By Bryan Allen Lockhart, DDS

The number of orthodontic patients undergoing orthodontic treatment with clear aligners in the United States is steadily increasing. However, the number of patients that need orthognathic surgery has not changed. This has led to an interesting conundrum leaving the orthodontists and oral surgeons searching for a solution for surgery patients undergoing aligner treatment. Oftentimes, because of this, orthodontists and surgeons have to derive a “think out of the box” plan that will allow the surgeons performing the surgery to connect their surgical guides similar to how they would with fixed appliances.

The most common options are short term braces or temporary anchorage devices (TADs). The issue with fixed appliances is that they typically have to be worn for a short period of time as it is very difficult to place brackets passively that will allow placement of surgical wires from the beginning. Even if the teeth are somewhat straight from the aligner treatment, there is still some sort of wire progression that has to occur. This results in extending overall treatment time and patients have to wear braces which they didn’t want in, as they chose clear aligners for their modality of treatment.

TADs, the second option, are more invasive and increase discomfort and healing time for the patient.

A great solution for surgery patients undergoing aligner treatment is Lock-On, a device that will allow the mimicking of fixed appliances so that surgeons feel comfortable, but at the same time, non-invasive, which provides a smoother healing process. The appliance is bonded passively, allowing it to be placed as close as the day before the surgery. This will avoid the normal wire progression process with fixed appliances and minimize the amount of time the patient has to wear something fixed. It comes in one piece and is extremely easy to bond resulting in a happy orthodontist, happy surgeon, and, most importantly, a happy patient. OP

Dr Bryan Allen Lockart

Bryan Allen Lockhart, DDS, is in private practice at Dual Image Orthodontics in Charlotte, NC.

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