straight smile solution straightsmastsolutions.com and today we're going to talk a little bit more
about invisalign with m a m a stands for mandibular advancement and it's something
that we've been using in not this exact product but a derivation of this product in orthodontics
for i don't know a century like a really really really long time at least so it's nothing new for
orthodontist it's kind of new in that it's married to an aligner so let me explain a little bit more
about how this appliance works and what you can use it for the risk the benefits the alternatives
and i'll be doing this week a lot of videos on various appliances to help advance jaws
i have a lot of other content on this topic already so any type of keyword that you want
to look up at like if you want to look at my other videos on invisalign with ma you could
just go to my home page which is on my youtube channel not your youtube channel so go to your
youtube channel put it in the search bar straight smile solutions it'll take you to my youtube
channel which has a green banner scroll down and find the invisalign playlist on the home page
within there you've got everything you need to know about invisalign and guess what it's free yay
so remember i put this out here just to be helpful um if you like it i appreciate the
comments i appreciate the likes and the shares that helps me grow my brand so i really appreciate
it when you do this and if you ever need help with a case you're welcome to reach out to us
we do help with cases clinch optimization it's not just invisalign braces phase one appliances
airway obviously growth modification you can reach us at straight smile solutions and we help with
cases anyways so let's talk about invisalign with m.a remember unlike other content that might be
out here on this topic i am not at all employed by align technology invisalign never have been
never will be so i can speak freely about it i'll tell you what i tell you is the honest truth
and the beauty of what i do is that i am an orthodontist but i also work with other dentists
and orthodontists um as part of my consultancy group so i have a really cool bird's eye view
of that's even greater you know than any single orthodontist can have because i see so many cases
per week um so i really feel very comfortable with a lot of products and i feel like i can
explain things really really really well so first of all i would not do invisalign with ma
until you have done some invisalign cases because it's a little bit trickier and i feel like there's
a lot more variables so you might get confused so do a few regular invisalign cases first so you
can get the hang of how invisalign works and then you can do an invisalign with makes now
you should watch all my other videos on various other appliances that work similarly similarly
like twin blocks or bionators are probably my top two but there's all the other ones frenkels herbs
activators things like that but for simplicity's sake i keep two appliances that i think are easier
to use so invisalign with ma comes in two different products okay so depending on what
country you're from there's different menus of options that you can purchase from invisalign
everyone has invisalign comprehensive that's available in every country and you can get
invisalign with ma with invisalign comprehensive i don't know if you can get it in every country
now for example in the u.s it's there whether you're a general dentist or an orthodontist
in canada it's there whether you're a general dentist or an orthodontist whenever you submit a
comprehensive case it'll pop up as an option that you can pick that it's on the page where and i and
i have other videos that show you exactly how to do this if you're submitting a case but it's on
the page where they talk about anterior posterior changes and anterior posterior changes mean
jaw your jaw being forward your jaw being back your lower jaw eg a class 3 or a class 2 kind
of byte so they're going to ask you how do you want to fix the anterior posterior discrepancy
what are your options elastics ipr sequential distillation or invisalign with ma is another
option or leave it right so those are generally your options invisalign with
ma is only going to work if the patient is growing the patient is done growing not going to work so
first of all you need to pick the right patient it is not invisalign's job to know if your patient is
still growing they don't know now this is a whole nother story i could talk it for an hour about so
if you want to know about is your patient still growing you can either ask the questions and i
have videos on all that i'm not going to get into that today all the puberty questions all that kind
of stuff or you can get growth charts from the pediatrician pediatrician will send them to you i
mean to me that seems a little lazy you might just ask the questions if you're not comfortable asking
the questions have a team member ask the questions it's obviously a little more comfortable with a
male than it is with a female because there's nothing inherently embarrassing about asking
about shaving or feet growing or voice changing i mean you can kind of tell by looking at the mail
adam's apples i mean there's so much i can look at a boy and tell you if they're still growing
i can tell you if they're almost done growing i may not know if they're still growing so i'm
going to ask a few questions but there's nothing embarrassing girls it's a little more sensitive
and a lot of times even if you have it on the medical history first of all that they parents
may not know because they don't always know trust me and they may not they're thinking well this is
a dentist why does it matter if my patient has had you know if my child has had this and this already
you know milestone in their life so they may not even answer truthfully even if they know so you
have to explain the why behind that a little bit more to the patient and parent have a team
member do it if you're embarrassed but it's not a big deal you know it's just it's part of being
a healthcare provider you need to know these things okay so patient has to still be growing
um or it's not gonna work so don't bother so find that out first then we're looking for patients
that need mandibular growth how do you know well you're not going to know unless you take a cef
okay and you need to interpret this f which means you need to run this f through the numbers
and get the norms and get the standard deviations that is how you do it i mean clearly i can look
