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Clear aligner treatment has progressed immensely since its inception and Align Technology’s product innovation team continue to innovate to improve treatment outcomes with the Invisalign® system. Innovations based on fundamental biomechanics, biomaterials and orthodontic knowledge and experience have enabled practitioners to treat highly complex cases with excellent clinical results. This ability to treat complex cases and acceptance by the profession has resulted in phenomenal growth. With each new innovation and an increasing number of doctors treating more cases, their confidence in achieving excellent treatment outcomes increases. Although treatment of patients with the Invisalign system has seen tremendous growth, even larger opportunities lie ahead. In 2017, 60–70% of the United States population felt that they had crooked teeth, with similar numbers worldwide.
The Invisalign system employs the fundamental principles of biomechanics to control tooth movement. The innovations built into the system over the past two decades now facilitate control of both crown and root movements. With this, the appliance can control the entire range of individual tooth movements including intrusion, extrusion, rotation, simple tipping, controlled tipping, bodily translation, and root movement.
The system now alters the shape of the aligner and applies attachments to modify the shape of the tooth in a group of innovations referred to as SmartForce® features. Optimised Attachment shapes are increasing in complexity and proving clinically to better control tooth movements. These Optimised Attachments have an ‘activation’ through a controlled change in the aligner shape to exert an articulated force for more predictable movement.
SmartStage® technology is an advanced algorithm that applies the necessary force system and determines the shape of the aligner at every stage with intentional precision. It employs technology that plans the optimal progression of tooth movements to achieve the desired final position.
SmartTrack® is a proprietary highly elastic aligner material that achieves more tooth movement with each aligner than other off-the-shelf materials. The result is improved tracking throughout treatment by maintaining a more constant force over time to elicit excellent biological response for orthodontic movement. SmartTrack material plays a vital role in optimising the use of sophisticated techniques like SmartForce and SmartStage.
In the world of digital treatment planning, the anticipated end-result allows visualisation of the treatment plan not only at beginning and end but also step-by-step, aligner by aligner throughout the treatment. This has revolutionised how practitioners plan for orthodontic and interdisciplinary treatments. It allows provision for a more simple decision-making process between alternative treatments as each approach can be visualised and compared. ClinCheck® software is the virtual treatment planning tool used with the Invisalign system. With typical modiﬁcations, written comments are used to communicate with a technician. However, within ClinCheck Pro with 3D controls, the clinician has the ability to set the ﬁnal position that is often difﬁcult to convey by written instruction, providing more control over the treatment planning process. One of the functionalities that sets ClinCheck Pro software apart from other software is the real-time visualisation of planned movements and their impact on adjacent teeth and the arch can be seen during modiﬁcations. Some of the capabilities available to clinicians include addition of elastics provisions, ability to adjust IPR, veriﬁcation of occlusal contacts, space management and tooth size discrepancy check with input from a Bolton analysis.
Looking toward the future, Align Technology will continue to innovate in areas of appliance performance and software, scanning, doctor communication and interface, and workﬂow. As technology incorporates “orthodontic smartness” into the Invisalign aligner and improves protocols and tools for treatment planning, aligner therapy moves closer and closer to becoming the true state-of-the-art treatment. Many examples of these cases can be seen on Align Technology’s website.
Design of the Invisalign system performance, 2017
John Morton, BSE, Mitra Derakhshan, Srini Kaza, and Chunhua Li