Aligners and orthodontic devices
The In.Nova systematics
In the clinical setting of a patient’s malocclusion, the most evident problems are based on the altered position of the teeth, often associated with others of an orthopedic-functional nature. A skeletal disharmony determines a bad relationship between mandible and maxilla.
What is In.Nova
Therapy with functional devices usually involves two phases: one of repositioning the bone bases and another of dental alignment. The genesis of In.Nova is linked to the concept of programming the dental arrangement which makes the relocation of skeletal structures predictable. In.Nova programming involves alignment and contextual repositioning with the use of ITS aligners (invisible touch system) and a device to be worn over these. The customized device is made with 3D printing. This is compatible with the entire sequence of aligners. The device is not a preform, but is made by following the dynamics of the movements of each individual tooth.
THE EVOLUTION OF ORTHOPEDIC-FUNCTIONAL DEVICES
How In.Nova works
ITS aligners are replaced according to the prescriptions of the clinician; the device on the other hand, unique for the entire treatment, requires a daily collaboration time identical to that of functional appliances. The aligners provide for a reconfiguration of the dental arches in synergy with the In.Nova device which favors the re-establishment of a correct mandible-maxillary relationship.
The shape of the devices
The In.Nova device provides different embodiments, depending on the clinician’s requirements. It can be made up of two separate plates that can be mutually coupled through guide means that cooperate with each other by interference in the closing phase of the jaw, inviting it to close in a different therapeutic position than its usual one.
In.Nova class II device in 2 plates
In.Nova device class III in 2 plates
In.Nova monobloc type device
The guides consisting of inclined planes have a different configuration in relation to the malocclusion in place. If required, the device can be a single monobloc type.
How the devices are made
In.Nova devices are made for additive manufacturing, with class IIa biocompatible material. In case of loss or accidental breakage of the device it is not necessary to take new fingerprints or registrations, as the files in memory are simply reprinted. This is one of the notable benefits of 3D printing.
Advantages of Systematics
The use of systematics for treatment in classes II allows to obtain a predictable biological response by observing the traditional timing of functional therapy. In the presence of permanent dentition, the entire therapy can be carried out in one step. Their simultaneous use favors a rapid remodeling of the dental arches and the restoration of a correct mandible-maxillary relationship. It is possible to avoid a subsequent treatment with the multi-attachment technique.
For movements such as distalization, expansion, and symmetrical or asymmetrical contraction of the arches, the programmed presence of the "overlay" device can increase the anchorage. Since it is positioned above the aligners, it enhances their action and disperses unwanted forces, to search for more dental movements at the same time and reduce sequencing. This synergy shortens the treatment and the rapid improvements motivate the patient to collaborate.
In cases of class The deep bite associated with a deficit of height of the lower third, after the jaw jumping, a lateral open bite is usually manifested. In the In.Nova system, if the case requires it, the aligners are designed to favor the extrusion of the posterior sectors and level the Spee curve. In essence, the mechanics of resolving the deep bite can all be applied and find a powerful amplifier in the device.
If the patient does not wear the device for a few days there is no need for modifications or adjustments to readjust it, since the aligners always retain one of the many positions foreseen by the progression of the treatment, inherent in the device. The systematic does not require any kind of activation. This affects the amount of time spent in the chair and greatly reduces the urgency in the studio.
It is possible that the clinician may require a progressive advancement activation, and the device grants this option by taking a new repositioning spatial reference. In addition, In.Nova in the double plate variant can also be reactivated in the chair, by relining the release elements with composite.
In.Nova devices are made for additive manufacturing. In case of loss or accidental breakage it is not necessary to take new fingerprints or registrations, but just reprint the files in memory.
The system can be applied whenever a mandibular repositioning, an increase in anchorage is required or to replicate a pre-established closure, while aligning the teeth with the aligners.
By changing the predisposition of the fins, the system can also be useful in cases of pseudo-class III. In.Nova is hypoallergenic due to the total absence of metal elements, and even without the presence of direct retention hooks on the dental elements, the anchoring is excellent with a perfect fitting device-aligner-teeth.
The innovation of In.Nova devices
Assembly Sequence
ITALIAN ORTHODONTICS 4.0
Indications for treatment
The In.Nova system allows the use of aligners with a mandibular repositioning device. It is of choice in growing patients, class II skeletal type from mandibular retrognathia with convex facial profile and reduced lower third. It is essential when you want an increase in anchorage and where you want to use the aligners with a device that constantly replicates a predetermined closure.
PROGRESSION OF WORKING PHASES
In.Nova Digital Flow
DIAGNOSIS AND TREATMENT PLAN
FOOTPRINT DETECTION
BITE DETECTION
TREATMENT SIMULATION
PRODUCTION AND PRINT
START THERAPY
The construction bite
For the realization of the In.nova system, it is absolutely necessary to detect a construction bite. In the event that intraoral optical reading is used, two scans must be detected, one in the usual occlusion and the other with the activation bite. The construction bite determines the degree of activation of the device. We abide by Clark’s prescriptions for his Twin Block. The parameters are those of a single large activation bringing the arches head to head with 3 or 4 mm of interincisal space. This indication applies to patients with overjet up to 10 mm, in cases where this is greater, the advancement can be carried out gradually. The clinician at his discretion can change both sagittal and vertical activation. On the frontal plane, in the case of mandibular latero-deviation, correction is recommended by centering it on the median of the face.
ACTIVATION ON THE FRONT PLANE
ACTIVATION ON THE SAGITTAL PLANE
Assembly Sequence
Delivery of devices
Therapeutic Possibilities
- Mandibular advancement
- Centering of the medians
- Expansion of the dental arches
- Verticality management: open and deep bite
- Dental movements in the three orders
- En-mass distalization
- Asymmetrical expansions and distalizations
- Control of bad habits and OSAS therapy
TIMING
Interceptive Therapy
Mixed dentition even in the absence of some elements due to premature loss, agenesis or eruption
TARGETS
- Expansion of the dental arches and resolution of symmetrical and asymmetrical lateral and anterior crossbites
- Correction of scissors bite
- Excellent anchorage for distalization
- Deep bite resolution
- Latero-deviation correction
- The reconfiguration of the dental arches which, in synergy with the In.Nova device, favors the re-establishment of a correct mandibular-maxillary relationship
TIMING
Orthopedic-Orthodontic Therapy
- Spike in mandibular growth stage CS3 maturation of the cervical vertebrae
- Permanent dentition
TARGETS
- All the advantages listed above
- Correction of skeletal disharmonies
- The therapy takes place in a single phase, avoiding a subsequent intervention with a multi-attachment technique
- OSAS therapy
TIMING
Adult Patient
TARGETS
- Indispensable when you want an increase in anchorage and where you want to use the aligners with a device that constantly replicates a predetermined closure
- OSAS therapy