Louis-Charles ROISIN 先生 France
第４回 日本アライナー矯正歯科研究会 (2017)
- AIM: Aligner orthodontics have made tremendous progress with more predictable results and shorter
treatments, even in extraction challenging cases. But as technique becomes more powerful, the
clinician needs more control to care on compliance of aligner wear, or vibratory devices.
As interval of changing aligners is reduced, is it more and more important to be able to detect possible
untracking of aligners, and possible aggravation of this untracking, before the next appointment.
METHODS: Previous protocols of changing aligner were established from the historical beginning of
aligners, on standard estimate of two weeks then now one week. Clinicians and studies begin to
demonstrate that interval of changing could decrease to five, four, three days but for specific
movement prescription and at specific stages in the treatment.
In fact, changing aligner is a clinical act each time, and in theory should be controlled each time.
Of course, it is not possible in practical, but remote controls could be a solution and will be the logical
way to continuously control changing aligner, whatever the speed of changing aligner.
RESULTS: Patient will take intraoral pictures with and without aligners, via his smartphone and the
Dental Monitoring App, at the rhythm of estimated aligner changing: four, seven, ten, fourteen days…
Patient will not change aligner until he receives instruction:
- Go: “change your aligner” if no incident is detected on the photos
- No-Go: “don’t change your aligner” in case of for example, slight unseat is detected. This No-Go will
be associated with instruction or message to check compliance or use more longer chewies or
vibratory devices. Automatic answers and protocols can be predefined according the different types of
notification: new slight unseat, increasing of unseat, or noticeable unseat…
Also debonding of button, hygiene insufficiency can be checked in time.
CONCLUSION: Time is now to customize changing aligners with GOLIVE: a rational clinical remote
control of each aligner. This is the logical way, to try and use the shortest changing interval as
possible, but with the security of detecting many problems, at the beginning, to intercept them in time,
and avoid aggravation or bad surprise at next appointment.
DENTAL MONITORING: THE FIRST SELF MEASUREMENT TOOL IN ORTHODONTICS FOR TREATMENT FOLLOW UP
- Aligner orthodontics have made tremendous progress in the last ten years. But the clinician was missing something: there was no high tech, precise measurement tool to continuously control the clinical response to these techniques.
METHODS: Since 2013, Dental Monitoring has been developing the first mobile application of self-measurement in orthodontics, using 3D reconstruction technology from an initial model and simple photos regularly taken by the patient's smartphone. Frequent and continuous controls provide:
● A photo gallery of clinical evolution
● A graph of global activity for upper and lower arch
● A 3D matching to replay and visualize the history of 3D movements
● Exhaustive movement graphs for each tooth
● Precise measurements on six axes for each tooth
RESULTS: Clinical examples illustrate the value of monitoring aligner orthodontics to:
● Stimulate cooperation on hygiene and compliance, particularly for teens
● Improve diagnosis and follow-up with new measurement tools and graphs
● Continuously compare reality of movements and set-up prescription
● Individualize and adapt in time the schedule of aligner change
● Detect many incidents before next appointment, such as attachment debonding or unseat of aligners
● Avoid late diagnosis and correct incidents at the beginning to reduce many aggravations and complications
CONCLUSION: Self-monitoring is well recognized in medicine and has proven, for many years, its efficiency in the follow-up of diabetes or hypertension.
In orthodontics, Dental Monitoring is the first and solution based on the same concept and developed for the specific needs of orthodontics and particularly adapted for aligner techniques.
Dr L-C ROISIN graduated in stomatology with a specialty in Dento-Maxillofacial Orthopedics in 1988 in Paris, and then embarked on an unconventional, self-taught path: a first diploma under the supervision of Jean DELAIRE in Nantes, EPGET and Tweed Foundation with Alain DECKER, Club TTD with Pierre PLANCHE and the courses of Didier FILLION and Dirk WIECHMANN for lingual.
A former Private Attending Physician in the maxillofacial surgery wards of the Foch, Saint Louis, Percy and Necker hospitals, he attended numerous oral & facial, and later craniofacial surgeries with Daniel MARCHAC. He has been a consultant in the multidisciplinary team of the Centre of Reference for Craniofacial Dysostosis and Neurosurgery at Necker hospital for 20 years. In 2008, he obtained an expert’s degree in maxillofacial and oral-dental health.
In 2002 he became one of the first and very enthusiastic users of Invisalign.
Since 2013, he has been sharing his time between his private office and clinical direction of a new project: Dental Monitoring.
He is now International speaker for courses and lectures on Dental Monitoring, traveling the word from Europe, USA, Russia, Middle East, Asia, Australia and … Japan.