Two Basic Principles for Clear Aligner Treatment

Clear aligners have a lot of advantages over metal braces-most obviously, they're clear and they're removable. There is a trade-off, though. Because they aren't attached to the teeth, some movements can be more difficult to achieve than they are with traditional braces.

For this reason, it's important for you to know the limitations of clear aligners so that you can properly assess whether they can achieve the treatment outcomes that you and your patient desire.

There are two principles to keep in mind.

Principle 1

Teeth need space to move: When you prescribe your case, you can plan to create space with extraction, arch expansion, or IPR, depending on how much space is required.

• Tools for Creating More Space

1. Hand stripping/IPR
2. Request expansion or IPR (in prescription or a revision)

Principle 2

Teeth need pressure to move: Most teeth will move with a bit of consistent pressure on them. However, some types of teeth, some movements, and some other factors are more prone to issues than others.

• Tools for increasing Pressure

1. Engagers 
2. Dimples 
3. Overcorrection 
4. Digital power chains
5. Extruding with auxiliaries
6. Rotating with auxiliaries

• Movements and factors that are prone to issues include: 

1. Maxillary laterals
2. Premolars
3. Short clinical crowns
4. Molars 
5. Age and health of teeth
6. Intrusions
7. Extrusions
8. Rotations