The document discusses recent advances in clear aligner therapy. It describes how aligners produced using CAD-CAM technology and incorporating CBCT scans can now treat more complex malocclusions. New materials like shape memory polymers may allow for dynamic aligners. Hybrid approaches combining aligners with other techniques like corticotomy or vibrational devices can accelerate treatment. The conclusion acknowledges that aligners have limitations and usually can't solve all issues alone.

1. ADVANCES IN ALIGNER TREATMENT
Dr. Genoey George

2. INTRODUCTION
• The plastic version of braces has become popular as a way for adults to straighten
their teeth discreetly. It has always had the advantage of being hard to see and
requiring fewer dental visits to tighten, rewire, and replace. In recent years,
advances in the aligners have made them more effective for more people.
• Over the years, aligners have become more advanced, and new materials and
attachments have added options for dentists and their patients. These aligners
may now offer help for those with unique situations.

3. ALIGNERS PRODUCED BY CAD-CAM TECHNOLOGY
• Invisalign being the best-known aligner system has become a generic name for
other high-quality systems using CAD-CAM technology.
• Development of different attachments and auxiliaries now enables to perform
major tooth movements and treat more complex cases such as those requiring
premolar extraction.
• The combination of computerized virtual treatment planning, and
stereolithographic prototyping technology for manufacturing gives Invisalign a
leading role in aligner therapy

4. 3 SPLINT SYSTEM

5. INTEGRATION OF CBCT INTO CLINCHECK TREATMENT
PLANNING SOFTWARE
• For digital orthodontics and restorative dentistry today announced the new Cone Beam
Computed Tomography (CBCT) integration feature for ClinCheck digital treatment planning
software, a user-friendly tool that combines roots, bone, and crowns into a single three-
dimensional model that enables doctors to visualize a patient’s roots as part of the digital
treatment planning process.

6. INTEGRATION OF CBCT INTO CLINCHECK TREATMENT
PLANNING SOFTWARE
• The integration of CBCT scan data into digital treatment planning gives doctors the control
and confidence to leverage their expertise and expand treatment to all types of
malocclusion,
• Ortho-restorative cases
• Implant site preparation
• Treatment planning options (such as expansion versus extraction), as well as teen
• Navigation of impacted Teeth
• visualizing underlying anatomical structures
Dr. Graham Gardner

7. SHAPE MEMORY POLYMERS
• These polymers that attain their original shape when deformed due to the application of a
recovery trigger in the form of either light, heat, electrical or magnetic fields, infrared
radiation, or immersion in water. Due to interatomic robust and directional bonds, SMPs
can remember its original shape and return back.
• They consists of hard and soft segments and have gained increased popularity among many
clinicians due to their glass transition temperature, which is near the body temperature.
Mahmood, H. T., Kamal, A. T., Khan, B. N., and Fida, M. (2019). Application of New Biomedical Materials in
Orthodontic Appliances. J. Coll. Physicians Surg.Pak 29 (7), 654–657. doi:10.29271/jcpsp.2019.07.654

8. SHAPE MEMORY POLYMERS
• The idea of clear aligners made of SMPs is aiming to reduce the cost and time of
the treatment by using a dynamic aligner that can change its shape intentionally
over treatment time, and consequently one shape memory aligner could
substitute a series of conventional aligners
• Furthermore, it helps to decrease the plastic consumption by decreasing the
number of plastic aligners per treatment plan.

9. SHAPE MEMORY POLYMERS
• There still there is a great lack of data in the literature about clear aligners made
from SMPs. So far, it is difficult, biomechanical wise and biocompatibility-wise, to
favour an appropriate material
• Initial investigation of a 3D-printed aligner made of SMPs (4Daligner) shows its
capability of moving teeth by biocompatible orthodontic forces after a suitable
thermal stimulus within the oral temperature range.
Elshazly TM, Keilig L, Alkabani Y, Ghoneima A, Abuzayda M, Talaat S, Bourauel CP. Primary evaluation of shape recovery of
orthodontic aligners fabricated from shape memory polymer (a typodont study). Dentistry Journal. 2021 Mar 10;9(3):31.

10. HYBIRD APPROACHES
Cassetta M, Altieri F, Barbato E. The combined use of corticotomy and clear aligners: a case
report. The Angle Orthodontist. 2016 Sep;86(5):862-70.

11. Cassetta M, Altieri F, Barbato E. The combined use of corticotomy and clear aligners: a case
report. The Angle Orthodontist. 2016 Sep;86(5):862-70.

12. Cassetta M, Altieri F, Barbato E. The combined use of corticotomy and clear aligners: a case
report. The Angle Orthodontist. 2016 Sep;86(5):862-70.

13. Cassetta M, Altieri F, Barbato E. The combined use of corticotomy and clear aligners: a case
report. The Angle Orthodontist. 2016 Sep;86(5):862-70.

15. HYBIRD APPROACHES
• AcceleDent is a ‘vibratory orthodontic device’ that claims to speed up brace
treatment using vibrations known as micropulses. It does this through a
mouthpiece, which you fit over your fixed brace or Invisalign aligners for 20
minutes each day.
Bilello G, Fazio M, Currò G, Scardina GA, Pizzo G. The effects of low-frequency vibration on aligner
treatment duration: A clinical trial. J Int Soc Prevent Communit Dent 2022;12:345-52.

