2020, Number 2
Orthodontics with aligners
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Language: English/Spanish [Versión en español]
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Page: 78-80
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It is a fact that the world is constantly changing. Technological innovations appear even more frequently, which makes it difficult to keep up with all advances presented globally. This is also reflected in the dental area, which requires operators to be under continuous education to stay a step ahead.
Currently, in orthodontics, there are multiple systems to achieve the correction of malocclusions and dental alignment, from different designs, prescriptions, and different ligation types to orthodontics without the need to use fixed appliances. More often, the patient is looking for the most aesthetic and hygienic treatment alternatives and, above all, that such alternatives can adapt to their daily routine.
In the search for the best work tool, the priority is the patient's health and treatment results; therefore, we should always implement work tools that not only cover the needs and requests of the patient but at the same time allow us to achieve the treatment objectives. This leads us to ask the following question: Do we use the latest technology and innovations by trend or necessity?
Using aligners in our daily practice should be carried out with a certain modesty, as there is a learning curve as in any process. By not acknowledging this, we may end up with unfavorable results and a bad experience using this tool.
It is necessary to consider that there are three key factors to success in aligner treatments: correct diagnosis, good biomechanics knowledge in aligners, and adequate ClinCheck analysis.
The controversy surrounding the use of aligners has always existed, as the controversy is caused by the self-ligating systems. We must keep in mind that aligners are just one of many systems within our treatment options, so the use and knowledge of biomechanics in dental movements in conjunction with an accurate diagnosis are the most important factors in any system we use.
To achieve the desired success, we must pay close attention when performing our dental movements in the digital software ClinCheck. This is a key point in the process since it is where we will establish our tooth movement from start to finish. We must understand that the clear aligner system becomes a programmed orthodontic instead of a reactive one, as it is with fixed appliance systems.
Within our daily practice, the clear aligner system is our tool of choice for our patients for different reasons, such as:
Predictability of tooth movement: with the use of clear aligners, some dental movements are more predictable than others, so we must consider that we can use extra accessories to complete the tooth movement desired.
Hygiene: since we are using a removable system, brushing techniques and the use of oral hygiene aids are not altered, thus maintaining the periodontal health of the patient and avoiding cavities and/or white spots. For this reason, it is a highly recommended treatment in patients with a history of periodontal disease.
Visualization of final occlusion: we can observe in advance the result and the final occlusion of the treatment by programming the dental movement utilizing the software. It is important to specify what could be achieved as long as we implement adequate control of the use of the aligners and the correct techniques of these. This is a great advantage when we show to the patient the outcome of the orthodontic treatment with different plan options.
Aesthetics: it is evident that one of the main advantages that this system offers us is a high aesthetic, because, in general, it can pass unnoticed that the patient is undergoing orthodontic treatment.
Control of dental movement: In some cases, where it is needed, dental movement can be avoided in specific dental organs. In the same way, we can determine the amount of movement. For example, in patients with periodontal disease or with root resorption, we want to decrease the amount of tooth movement by aligner to avoid applying excessive force.
Dental chair time: because it is a digital system that requires software programming, it considerably reduces the time in the dental chair compared to conventional techniques. Since most of the work is done from the computer itself, the work can be done from the dental office, home or anywhere in the world.
It is true that to be able to perform more complex or unpredictable movements with any clear aligner system, it is necessary to use auxiliary mechanics such as resin attachments, buttons, orthodontic miniscrews, and sometimes partially fixed appliances. However, complex malocclusions are not a limitation to being able to carry out treatments with clear aligners as long as the technique is mastered.
We can conclude that the use of an aligner system is a great work tool in daily practice, as long as the orthodontist is committed to mastering the technique and not doing it just by tendency; otherwise, the results will be compromised. We strongly invite you to take that learning curve and be able to discover the benefits of dental aligners, both in simple and complex cases.
AFFILIATIONS
1 Docente de la Maestría en Ortodoncia, Universidad Intercontinental. Docente de Posgrado Ortodoncia, Universidad Latinoamericana.
2 Docente de la Maestría en Ortodoncia, Universidad Intercontinental.
CORRESPONDENCE
Raquel Rodríguez Salmerón. E-mail: rrodsa87@gmail.com