with elastics to work on bite in that case i don't and also the other trick that you might
do as well if you really want to be like extra strong you know is i will often i
mean i do this anyways with most of my doctor's treatment plans i reckon they slow them down
so invisalign says it's 15 i say it's 30 right if i'm really want to do class 2 elastics with
slots and not buttons like you're having issue with the buttons staying on or those crowns or
um patients complaining about the buttons or something you know they're uncomfortable
then i double the trades even more invisalign said 15. normally i go 30 because i think their stuff
is too fast anyways well guess what now i'm going at least 45 50 i need elastics and i can't bond
up to the teeth so i need this to go real slow and gradual and so that they can you know right
now what's really important to me is just having the movements as slow and predictable as possible
if i'm going to be pulling the trays off with the elastics all the time right i don't want to go too
fast because i know i'm going to get off track and i got to just do things like three times as slow
and or you can tell the patient to stay in 14 days instead of seven i don't quite think that does the
same thing but you could do a combination of all the above if you get the idea so
basically it still takes the same amount of time ultimately it's just slightly less inconvenient
a little grosser for the patient i think but all right hopefully that was helpful thanks