Aligners

One of the key advantages of aligners is their discreteness (invisibility). This is achieved through the use of special strong and transparent materials.

Depending on the material, aligners can be made from:

• polycaprolactone (medical plastic);
• polyurethane;
• polyethylene terephthalate;
• acrylic polymers.

Depending on the direction of impact, there are:

• retention aligners, used as an additional tool for maintaining orthodontic treatment results;
• active aligners, used for bite correction or teeth positioning.

Patients with orthodontic problems often have the option to use aligners before and after teeth straightening and bite correction. Sometimes, after bite correction with braces, it is necessary to maintain the achieved result — to prevent the bite or teeth from returning to their original position. In such cases, the orthodontist may prescribe wearing transparent trays — retainers. The duration of the treatment course depends on the clinical situation and can range from several months to several years. It is usually recommended to wear retainers for eight hours a day.

An aligner can be a worthy alternative to a brace system when it comes to the need to correct minor bite defects.

Key indications for using aligners:

• orthodontic treatment;
• metal allergy.

Aligner treatment can also be performed in cases where teeth are at a slight angle, too crowded, or conversely — there are large gaps between the patient’s teeth. However, in each individual case, the doctor makes a decision based on a thorough study and analysis of the clinical picture. There is no strict list of pathologies for which aligners are specifically indicated, and the best solution is to come for a consultation during which the doctor will perform the necessary calculations.

In a number of cases, the effect of aligners proves insufficient or the patient cannot use them. These include:

• complex orthodontic problems;
• bone tissue deficiency;
• mucosal diseases (periodontitis);
• untreated caries;
• presence of tartar;
• allergy to materials;
• mental health conditions.

Bite correction with aligners is not a quick procedure. Depending on the clinical picture, trays will need to be worn for several months to several years. Much depends on self-discipline, as in the early stages trays should be worn 22 hours a day. That is, the aligner can only be removed during meals. Bad news for smokers — aligners also need to be removed during smoking breaks. For this reason, some doctors do not recommend them for people who are not ready to give up the bad habit.

Treatment stages:

1. Diagnostics

Aligner treatment, like any other, begins with diagnostics. The doctor examines the clinical picture, studies the X-ray and develops a treatment plan.

2. Manufacturing

Teeth straightening with aligners is a high-tech process: creating a set of trays requires not just a dental impression, but also a 3D jaw model and programming the production of individual trays.

3. Wearing

The longest period during which the patient must wear aligners — at least 22 hours a day. The process of bite and teeth position correction works as follows: the first pair of trays exerts pressure and causes slight teeth displacement, then the second pair is used, which also provokes displacement. And so on until the teeth and jaw reach the correct position. That is why when using active aligners, we are talking about a set of trays: on average 25 pairs (for lower and upper jaws). When correcting complex cases, more trays and additional attachments may be needed. Trays are changed on average every two weeks.

4. Monitoring

Changing trays and tracking the treatment process occur under the doctor’s supervision. That is why the patient needs to free up time in their schedule in advance for regular, ideally every two weeks, visits to the clinic.

5. Retention

After correction is complete, aligners for teeth straightening are replaced by retainers — trays for maintaining the result. They can be used both after orthodontic treatment with braces and after aligner treatment.

Many dental clinics in Ukraine and Kyiv position aligners as an advanced technique, which is well deserved. However, there is no panacea in medicine: any technology has both its advantages and disadvantages. The choice in each clinical case depends on indications. But in general terms, the pros and cons of aligners can be highlighted.

Advantages:

• discreteness (invisibility);
• distalization and full impact (aligners surround the tooth from all sides — they affect the entire tooth surface, unlike braces; additionally, aligners are capable of distalizing, moving teeth backward);
• comfort (aligners are smooth, they irritate the mucosa less and for many patients prove more comfortable to wear than braces);
• removability (partly an advantage that allows comfortable eating and teeth brushing, but also a disadvantage since many patients significantly complicate the correction process by not wearing trays the required number of hours);
• hygiene (trays are easy to clean, do not interfere with regular teeth brushing and do not provoke excessive plaque buildup on teeth);
• gradualness (aligner straightening does not involve a drastic change — correction happens imperceptibly).

Disadvantages:

• selective application (ineffective in correcting complex orthodontic problems such as significant teeth overlap, deep bite, or large gaps between teeth);
• adherence to regimen and self-discipline (treatment implies a lifestyle change: quitting smoking, certain food habits, etc.; additionally, strict adherence to the wearing schedule and good self-discipline are required, especially in the early stages before adaptation occurs);
• cost (aligners are more expensive than most types of braces).

Buying aligners for teeth straightening and not using them — this is the most common patient problem. Effective aligner treatment requires tremendous self-discipline: if you don’t wear the trays 22 hours a day, miracles unfortunately won’t happen. That is why, by agreeing to buy aligners for teeth, the patient automatically agrees to a lifestyle change.

The good news is that over time a person gets used to everything, especially to relatively comfortable trays that, unlike braces, do not irritate or injure the oral mucosa. An important addition to patient motivation is not only the desire for a beautiful smile but also the cost of aligners — invested money should be used as effectively as possible.

What you can do while wearing trays:

• sleep;
• kiss;
• exercise;
• visit saunas, pools, beauty salons, etc.

What you cannot do while wearing trays:

• eat;
• smoke;
• drink wine and other staining beverages;
• brush teeth.

When brushing teeth, aligners must be removed and also cleaned. No additional devices or products are needed: a toothbrush and toothpaste are sufficient.

The cost of the service is formed based on the price of aligners and the doctor’s fee. It is impossible to state the exact cost of aligners since the number of tray pairs depends on the clinical picture: in some cases 22 pairs are sufficient, while in others 50 pairs are needed.

The price of dental aligners also depends on the material or manufacturer. For instance, Invisalign by Align Technology can cost the patient several thousand dollars. In Kyiv, you can buy aligners (one pair) on average for 4–6 thousand hryvnias. However, a full course of treatment will cost much more: taking into account consultations, the preparatory period, treatment planning and the price of aligners, it comes to about 80 thousand hryvnias in the simplest cases. Complex cases requiring prolonged tray wearing are estimated by Kyiv clinics at 100–200 thousand hryvnias.