Surgery vs Non-surgery

Skeletal Anchorage in Surgery First with Clear Aligners

Flavio Uribe

Dr. Uribe received his Master's degree and Certificate in Orthodontics from the University of Connecticut after receiving his DDS degree from the Instituto de Ciencias de la Salud in Medellin, Colombia. He also completed a 3- year residency and fellowship program at the Advanced Education in General Dentistry Program at the University of Connecticut.
Dr. Uribe is a Full-time Associate Professor, Program Director, and Chair of the Division of Orthodontics at the UConn Health. He is a Diplomate of the American Board of Orthodontics and member of the Edward H Angle Society of Orthodontists. He was a member of the Council of Scientific Affairs for the American Association of Orthodontists (AAO) and is part of the committee implementing practice-based research networks for the AAO. Dr. Uribe is a section editor of the Book Temporary Anchorage Devices in Orthodontics, co-editor of the book Atlas of Complex Orthodontics and of the new edition of Temporary Anchorage Devices in Orthodontics. Dr. Uribe has authored and coauthored numerous book chapters and articles in peer-reviewed journals. He is a past recipient of the Biomedical Research Award from the AAO Foundation in 2012 and 2019. Dr. Uribe holds the Charles Burstone Professorship at the University of Connecticut.

Lecture Description

Clear aligner therapy (CAT) is increasingly being adopted in orthodontics to treat more complex malocclusions. One specific example is the use of clear aligners in orthognathic surgery. This technique has been applied with a conventional approach consisting of a presurgical orthodontic phase of tooth decompensation and a postsurgical orthodontic phase geared to detail the occlusion after surgery. More recently, we have applied CAT in orthognathic surgery with the surgery first approach (SFA). Temporary anchorage devices (TADs) are very useful for this approach during surgery and in the postsurgical phase. During surgery, TADs are used to connect the maxilla and mandible to the interocclusal splint for intermaxillary repositioning. After surgery, these same TADs may serve for intra-arch and inter-arch tooth movements that may be needed to refine the surgical result. Also, TADs such as miniplates may be used with clear aligners to actively distalize the maxilla in a SFA. This lecture will highlight with case examples many applications of TADs in surgery first with clear aligners.

Learning objective

Illustrate all the applications of TADs using the SFA with CAT.
Highlight the biomechanical applications of TADs used in conjunction with clear aligners after orthognathic surgery with a SFA.