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Rotations, extrusions and intrusions are some of the more difficult movements to achieve with clear aligners. Here are some basic principles to observe when attempting to rotate, extrude or intrude a tooth during clear aligner treatment.
Basic principles for intrusions & extrusions
1. A tooth that’s not upright will not extrude or intrude easily.
2. Place a horizontal engager and tilt it upright first.
3. Make sure there is adequate interproximal space; use IPR where appropriate to make space and prevent collisions.
4. Then extrude or intrude slowly.
Extrusion
Intrusion
5. If an extrusion doesn't work, try button & elastic auxiliaries.
Basic principles for rotations
1. A tooth without space won't rotate.
2. Give it adequate space to move/rotate without restriction by adjacent teeth.
3. Then place an engager on the tooth to be rotated and rotate it.
4. If you're having trouble with rotations, see our article on troubleshooting rotations.