Gutters or transparent and invisible aligners: Invisalign and others

WHAT IS IT?
 

This new technique emerged in 1997 in Santa Clara, California within the company Align Technology (Invisalign). Modern and aesthetic, it has revolutionized orthodontic treatment in recent years. The first aligners were marketed in 1999 in the United States and in 2000 in France. Its effectiveness has been clinically proven: it is as effective as traditional multi-bracket treatment for most cases of dental misalignment. It consists of a successive series of clear, resilient, and thin plastic aligners that cover the teeth. Each aligner is unique, individualized, and tailored to each patient's teeth because it is custom-made using digital impressions and a 3D printer. The aligners are developed from a personalized and precise computerized treatment plan for each patient.
 

This virtual treatment plan (the clincheck) created by the orthodontist allows for the step-by-step monitoring of the treatment's progress and provides a digital simulation of the final result. The design work of the clincheck is established by the orthodontist: Each tooth is studied in all three spatial planes, and the orthodontist selects the tooth's position, the shape of the attachments (small composite dots of the same color as the tooth attached to it), the use of stripping (interdental grinding), and other technical elements to achieve an optimal treatment plan based on each case. The orthodontist's expertise is crucial in assessing the clinical predictability of the computer-designed movements and is a major criterion for the treatment's success. A movement that is possible in a virtual sense is not always feasible clinically! Teeth cannot be moved as desired!
 

These aligners are worn 22 hours a day and are changed weekly, every 10 days, or every 15 days depending on each case and the treatment's progress. Adhering to the prescribed wear time is essential to achieve the optimal result within the anticipated time frame. If the aligner is worn for less time than prescribed, it will inevitably lengthen the initially planned treatment time. As the treatment progresses and the aligners are changed, dental movements occur gradually, leading to the desired result. Invisalign offers a range of aligners for adults as well as for teenagers: Invisalign Teen or First.
 

Depending on the cases, the treatment may begin with another orthopedic correction device, such as an expander or a Carriere Motion, either alone or in combination with the aligners.

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ADVANTAGES
 

Invisalign aligners are nearly invisible to the naked eye, discreet, and aesthetic. Most people will not notice their presence. The aligners are very thin, and their material is very light, providing maximum comfort to the patient. Several pairs (one aligner for the upper jaw and one for the lower jaw, the number determined by the orthodontist) of aligners are given to the patient at each appointment, allowing the patient autonomy in their treatment and greater flexibility in scheduling appointments, which is compatible with travel.

Similarly, the aligners can be completely removed for important events (weddings, ceremonies, public professional events, etc.). This treatment adapts to the active lives of adults, whether in a professional, personal, or social context. The removable nature of this technique offers many advantages: the maintenance and cleaning of the aligners are simplified. Oral hygiene is promoted: it is simply a matter of removing the aligners to brush teeth or floss. The aligners are easy to use: the patient can easily remove them to eat, drink beverages other than warm or cold water, vape, or smoke. Therefore, the patient can eat without restrictions or discomfort. Similarly, all foods and drinks are allowed since the aligners are removed during meals.

There are no dietary restrictions or special precautions as with traditional orthodontic systems. It is only recommended not to consume highly pigmented items in the two days following the attachment placement to avoid staining them. For a given dental misalignment, the treatment duration is generally shorter with aligners than with traditional multi-bracket treatment. It is possible to engage in combat sports with the aligners (replacing the need for a mouthguard), sing, or play a wind instrument. It requires a short adaptation period of a few days, and the discomfort disappears afterward.

It is important to note, as the question has arisen a few times, that it is possible to kiss with the aligners without any problem!

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DISADVANTAGES
 

This device requires a certain level of autonomy, cooperation, and responsibility from the patient. The patient is an integral part of the treatment's success! In adolescents, their cooperation, understanding of the treatment, and diligence are essential prerequisites for starting treatment with aligners.

To monitor the treatment's progress, Invisalign Teen offers wear indicators in the form of blue tabs placed on the aligners. These tabs will fade over time if the aligners are worn sufficiently and correctly.

This technique is not suitable for the treatment of all dental misalignments. The practitioner will illuminate the contraindications following their diagnosis. In particular, Invisalign Teen may not be indicated for all adolescent situations. The cost is higher than traditional orthodontic treatment because these aligners are manufactured and billed in America according to the treating practitioner's instructions.

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