Macro & Micro Staging in Clear Aligner Therapy

1. Foundations of Staging

• The role of staging in treatment predictability
  
• Biological timing and limits of tooth movement
  
• Why aligners fail when staging is ignored.
  
  

2. Macro-Staging

• Phased sequencing: transverse → sagittal → vertical corrections.
  
• Building anchorage before anterior alignment.
  
• When to move teeth together and when to stage separately.
  
  

3. Micro-Staging

• Breaking down complex mechanics into smaller steps.
  
• Sequential intrusion/extrusion protocols.
  
• Controlled rotations and root torque staging.
  
  

4. Keyframes

• Concept of digital checkpoints for stability.
  
• Using keyframes to anchor hinge movements, rotations, and space management.
  
• Case examples where keyframes prevent force conflicts.
  
  

5. Advanced Staging Techniques

• Hinge Movements: Two-step rotations using torque and retraction.
  
• Round-Tripping: Controlled overcorrection strategies to unlock space.
  
• Frog-Style Staging: Alternating canine and incisor intrusion/retraction for COS leveling.
  
  

6. Synergistic vs. Antagonistic Movements

• Movements that can be combined safely (e.g., expansion + derotation).
  
• Movements that must never overlap (e.g., expansion + intrusion).
  
  

7. Common Errors in Staging

• Starting anterior alignment too early.
  
• Overloading with incompatible simultaneous movements.
  
• Underuse of torque, leading to crown tipping.
  
  

8. Clinical Applications

• Case-based staging demonstrations.
  
• How small adjustments in sequencing change the outcome.
  
• Tips to reduce refinements through precise staging.

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