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In 1997, Invisalign was created with the vision of providing an aesthetic and comfortable aligner appliance with which doctors could treat their patients. Collaboration between orthodontists and the researchers at Align Technology, Inc. throughout the past 20 years has greatly increased the capabilities of the appliance. The ability of the Invisalign system is progressing rapidly and improvements are being introduced nearly every year, including biomaterials, biomechanics, and 3D software.
ClinCheck proprietary 3D software is the virtual treatment planning tool used to communicate a treatment plan to Align Technology. It communicates the way in which Align Technology has staged the progression of tooth movements for the case. However, the practitioners’ knowledge is critical in evaluating the tooth positions and movements required to achieve the expected outcome. In the world of digital treatment planning, the anticipated end result can be visualised by both clinician and patient using 3D computerised technology. This digital computerisation allows visualisation of the treatment plan not only at beginning and end but also step by step, aligner by aligner throughout the treatment.
Digital treatment planning has also revolutionised how practitioners plan for orthodontic and interdisciplinary treatments. It provides a simple decision-making process between treatment alternatives because each approach can be visualised and then a comparison made. For example, visualisation of alternative plans can be helpful in cases presenting with small upper laterals and the decision whether to restore or not. One can digitally compare the aesthetics and occlusion between maintaining the laterals as they are in the arch, or if the occlusion outcome would be superior if the laterals were to be bonded post-restorative. In a case with congenitally missing teeth, one could explore whether to position the canine to camouflage the lateral or open space to restore the lateral.
Digital treatment planning allows more accurate measurements between teeth. Hence, digital planning can lead to more accurate plans for restorative procedures in conjunction with orthodontics. In the past, treatment planning on plaster models was at the millimetre scale. Digital calipers provided greater accuracy. Today’s digital treatment planning is on the hundredths of millimetre scale and some even better. Precision has improved to the extent that it can be difficult to see with the eye.
Previously doctors would communicate with a technician at Align Technology via written comment in the ClinCheck software interface. In this scenario it is important to be precise with the direction of tooth movement, the amount of tooth movement, and the location of tooth movement. This helps the technician in setting and interpreting the small nuances of the desired final position. With the introduction of ClinCheck Pro 3D modifications, the clinician has control to set the final position that is often difficult to convey in words or by written instruction. By using the 3D controls, the clinician has more control over the treatment planning process. Real time feedback is provided on the modifications that are being made and the impact of those changes. ClinCheck Pro software enables real time visualisation of planned movements and their impact on adjacent teeth and the arch can be seen during modifications. Clinicians also have the ability to add/remove precision cuts, adjust IPR, increase or decrease space with input from a Bolton analysis, or adjust conventional attachments for retention. Additional capabilities the clinicians have are verification of occlusal contacts, tooth size discrepancy check, and to check that all tools fine tune the final occlusion. For Invisalign providers there is 24/7 access to tutorials designed to demonstrate these features and improve doctor experience with the ClinCheck Pro software, these are accessible via the Invisalign Academy.
Looking toward the future, Align Technology will continue to innovate in areas of appliance performance and software to improve treatment outcomes with the Invisalign system.
For more information on the Invisalign System visit invisalign-doctor.com.au
Article reference: “Design of the Invisalign system performance” published in Seminars in Orthodontics, Vol 23, No 1, 2017: pp 3-11 by John Morton, BSE, Mitra Derakhshan, Srini Kaza, and Chunhua Li. The authors are employed by Align Technology, Inc., their opinions are their own.