How much overall tooth movement can I expect?
The current general statement is 0.5 mm of tooth movement per tray equals a total of 2.5 mm of movement in the treated arch using a series up to 5 aligners. However, the answer actually lies in how many teeth are being repositioned. A rule of thumb is 0.5 mm of movement per tooth per aligner. It is important to understand that the maximum amount of movement allotted to any one tooth is 2.5 mm of movement and cuspid movement is about one-half of the movement we can achieve with incisors. For examples of appropriate Clear Image Aligner cases, visit Case Selection.
How many Aligners can be made for a patient?
Up to 5 Clear Image Aligners may be fabricated in a series from a single work model. If more aligners are required to treat the mal-alignment, new work models or impressions should be submitted after the final aligner in the first series has expressed itself completely. The patient will continue to wear the final aligner until the next aligner or series of aligners are returned. The second series of aligners will be invoiced according to the number of aligners fabricated.
What if I am not sure my patient’s case is suitable for Clear Image Aligners?
The lab provides a wide variety of example cases for review that are appropriate for Clear Image Aligner therapy under the Case Selection section. You may also send your work models to the lab and request an evaluation of the case and a phone call to discuss options before processing on the prescription form.
What do I need to send to the lab to submit a case?
The process requires a set of high quality work models poured in stone and void of any distortions. Kromopan or 100 hour-Algimax impressions may be submitted and we will pour them in stone. These impressions must also be perfect in every aspect. Alginate impressions may be taken if they are perfect and poured immediately in stone. For best aligner results, it is recommended to include the opposing arch when requesting single arch treatment. Sending the opposing arch helps the lab detect possible interferences during the reset process.
How often should patients change to the next Aligner?
Patients generally wear each aligner in the series for 3-4 weeks. If an aligner seems to not be moving a certain tooth, check for contact interference with the teeth mesial and distal to the tooth in question as well as with a tooth in the opposing arch. In some cases the interference can be below the gingival margin. To ensure aligner therapy is progressing on schedule, many clinicians will re-appoint patients at 4-8 week intervals.
How many Aligners are delivered at one time?
The number of aligners given directly to the patient is determined by the type of case and whether or not IPR, if required, is performed all at once at the first appointment or prior to fabrication of the aligners. Many clinicians prefer to see the patient for delivery of each aligner to review progress to date. Some cases, such as space closure, accommodate multiple aligner changes without supervision better than cases presenting with rotations and crowding.
What happens if a patient breaks or loses an Aligner?
An impression needs to be taken and new work models submitted. It is helpful to return the original set-up, but not necessary. New aligners will need to be made replacing the original aligners remaining in the series. It is important to make an invisible type retainer to hold the teeth in their current position. When the patient breaks (their fault) or loses an appliance each aligner re-made is charged at full price.
Is a new impression (or model) required for a second series of aligners?
Yes, new impressions/models will need to be submitted to make a second series of aligners. The patient will need to continue to wear the final aligner or an invisible retainer should be made to hold the teeth in their existing position. It is paramount to hold these teeth in position until the next series is delivered.
What types of retention are used after Aligner treatment?
One option is Removable Clear Retention. Clear retainers made from .040 ACE plastic maintain the results from active treatment. This material lasts up to one year and is typically worn only at night. This type of retainer can be requested as an addition and will be made from the final set-up in the series. However, because of the many factors involved in tooth movement, many clinicians will wait until the case has expressed to its best position and send in a new model reflecting the actual alignment achieved.
Another option the lab offers is Fixed Lingual Retainers. There are several designs to choose from for the upper and lower arch. These retainers are very comfortable for patients and require no cooperation as they are bonded to the teeth.