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课件讲稿xliii卷期439jco.pdf

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SequentialMARA-

InvisalignTreatment

JAMESE.ECKHART,DDS

Althoughorthodontictreatmentwithclearalign-Analternativeapproach,asdescribedinthis

ersystemssuchasInvisalign*isusuallyarticle,issequentialtreatmentwiththeMARA

contraindicatedinteen-agepatientswithClassIIfollowedbytheInvisalignsystem.

malocclusions,itcanbeanoptioniftheteethare

sufficientlyeruptedforthealignerstograspthem.

ApplianceDesign

WhenClassIIelasticsareusedconcurrentlywith

aligners,however,theresultingchangesmaybeInanadolescentpatient,theMARAcanbe

primarilydentoalveolar.Incontrast,approxi-usedtoacceleratemandibulargrowthbyposturing

matelyhalfthecorrectionseenwiththeMandibularthemandibleforwardaswithaHerbst***appli-

AnteriorRepositioningAppliance**(MARA)inance.UnliketheHerbst,ithasnoconnection

adolescentClassIIpatientsisskeletal.1Inseverebetweenthejaws;likeafixedTwinBlock,†itholds

ClassIIcases,theMARAcouldpreventsidethemandibleforwardwithtwointerfacingvertical

effectsthatwouldbedifficulttocorrectwithsurfaces.TheMARAreportedlyproducesresults

Invisalignalone,suchasfirstmolartippingorsimilartothoseoftheHerbst,butwithlesshead-

posteriorintrusion,bothofwhichhavebeengeareffectandlessmandibularincisorproclina-

observedduringtreatmentwithacombinationoftion.1

fixedappliancesandtheMARA.ThedesignoftheMARAhasevolvedov

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