🚨 **Orthodontic Aligners: A Cautionary Tale** 🚨

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I recently received a treatment plan for orthodontic aligners via DM from a company, with zero knowledge of basic orthodontic mechanics. Here’s a summary of the issues I noticed (and trust me, they’re not minor): 1️⃣ **Attachment Misalignment**: Inadequate size and position of the attachments. aside from this the plan relies on a buccal attachment for upper premolar rotation, for almost 20-degree without utilizing palatal attachments or elastics. 2️⃣ **Bone Health at Stake**: The continual expansion and retraction of the premolars can have a drastic effect on bone density. We must prioritize the long-term health of our patients! 3️⃣ **Timing Trouble (wrong staging) **: The plan appears to be moving all teeth simultaneously, leading to unsynergistic movements. Timing is everything in orthodontics as teeth move like a chess pieces. 4️⃣ **Torque Trouble**: The wrong mechanics used with cross elastics for correcting the lower right five are questionable, introducing negative torque in th
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Comparison of anterior retraction and anchorage control between en masse retraction and two-step retraction (Summary)

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  Orthodontic treatment often involves the extraction of teeth to create space for proper alignment. However, closing the extraction spaces can be challenging, and different techniques have been developed to achieve this goal. This study compared two such techniques: en masse retraction (ER) and two-step retraction (TSR).

 En masse retraction involves moving all the teeth in the extraction space as a single unit, while two-step retraction involves moving the posterior teeth first and then the anterior teeth. The study aimed to determine which technique was more effective in closing extraction spaces in adult patients. 

 The study found that both ER and TSR were effective in closing extraction spaces, with no significant differences in the amount of incisor retraction or anchorage loss of molars between the two methods. However, both methods resulted in some movement of the posterior segment, and incisors moved more than molars during space closure. 

 The study challenges the belief that TSR is more effective in preventing anchorage loss and suggests that using ER should be considered for closing extraction spaces unless anterior crowding is present. Additional anchorage reinforcement may be required if more retraction of the anterior teeth is needed. The study also found that changes in incisor and molar tipping were similar, with the crowns showing more movement than the apex. This finding suggests that clinicians should be aware of the potential for crown tipping during space closure and take steps to minimize it. 

 Overall, the study provides valuable insights into the effectiveness of different techniques for closing extraction spaces in orthodontic treatment. Clinicians can use this information to make informed decisions about which technique to use based on the specific needs of each patient.t.

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