Clear aligners are the latest innovation in the world of orthodontics that have emerged as a possible alternative to conventional fixed braces. They can be described as orthodontic appliances fabricated from thermoplastic material which is virtually inconspicuous, making it one of the best choices for those who are aesthetically concerned. They have been growing in popularity owing to their numerous benefits like comfort and efficiency. Yet, one of the most important factors that govern the success rate of clear aligners is strictly the selection of the case.
What are the ideal cases to treat with clear aligners?
As a dental practitioner, assessing the dental condition of the patient and classifying them according to their malocclusion is the first skill that needs to be developed. A deep understanding of the grade of severity of malocclusion is needed to be able to decide if the case is suitable to be treated with clear aligners. Listed below are few of the ideal cases in which clear aligners prove to be effective-
- Crowding- Insufficient space in either of the arches can be the primary cause for crowding. Ideally, crowding falling in between 0mm to 3mm can be corrected effectively through clear aligners.
- Spacing- Presence of excessive gaps between teeth is definitely an aesthetic setback and can also compromise the dental hygiene of the patient. If the spacing is less than 3mm it can be called
asmild spacing and if it is more than 3mm but less than 6mm, it is classified as moderate spacing. Mild to moderate spacing can be dealt with clear aligners.
- Narrow arches- The case with narrow arches can be corrected by clear aligners through expansion without tipping the teeth extensively
- Intrusion- An intrusion of less than 2mm in anterior teeth and less than 1 mm in posterior teeth can be treated with the help of clear aligners.
- Rotation- Care must be taken while choosing a case for treating rotated teeth. Up to 30 degrees of rotation with incisors, 20 degrees with canines and 15 degrees iwith premolars/molars is acceptable. Higher degrees of rotation should not be selected as a case for clear aligners.
- Deep bite (Class II div 2 cases)- Deep bite refers to the excessive overlap of the upper anterior teeth over lower anterior teeth. This condition can be traumatic to the palatal gingivae of upper incisors and also not pleasant to look at. This case can be improved with the help of clear aligners.
Clear aligners alone may not be the right solution in every case. In some situations a combination of both conventional fixed braces and clear aligners can prove to be more effective.
However, to provide the best treatment with aligners ,the clinician requires extensive knowledge of aligner biomechanics, understand the correct staging of movements, the type, position and size of the attachment for various movements, the overcorrections required for different objectives and a realistic understanding of movements that can be achieved. This requires a wealth of training , learning and experience to develop excellent knowledge .
It is this extensive knowledge that will help provide good and predictable results with aligner therapy