Today's tips come to us from Dr. James Grigsby of Garland, Texas. He started treating patients with ClearCorrect as soon as we got FDA approval in 2009, so chances are, he knows what he's talking about.
The easy way to install engagers
Dr. Grigsby calls this "the best tip of all." When he places engagers, instead of using the entire engager template, he trims off the sections that don't have engagers. The engager still gets placed accurately, but it's a lot easier to pry off just a small portion of the template. (We got a similar suggestion from Dr. Mark Bentele last year.)
Dr. Grigsby says that he and his staff "used to sigh" when they had to place engagers because they were so cumbersome, but now it's a breeze.
Dr. Harvey Mahler of Chicago shared a tip about taking impressions with us last year.
After reading last week's tech tip, he generously wrote in again to share some of his tips for placing engagers:
- Prior to etching any enamel surface, try the template in to see exactly where the engager will sit.
- Use air abrasion with 50-micron aluminum oxide to lightly and quickly "prep" the surface. This will clean the surface prior to etching.
- Then etch for at least 20 seconds (only the area that was air-abraded). Apply resin bonding and light cure.
- Prior to placing composite in the template, take an explorer or needle diamond and pop a small hole on the engager surface for two reasons:
- to allow any air to escape and prevent a bubble, and
- to reduce surface excess for easy clean up.
- After seating the template and before light curing, wipe any excess that pops through the hole.
Today's tip comes from Dr. Mark Bentele:
One tip that I have is on placing the engagers. The engager template may not fit passively over the entire tooth if the teeth are not tracking fully. In that situation, the engager may not end up in the right place when you use the entire template. Instead, trim the template down to just the tooth with the engager and about 2/3 of the teeth on either side of it. The template will fit fully in place and the engager will be bonded correctly. This is also helpful because the engager template can be peeled away from the tooth facially rather than trying to pull it off vertically, which is more difficult.
Engager template tips
ClearCorrect provider Dr. Gene Shapiro shares two valuable tips on how to properly seat and easily remove the engager template without disrupting the engager.
Seating the engager template
Sometimes, the engager template can be difficult to seat, which may lead to inaccurate placement of the engagers.
Here's how Dr. Shapiro seats his engager templates:
I simply deliver the engager template to the patient as a next set of trays 1-2 days before the engager placement appointment, and ask them to wear [the templates] instead of the current [aligners]. I also make sure they wear them in the same manner as they would the aligners.
By the time they return to have the engagers placed, the trays are now seated perfectly and exact engager positioning is achieved every time.
Tech tip: One provider shares his engager tips
Removing the engager template after placing engagers may also prove difficult. When the engager is bonded correctly, the engager template will be formed tightly around the teeth, making it difficult to pry off without disrupting the bond or scratching the engager.
Dr. Shapiro shares his trick for removing engager templates by splitting them mesiodistally:
Using a medium grit diamond bur, I thin out a few spots along the central fossae of the molars.
Then, using curved Goldman-Fox scissors, I create small "snaps" or cuts all along occlusal in mesio-distal directions.
I gently lift the areas around the borders of the cuts with a curette.
By now, the templates are easy to cut along the occlusal surfaces. This allows me to separate the buccal and lingual parts of the templates.