Desirable vs. undesirable undercuts
Mosby's Dental Dictionary defines an undercut as "the portion of a tooth that lies between its height of contour and the gingiva, only if that portion is of less circumference than the height of contour."
Undercuts exist because of natural tooth morphology and contours. Aligners rely on these naturally-occuring desirable undercuts for normal retention.
Undesirable undercuts, however, are too retentive, making it difficult to remove impressions or aligners.
With undesirable undercuts, impression material can get locked in the patient's mouth because the material fills in between the teeth. When the impression hardens, there isn't enough flex to remove the impression.
Some common causes of undesirable undercuts include:
- Gingival recession whereby a notch exists at the cementoenamel junction
- Under restored dental implants and bridges
- Anomalous tooth morphology
- Overcontoured restorations
- Black triangles
How to deal with undesirable undercuts.
One of the most common techniques for dealing with undesirable undercuts is to block them out, try the following:
- Before taking impressions, fill in the undesirable undercuts with a soft material that will not bond to the impression (like wax). This will make the impression easier to remove, and also eliminate those undercuts from the resulting 3D model, making the aligners easier to remove as well.
- Do not allow the wax used to fill an undercut to obscure any actual anatomy, such as tissue or teeth.
Another technique is to trim the medium body material:
- Between the first and second steps of a two-step impression, use a knife to trim away the impression 2 millimeters above the gingival in the medium body material. This will ensure that the only material covering the undercuts is the flexible light body material, allowing the impression to be removed easily.
Note that if you use this technique (or if you take intraoral scans), the undesirable undercuts are still likely to show up in the 3D model and aligners. In these situations, you may want to ask ClearCorrect to block them out digitally:
- When you submit the case, use the additional instructions section to describe any undercuts that you want ClearCorrect's technicians to digitally fill in. When you get the treatment setup, inspect these areas of the 3D model carefully to ensure that they meet your expectations.