4 Common Reasons Clear Aligners Fail
When it comes to planning on great results from the treatment of orthodontic patients, one of the first things to plan for is managing patient behavior. Like we always say... the great thing about aligners is they are removable. The bad thing sometimes about aligners is they are removable. Here are few thoughts to keep in mind when using aligners in your practice.
Not monitoring the fit from aligner to aligner. If it stops fitting, you need to know that
Monthly, the aligner fit needs to be checked to make sure they are completely seated. When the patient snaps the aligner into place in their mouth, there should be no space between the incisal edges of the teeth and the incisal aspect of the aligners. They also should not be "springy" "bouncy" when they try to seat the appliance onto the posterior teeth. If it is kind of bouncing when trying to seat it, then look for undercuts that have not been filled before the thermoforming process. If there is not too much undercut it may be able to be relieved with a small bur. Have the patient send photos/videos monthly with the appliance in place and no appliance.
Moving teeth too quickly or unrealistically can cause aligners to stop tracking
As you can see in this photo of an aligner setup, there is no way that central incisor is going to move facially without moving the other teeth out of the way first.
Ortho 101... you can move teeth through bone but you can not move a tooth through wire, plastic or another tooth. In this case it will require sequential tooth movement in the planning process. Only some software for aligner / tooth movement planning has that ability, fortunately for you, the software that make and use does! :)
Bad scans & impressions will set aligners up for failure
Of course GIGO - Garbage In Garbage Out. One of the best things that you can do is to get some digital methods for getting your data into the computer. The sooner in the process that the data is digital, the sooner you will reduce errors from bad data.
Aligners need to be worn.
If the patient is only wearing it once in a while then treatment will take longer. We know for sure that any orthodontic appliance will not work as well on the top of the night stand next to your bed as they will in your mouth.