Aligners: do patients wear them and do attachments really work?

orthodontics In summary

Join me for a summary of Tommaso’s lecture on aligner treatment, exploring questions on the use of aligners. Tommaso described how compliant patients are with the use of aligners, who is more likely to wear aligners well and methods to increase compliance. He critically reviewed the use of attachments, and revealed aligner deformation and staging as key areas of treatment. This podcast is a summary of the WFO online webinar from November patient compliance, biomechanics , rotation, distalisation and intrusion

Patient Compliance

Sample of over 200 patients treated with aligners under remote monitoring, Thirumoorthy 2021:

• 36% of the sample was fully compliant

• 25% has poor compliance

• 1st time Ortho patients are more compliant

• Conclusion: early detect non compliant patients with remote monitoring

Patient factors which vary compliance of removable appliances Fleming 2019

The study came with some recommendations:

1. Effective communication with our patients, with visual aid, pictures or movies.

2. Using of tracking sensor included in the device

3. Using some reminding tools – remote monitoring Biomechanics and material properties. Distalisation class 2 Incisors intrusion Conclusion

• We need to consider the lines of forces and aligner deformation not only on the attachments

• Any malocclusion that can be corrected by tipping has better predictability

• Add less activation Per aligner (to help flattening the steep decline in force over time and create consistent and continuous force system)

• Attachment driven mechanics are not always effective, aligner Activation is more effective

• Graphy is the trending technology in aligner activation