Aligners - recent developments and clinical aspects By Dr. Shiu CM

Aligners have been used for over a decade. Nowadays, over a million of aligners have been dispatched to patients. But do we know all the myths in the aligners that we had provided? With the advancement of the digital technology, the movement of the teeth can be planned, predicted, and tracked.

The history of aligners can be traced back to the 1926 by Remensnyder, but in the good old days we can remember the name of Dr. Kiesling, in which was famous for the Kiesling setup for estimating the outcome of movement of the teeth by repositioning the required teeth as planned with wax up, called it as the ‘Tooth positioning appliance’. Later, Sheridan invented the the Essex aligners, mild to moderate crowding can be solved. In 1997, Align technology was established to combine the former Aligner techniques and combine them with CAD/CAM technology. After years of experience, tooth movements can be achieved. With the invention of digital orthodontics, the treatment planning, the movements of the teeth can be planned and monitored in a predicted way. Recently, the Aligner systems are further flourished with the introduction of Wrap around technology. ClearCorrect and Trio Clear systems are one of the pioneers in integrating this technology into their Aligner systems.

Dental monitoring is another breakthrough in digital dentistry. It was established in 1990 and integrating the Artificial intelligence into daily dental practice for monitoring, communicating with the patients.

Orthodontic treatment can be treated with both aligners and braces, or either one of them.

There are advantages and disadvantages of the Aligner treatment.

Traditionally, the aligners mainly used different sets of plastics to move the teeth with prescribed distance. Teeth can be moved bodily or by tipping. Attachments were incorporated onto the teeth to perform specific movements. With the advancement of the materials science, there were a breakthrough for the plastic in fabricating the aligners. And they were used with extension beyond the gingival for a few millimetres for wrapping the tooth. The purpose of this extension is just want to alter of the position of the center of resistance or movement of the tooth. That means that we can provide teeth movement more effectively and efficiently in treating patients.

Patients who need orthodontic treatment may have different aetiology. We should aim at doing a good treatment planning before deciding the types of treatment. If aligners were prescribed, several issues should be noted, namely non tracking, difficult rotations, posterior openbite, premolars rotations, openbite and extrusions. More will be coming up. Stay tuned.

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