According to production methods, clear aligner systems can be broadly grouped into two categories; aligners made from thermoplastic materials via manual set up and systems using CAD-CAM technologies to design and produce aligners.
ALIGNERS PRODUCED BY MANUAL SETUP-
The manual approach is a labor-intensive process, requiring manual repositioning of the teeth, wax setting, and production of vacuum-formed retainers. This approach allows the fabrication of aligners easily in laboratory conditions in a cost-effective manner. It also facilitates the follow-up process of the treatment and allows the orthodontist to make the necessary treatment changes at an earlier stage.
ALIGNERS PRODUCED BY CAD-CAM TECHNOLOGIES:
Invisalign® being the best-known aligner system has become a generic name for other high-quality systems using CAD-CAM technology. This system is known to be the most sophisticated and most commonly used clear aligner technology currently available. In 1999, the Invisalign® system was introduced to the orthodontic market to treat mild malocclusions only; however, the development of different attachments and auxiliaries now enables Invisalign® system to perform major tooth movements and treat more complex cases such as those requiring premolar extraction.
Aligners in Invisalign® system are designed and produced using CAD-CAM technology. The combination of computerized virtual treatment planning, and stereo lithographic prototyping technology for manufacturing gives Invisalign® a leading role in aligner therapy. Today, Align Technology continues to be a leader in the market, and Invisalign has become a household name for aligners produced by computers since more than 4 million people are treated by this system .Companies like Orthero, ECligner, EON Aligner, and Clear Correct are examples of other aligner systems created using computer technology.
Scope and Limitations of Treatment with Clear Aligners
Although the number and complexity of cases treated with clear aligners continue to increase, it is impossible to treat all kinds of malocclusions with this system. Clear aligners are convenient in mild to moderate crowding or diastema, posterior expansion, intrusion of one or two teeth, lower incisor extraction cases, and distal tipping of molars. Movements like extrusion, correction of severe rotations, molar uprighting, and closure of extraction spaces are known to be more challenging to accomplish with aligners. Even so, incisor extrusion, molar transition, and closure of extraction spaces are possible with the use of attachments in the Invisalign® system.
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