Ortho Tribune United Kingdom Edition

ORTHO TRIBUNE The World’s Orthodontic Newspaper · United Kingdom Edition Published in London www.dental-tribune.co.uk Vol. 11, No. 1 Clear aligners: How has the technology evolved? By Brendan Day, DTI Though still a relatively new ortho- dontic treatment modality, clear aligners have quickly become an increasingly popular alternative to ﬁ xed appliances for tooth straight- ening, since they provide an aesthet- ically appealing and comfortable choice. However, the recent rapid advancements in aligner technology are yet to be recognised by many dentists, leading to a low adoption rate. This article will provide an introductory overview of aligner treatment and its development. Traditionally, malalignment has been corrected using ﬁ xed orthodontic appliances. However, in 1999, Align Technology made its Invisalign system available for commercial purchase, altering the future path of orthodontics. A clear aligner, Invisalign offered an effective alternative in ortho- dontic treatment, as its correct use can minimise the plaque build-up, gingival recession and inﬂ am- mation of soft tissue sometimes associated with ﬁ xed appliances. Additionally, its complete lack of metal parts presented an aesthetic advantage, and the ability to re- move it at any time (especially relevant during eating) allowed Invisalign patients a level of com- fort and hygiene care previously unmatched in orthodontic treat- ment. Through its recently straightening intro- duced Invisalign Go system—a treatment programme aimed at guiding general dental practition- ers through the process of iden- tifying, planning and treating suitable cases using the aesthetic tooth solution— Align Technology has become entrenched as the global market leader in clear aligners. Other com- panies have since recognised the value of this therapy, though, and this increased focus has led to a rapid progression in the sophis- tication of aligner modelling and manufacturing. Dr Les Joffe, Sec- retary of the European Aligner Society (EAS), the only international organisation in Europe devoted to the promotion of education and research in aligner therapy, be- lieves that these advancements have not yet been fully recognised by all dental practitioners. In an in- terview with Dental Tribune, Joffe said that dental professionals often pass judgment on the suitability of aligners based on outdated in- formation and technology. “There is a misunderstanding by many Japan Academy of Aligner Ortho- dontics in 2012, with both organi- sations aiming to foster a space for increasing awareness of the appli- cations and advantages of aligner therapy. More recently, the EAS was es- tablished in 2013, with Dr Graham Gardner serving as its founding and current president. In order to promote education on the latest technologies used by clear align- ers, the EAS will be hosting its ﬁ rst AlignerLab workshop on 18 Feb- ruary 2017 in Vienna in Austria. It follows on from the successful ﬁ rst EAS congress in February 2016 and will provide clinicians with an opportunity to engage in a variety of hands-on sessions covering 3-D intra-oral scanning, 3-D printing, virtual treatment plan- ning techniques and tooth move- ment acceleration techniques. Gardner believes the Aligner- Lab will highlight how far aligner therapy has come in such a short time. “With the explosion in the 3-D treatment planning and manu- facturing processes now available, we at the EAS believe that not only do we need to update our knowl- edge on the various aligner systems available, we also need to under- stand the associated hardware —scanners, computers, software, 3-D printing—that is necessary to optimise the aligner system and improve treatment results,” he told Dental Tribune. Gardner envisions the event ideally becoming a reg- ular occurrence to allow dental professionals to trial and compare new systems and developments in aligner technology. © e d w a r d o l i v e / S h u t t e r s t o c k . c o m adopted, however, increasing re- search into its effectiveness and patient satisfaction rates has been conducted. For example, a 2015 study published in the BMC Oral Health journal compared oral health status and satisfaction lev- els among patients who had re- ceived ﬁ xed appliances and those treated with the Invisalign sys- tem. It found that Invisalign pa- tients were more satisﬁ ed overall and enjoyed greater periodontal health, with slightly lower levels of dental plaque. According to an- other study, conducted in 2013 and published in The Angle Ortho- dontist journal, compared with those treated with conventional edgewise brackets, patients who had received aligner therapy had signiﬁ cantly fewer dental visits, shorter treatment duration, fewer emergency visits and less overall chair time. Aligner therapy is one of the fastest-growing areas in ortho- dontics, driven signiﬁ cantly by patients who regard it as a more comfortable, convenient and dis- creet alternative to ﬁ xed appliances. Given that market research ﬁ rm Technavio has projected this mar- ket to grow at a compound annual rate of 12.68 per cent globally from 2016 to 2020, the need for organ- isational bodies to increase edu- cation and awareness of aligner therapy is essential. The German Association for Aligner Orthodon- tics was founded in 2007 and the m o c . k c o t s r e t t u h S / a h h h u p © clinicians that aligner treatments are limited,” said Joffe. “Many clini- cians base their view on the early stages of aligner development, from around 2001 to 2003. More than 15 years later, the huge strides that have been made in aligner perfor- mance are not fully understood and therefore the modality is ei- ther not adopted or provided.” These major advancements in clear aligner technology include the integration of much more sophisticated 3-D modelling soft- ware, able to customise each aligner to an individual patient’s needs. “Clear aligners have deeply changed orthodontics,” Agnieszka Dziedziul, Clear Aligners Depart- ment Manager for NimroDENTAL Orthodontic Solutions, told Den- tal Tribune. Established in 1991, NimroDENTAL is one of the larg- est orthodontic laboratories in the UK, using four different align- ment systems in its work with dental practices. “When we started making clear aligners 15 years ago, we were limited to creating move- ments by hand on a plaster model,” said Dziedziul. “Today, though, we use sophisticated software and the latest 3-D printers to create clear aligners that can correct the majority of malocclusions.” The lack of awareness of clear aligners’ beneﬁ ts among dental practitioners has sometimes been attributed to a lack of scientiﬁ c studies on this treatment mo- dality. As aligner therapy has de- veloped and been more widely

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