Surgery vs Non-surgery

Skeletal Anchorage in Surgery First with Clear Aligners
Flavio Uribe

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