Obviously, malocclusions are very different—consequently, aligner treatments are as diverse and complicated as the presenting malocclusions. Varying treatment goals, patient compliance, and preferences of the patient and clinician further compound the situation.
Because clear aligners are highly customized, it is important to recognize that a clear aligner system consists of more than a single appliance. Rather the system is analogous to a three-legged stool whose legs are:
- The dentist
- The aligners
- The auxiliaries
Each component contributes to the system as a whole to support effective treatment of the wide range of malocclusions that present. The first leg is the dentist:
- Properly trained and experienced in clear aligner treatment
- Selects prospective patients who will commit to full compliance
- Submits adequate patient information, records, and a detailed treatment plan that is designed by the treating doctor
- Monitors the patient’s treatment progress and recognizes when the progress is not as expected
- Determines if auxiliaries are required
- Able to respond to issues causing a delay in the treatment progress
- Adequately provides a retention strategy according to the treatment circumstances
The second leg is the aligners themselves:
- Preferably a system that is able to provide quality treatment for any malocclusion, ranging from limited, cosmetic goals to full comprehensive corrections
- Made from material capable of meeting all of the needs of a long term treatment
- Combined with systems designed to enhance the substance and predictability of the aligners’ capabilities
The third leg includes the auxiliaries:
- This includes Chewies, Outie tools, engagers, elastics, expanders, distalizers, TADs, etc.
- Auxiliaries are utilized before, during, or after the aligner treatment to effect movements or changes the aligners are not capable of providing by themselves
- These devices and techniques supplement and enhance the performance of the aligners
- It is the doctor’s responsibility to determine when to use these devices and which ones to use.