PROPELLING ORTHODONTICS
Figure 5: Case 3 intraoral pretreatment photos
Figure 6: Case 3 intraoral posttreatment photos
Case study 3 Case 3, a 40-year-old female, presented with a Class I malocclusion characterized by bimaxillary arch constriction, mild mandibular incisor crowding, and crossbite of the right canines (Figure 5). The patient was anxious to complete treatment quickly and elected to include Propel as part of her treatment plan. Propel was initiated immediately after the placement of the aligner attachments, at the time of the first aligner delivery. The patient was initially instructed to exchange aligners every 7 days (26 total aligners). After 2 months of treatment (eight aligners into the planned treatment), the patient reiterated her desire to finish treatment as quickly as possible. As a result, I changed the aligner protocol and instructed her to exchange aligners every 3 days for the remainder of her treatment. All clinical movements were expressed, and the patient completed treatment in less than 5 months (Figure 6). Dr. Thomas Shipley (Peoria, Arizona) originally proposed the protocol of aligner exchange every 3 days, as opposed to the standard 7-day period recommended when using Propel. Dr. Shipley has documented numerous cases with exceptional results using this exchange protocol. 38 Orthodontic practice
Over the past several months, we have experienced significant success using Dr. Shipley’s 3-day aligner exchange protocol. For more challenging cases, we have found the greatest success when educating patients on how to identify and monitor their own aligner tracking and empowering them to determine their optimal aligner exchange rate (either a 3-, 5-, or 7-day aligner exchange). For example, when employing the Nicozisis Extrusion Protocol for extruding maxillary incisors to establish smile arcs (Dr. Jonathan Nicozisis, Princeton, New Jersey), patients often require 4-5 days of aligner wear to maintain tracking when extruding dysmorphic maxillary lateral incisors. The success of this patient-centric approach relies heavily on patient understanding of the critical importance of monitoring tracking, and this is emphasized at each appointment.
Conclusion Incorporating Propel into our practice has proven to be a positive disruptor and has provided a solution to the dilemma of how to shorten treatment times without compromising clinical outcomes. We have found success using Propel for both fixed appliance
and Invisalign cases, but the results achieved with aligners have been especially remarkable. The use of Propel has consistently improved our practice efficiency, increased our productivity, and is attracting patients to our office through new patient referrals. Accordingly, as more orthodontists discover its advantages, it is anticipated that Propel will be identified as one of the most significant positive disruptors of next-generation orthodontic treatment. OP
REFERENCES 1. Teixeira CC, Khoo E, Tran J, Chartres I, Liu Y, Thant LM, Khabensky I, Gart LP, Cisneros G, Alikhani M. Cytokine expression and accelerated tooth movement. J Dent Res. 2010;89(10):1135-1141. 2. Alikhani M, Raptis M, Zoldan B, Sangsuwon C, Lee YB, Alyami B, Corpodian C, Barrera LM, Alansari S, Khoo E, Teixeira C. Effect of micro-osteoperforations on the rate of tooth movement. Am J Orthod Dentofacial Orthop. 2013;144(5):639-648. 3. Nicozisis J. Accelerated orthodontics with alveocentesis. Princeton Orthodontics Web site.http://www.princetonorthodontics.net/portals/0/alveocentesis_white_paper_ final_edit.pdf. Published December 19, 2012. Accessed January 18, 2015. 4. Shipley T. Proactive treatment with Propel. Ortho Practice US. 2015;6(2):38-39.
This information is sponsored and provided by Propel Orthodontics.
Volume 6 Number 5