Creative Adjuncts for Clear Aligners to Improve Predictability

- The purpose and advantages of individualizing clear aligners and applying adjunctive forces to increase treatment predictability- A variety of applications and uses for adjuncts to aligners such as miniscrew anchorage, the addition of buttons/elastics, and enhancement instruments- Preparation of streamlined process for enhancing the clear aligner treatment planning process to incorporate individualized modifications for each patient- The scope and predictability of clear aligner options- The limitations of clear aligner treatment based on the published literature- When treatment may be going `off-track` with teeth `lagging behind`- Posterior occlusion issues with aligners - The use of miniscrew anchorage with other adjuncts to clear aligners- The rationale behind the use of `boot-strap` mechanics.

Once limitations of clear aligner treatments were identified, conceptualizing techniques to improve the predictability in producing desired results was the next logical step. A variety of concepts, methods, and adjuncts have subsequently been introduced to enhance the efficacy and effectiveness of clear aligners. As a consequence, the scope of biomechanics and type of malocclusions that can be more predictably treated has increased. As one example, the inclusion of miniscrew temporary skeletal anchorage has permitted the addition of direct and indirect anchorage to support and control more predictable programmed tooth movements with aligners. After reviewing the reported shortcomings of plastic aligners, possibilities for improving predictability and effectiveness were suggested.