Why Lower Extrusion Attachments Often Fail (And What Actually Works)

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If you're new to my channel, hello and welcome ! I'm Dr. Petra van der Merwe, an orthodontist with over 30 years of experience.

I specialise in clear aligner therapy and bring a deep clinical background in prosthodontics, periodontics, and oral pathology. This channel is dedicated to helping dentists and orthodontists improve their aligner results with practical, real - world tips.

The short life story

I decided to follow family tradition and study medicine. Here is the journey so far:

Age 19: Enrolled at medical school
Age 22: Found the clinical reality of incurable diseases overwhelming and switched gears into Dental school
Age 25: Qualified with a BChD degree, graduating with several distinctions
Age 26: Appointed as a Lecturer at the Dental School. I loved getting involved in research, and when the opportunity presented itself, I enrolled for a Master’s in Oral Pathology
Age 30: Obtained my MChD in Oral Pathology
Age 35: Obtained my MChD in Orthodontics
Age 36: Started my main private practice as an orthodontist, Beautiful Smiles
Age 37: Opened four additional satellite orthodontic practices, running five practices in five different cities
Age 41: Closed the four satellite practices to improve my quality of life and shifted all my focus to my main orthodontic practice
Age 54: Made a conscious decision to continually educate myself in the field of orthodontics. I faithfully attended every local orthodontic conference and every renowned international speaker visiting South Africa. Still, the dots didn’t fully connect, and I began venturing beyond the traditional borders of orthodontics in search of answers
Age 59: I began focusing on multidisciplinary dentistry, serving mainly adult patients. My emphasis shifted toward a restorative approach-function, occlusion, and the forever-moving target of stability
Age 61: Approached by a tech start-up, Mia Healthcare. I was tasked with setting up the aligner department, particularly overseeing education and quality control
Age 62: Started working full-time as Chief Clinical Officer at Mia Healthcare, while still seeing patients at my private practice

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