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ePaper created 2017-03-17, 13:11:17 | version 1.38.0
| trends & applications clear aligners Creative adjuncts for clear aligners to improve predictability Author: Dr S. Jay Bowman, USA The concept of clear aligners has grown in leaps and bounds inter nationally since the introduction of Invisalign (Align Technology) in 1999. In the 1940s, Dr Harold Kesling first proposed the original theoret- ical basis for moving teeth with a series of retainers, but it took more than 50 years before computer tech- nology made the idea workable. Although some of the initial excitement attend- ing the idea that all patients could be treated with- out metal-fixed orthodontic appliances wore off quickly, early adopters and innovators have worked diligently to improve and enhance clear aligner methods. Limit ations of clear aligner treatment simply required some time and experi- ence to discover, but ultimately resulted in a series of articles quantifying issues often experienced clinically.1–16 As patients’ and practitioners’ desires for aesthetic alternatives to fixed appliances continued to coalesce in the past decade, there have been a number of techno logical and biomechanical advancements that have led to an ever- increasing number of treatment application possibilities for aligners, including the expansion to treating teenagers.17, 18 In those endeav- ours, a series of articles were published suggesting innovative treatment options with various adjuncts to clear aligners,19–21 including Hu-Friedy’s Clear Collection instruments (Fig. 1).22–24 Fig. 1 Fig. 2a Fig. 2b Fig. 2c Fig. 3 Fig. 4a Fig. 4b Fig. 5 Fig. 1: The Hu-Friedy Clear Collection consists of four instruments: the TEAR DROP, HOLE PUNCH, VERTICAL and HORIZONTAL. – Figs. 2a–c: The TEAR DROP is designed to cut a teardrop-shaped notch in the margin of clear aligners to retain orthodontic elastics for various applications. – Fig. 3: Class II clear aligner treatment enhanced with Class II inter-maxillary elastics and Class I intra-maxillary elastics attached to mini-screw anchors to produce the intended vectors of force. – Figs. 4a & b: The HOLE PUNCH is used to cut a half-moon of plastic at the aligner margin to clear the way for bonded buttons or brackets in order to connect orthodontic elastics or elastomeric chains. – Fig. 5: Seating elastics used to improve posterior intercuspation in finishing aligner treatment. The HOLE PUNCH cleared plastic to permit bonding of buttons for the inter-maxillary box elastics. 16 ortho 1 2017