16. Bilello G, Fazio M, Currò G, Scardina GA, Pizzo G. The effects of low-frequency vibration on aligner
treatment duration: A clinical trial. J Int Soc Prevent Communit Dent 2022;12:345-52.

17. HYBRID APPROACHES
Lombardo L, Palone M, Carlucci A, Siciliani G. Clear aligner hybrid approach: A case report.
Journal of the World Federation of Orthodontists. 2020 Mar 1;9(1):32-43.

18. Lombardo L, Palone M, Carlucci A, Siciliani G. Clear aligner hybrid approach: A case report. Journal of
the World Federation of Orthodontists. 2020 Mar 1;9(1):32-43.

20. Lombardo L, Palone M, Carlucci A, Siciliani G. Clear aligner hybrid approach: A case report.
Journal of the World Federation of Orthodontists. 2020 Mar 1;9(1):32-43.

26. Lombardo L, Palone M, Carlucci A, Siciliani G. Clear aligner hybrid approach: A case report. Journal of
the World Federation of Orthodontists. 2020 Mar 1;9(1):32-43.

27. RUNNERS APPLIANCE
Behroozian A, Kalman L. Clear Twin Block: A Step Forward in Functional Appliances. Dent Hypotheses 2020;11:91-4.

28. RUNNERS APPLIANCE
Arreghini A, et al., Class II treatment with the Runner in adolescent patients: Combining Twin Block efficiency
with aligner aesthetics, Journal of the World Federation of Orthodontists (2014),

29. RUNNERS APPLIANCE
Arreghini A, et al., Class II treatment with the Runner in adolescent patients: Combining Twin Block efficiency
with aligner aesthetics, Journal of the World Federation of Orthodontists (2014),

30. CASE REPORT
Behroozian A, Kalman L. Clear Twin Block: A Step Forward in Functional Appliances. Dent Hypotheses 2020;11:91-4.

31. CASE REPORT
Arreghini A, et al., Class II treatment with the Runner in adolescent patients: Combining Twin Block efficiency with
aligner aesthetics, Journal of the World Federation of Orthodontists (2014),

32. CASE REPORT
Arreghini A, et al., Class II treatment with the Runner in adolescent patients: Combining Twin Block efficiency with
aligner aesthetics, Journal of the World Federation of Orthodontists (2014),

33. INVISALIGN TEEN WITH
MANDIBULAR ADVANCEMENT
• Invisalign Teen with mandibular advancement is a clear aligner solution for Class II
correction. Offering the same benefits of Functional appliances.
• The Invisalign Teen with mandibular advancement aligners have been specifically designed
for moving the lower jaw forward while simultaneously aligning the teeth this makes the
treatment much more efficient and patient-friendly
Dr. Moira Wong

34. INVISALIGN TEEN WITH
MANDIBULAR ADVANCEMENT
CASES
Maureen 10/F

35. INVISALIGN TEEN WITH
MANDIBULAR ADVANCEMENT
CASES
Maureen 10/F
Gregorz, 15/M

36. ALIGNER SLEEP APPLIANCE(ASA)

37. ALIGNER SLEEP APPLIANCE(ASA)

38. ALIGNER SLEEP APPLIANCE(ASA)

39. MYOALIGNER
• Limited jaw movement
• Popping and clicking of the jaw
• Sore jaw muscles or joints
• Stiff jaw muscles
• Earache, tinnitus, and vertigo
• Headaches
• Teeth grinding and clenching (bruxism)

40. CONCLUSION
• The vast majority of published research on clear aligners is based on Invisalign, and
therefore, some bias is evident, thus not necessarily representing the rest of the
aligner spectrum available on the global market. Further robust clinical studies are
required to test and compare other systems, new technologies, materials, and
treatment outcomes and establish evidence-based clinical guidelines and limitations
of CAT.
“A series of aligners alone cannot solve most malocclusion issues, no matter
the quality of the software design, modelling, nor type of plastic used”
Dr. S.JAY BOWMAN

41. REFERENCES
• Mahmood, H. T., Kamal, A. T., Khan, B. N., and Fida, M. (2019). Application of New Biomedical
Materials in Orthodontic Appliances. J. Coll. Physicians Surg.Pak 29 (7), 654–657.
doi:10.29271/jcpsp.2019.07.654.
• Elshazly TM, Keilig L, Alkabani Y, Ghoneima A, Abuzayda M, Talaat W, Talaat S, Bourauel CP.
Potential Application of 4D Technology in Fabrication of Orthodontic Aligners. Front. Mater. 8:
794536. doi: 10.3389/fmats. 2022 Jan 28.
• Cassetta M, Altieri F, Barbato E. The combined use of corticotomy and clear aligners: a case
report. The Angle Orthodontist. 2016 Sep;86(5):862-70.
• Bilello G, Fazio M, Currò G, Scardina GA, Pizzo G. The effects of low-frequency vibration on
aligner treatment duration: A clinical trial. J Int Soc Prevent Communit Dent 2022;12:345-52.
• Lombardo L, Palone M, Carlucci A, Siciliani G. Clear aligner hybrid approach: A case report.
Journal of the World Federation of Orthodontists. 2020 Mar 1;9(1):32-43.

42. REFERENCES
• Behroozian A, Kalman L. Clear Twin Block: A Step Forward in Functional Appliances. Dent
Hypotheses 2020;11:91-4.
• Hartshorne J, Wertheimer M. Emerging insights and new developments in clear aligner therapy
(CAT)–A review of the literature. AJO-DO Clinical Companion. 2022 Apr 27.