Comprehensive Aligner Therapy for Patients
Marco Pinto, DMD, on the ClearCorrect® aligner system
Since its creation, ClearCorrect® has been evolving to become the aligner system with the best online tool for clinicians. The Straumann Group has invested millions into research and development to improve its ClearPilot™ digital treatment planning tool by adding features such as cutouts, bite ramps, and unique engagers. The ClearPilot treatment planning tool was designed to empower clinicians to create a specific plan for each patient that goes above and beyond the suggested treatment setup. One of the best features of ClearPilot is the individual tooth movement toolbar, which allows clinicians to incorporate the movement of an individual tooth to a desired location into the treatment plan. Within the ClearPilot application, there are several combinations of graphics and action icons that can be used to select specific movements. For example, a display window with the treatment simulation and a tooth movement chart are perfectly arranged to enhance the experience and prescribe movements such as extrusion, intrusion, buccolingual translation, mesiodistal translation, tipping, torquing, and rotation. The clinician has all of the control when using this intuitive platform.
ClearCorrect aligners have a high trimline; therefore, it is very easy for patients to engage elastics. This increases patient compliance and makes the treatment more efficient. There are two types of cutouts: double slit and semicircular. There is also a choice to use a button (with a semicircular cutout) based on clinician preference. For both Class II and Class III cases, cutouts start on step 5 and continue through the end of treatment. ClearCorrect's default protocol for Class II cutouts includes using a double slit cutout for the canines on the upper arch and a button cutout on the first molars on the lower arch; however, these are just the default cutouts, and the clinician can modify them as needed via the "additional information" section of the case submission form.
The bite ramps, which look like small pyramids, are usually placed on the back of the central incisors, but they can also be placed on the cuspids. The idea behind bite ramps is to disocclude the posterior teeth to relieve occlusal pressure. Depending on the treatment plan, the options include intruding the anterior teeth, extruding the posterior teeth, or a combination of both. It should be noted that accomplishing vertical movement with aligners is complex and that it is especially challenging to extrude posterior teeth.
Engagers, which are also known as "attachments," create the anchor points that are needed to help apply the force of the aligner. Oftentimes, expansion/interproximal reduction is required to allow for easier engager placement. There are several types of engagers, but the most used are vertical and horizontal ones. The vertical engagers help with movements such as rotations, whereas the horizontal engagers are mainly used to intrude or extrude teeth. Although engagers can wear down over time and sometimes need to be replaced, one tip to help avoid this is to use a filled resin because they are usually more wear resistant than unfilled ones.
With so many options to guide treatment and ongoing research and development resulting in new innovations all the time, the ClearCorrect aligner system provides a degree of customization and flexibility that is empowering. Partnering with ClearCorrect will help you take your clear aligner practice to the next level.
1. The ClearPilot 4.0 treatment planning tool offers flexibility in the customization of treatment options
2. Cutouts and elastics are available to increase efficiency and improve compliance
3. Bite ramps can be incorporated to accomplish vertical tooth movement
4. Different sizes of vertical and horizontal engagers are available to enhance the forces used in aligner therapy
Marco Pinto, DMD