at a patient's face and tell you if they need to grow a jaw so but if you're going to grow a jaw
you really need to take that stuff as a baseline that's standard of care does everyone do it no
should you do it yes if you are growing a job because that's baseline if something went wrong
you would they'd be asking to see if you took this f you know plus you need to know for sure
but you know i've got an entire playlist on seth's how to get sets if you don't have a cev
how to interpret zeff blah blah blah okay you don't have to know how to do that you can send
out for most of that you can outsource for all that it's not a big deal and if you would like
help on that or if you'd like help on learning to read a hand wrist radio glass we have a really
good monograph on that it's available at our document store at straight smile solutions okay
back to the invisalign with m.a so invisalign with ma basically takes a page out of how a bionator
or a twin block works where you're setting the mandible forward 24 hours a day okay not 12 hours
a day not 14 hours a day not just at night it has to be sitting forward 24 hours a day and then
the pressure of sitting it forward encourages the lower jaw to grow now you're gonna have to do this
for about at least a year nine months to 14 months somewhere in there it's a long time this is a
this is a marathon not a sprint and if they don't wear it 24 hours a day it's not gonna work okay
so it's not a nighttime only solution there is no nighttime only solution in my opinion
that really really really works now there's a few products out there but they don't work like
this they don't work as well and they're not as effective and they're not as predictable so
you the reason why i like this appliance is that it's very comfortable from the front it only
looks like an invisalign so it's you get a lot of compliance i have zero problems getting patients
to wear these type of things i've never had a problem nor have i really had i mean obviously
you can't pick up you gotta pick a good patient and parent you know there's gotta be not gonna be
weird stuff going on at home you gotta have good communication it's all about picking the right
family who seems to understand you mean if the kids coming in with greasy hair
torn clothes dirty clothes has poor grades they're not going to be a good choice because they don't
care about anything okay so you have to find the right patient and parent who wants this um
teenagers you know a few of them are going to be not great you know they're going through things so
you have to pick the right ones right so i can't tell you how to identify the right patient but
from my experience the younger the patient is and that's why i really like the invisalign
with ma because you can start this as young as five or six if you want to
they're incredibly compliant if you do this on a 15 year old they're they may not be compliant
but a 15 year old is probably not growing either maybe a male might be so that's why this is meant
to be done at 5 6 7 8 9 10 11 maybe even 12. by 13 we're probably getting on too old for girls and
by 15 we're probably getting too old for boys but again you have to ask the questions so basically
there's a it's an invisalign with a little ramp that comes here and this patient for example
probably had like a eight millimeter overjet so this ramp slides the lower invisalign forward
so that the lower jaw is sitting in an anterior position um you know for a long time while you're
straightening your teeth while you're leveling the arches and doing other things at the same time
so we're doing everything all at one time we're growing a jaw we're straightening the teeth right
so that's basically it i mean the only thing that can happen that i've seen that you just have
to know about is a lot of times you will get a posterior open bite in this area it's just because
of these wings but i've never seen an m8 case where you didn't have to do a major refinement
i mean i know they make it look like it's going to make everything perfect but i think the algorithm
is just not there yet so i think you go into it usually ma is somewhere between 30 and 40 aligners
that's first run okay and then once you're done with that part of it you either do a
refinement and do a little bit more or you just do a refinement just to settle the bite and fine tune
and you're done you've already grown the jaw so um all in all how long will it take about a year to
two years but it's no different than braces that's going to take a year to two years too right and
you can don't have to wear necessarily elastics i'm not promising you there's not going to be
elastics and you might need to use them on the on the refinement sometimes just to find two things
or just to balance things out a little bit or you know if we didn't quite get there that'll help at
the end but the majority of the growth will happen from the m.a and it works really well i've seen
tons of cases completed and people were really blown away at like the incredible
improvement now remember invisalign with ma is available in the comprehensive product
comprehensive is normally done in slightly older kids but you get five years to finish that case
in most countries you can also do it with the invisalign first product but not all countries
have invisalign first now my preference is to do the ma invisalign first now invisalign first
is a phase one product you're all it's doing is straightening the front teeth and fixing
the bite that's all you're doing there's still 12 more teeth that need to come in
it's not going to straighten those teeth invisalign first is just for front teeth
and bite that's it it's interceptive but i like getting the hard movements out of the way in the
really really young patients the 5 6 7 8 9. it's just so much easier and then you put them in some
type of retention obviously it's not going to be plain old invisalign and invisalign does
not have a good phase one retainer product yet i don't know why they do not it's not that hard
but it doesn't exist so vivera's are only a comprehensive product you cannot wear viveras
in for phase one retention now i have a couple other options for phase one retention you can
go to my website sorry you can go to my youtube and scroll down on the homepage to the retention
section and check out phase one retention there's a few options that are out there that work but you
do need some type of retention afterwards to maintain it and i'll go over what the options
are but yeah i think you really really like ma i highly recommend it love it alright thanks