Clear aligners have become increasingly popular due to their superior aesthetics, comfort and convenience as compared to traditional fixed braces. They are the treatment of choice for people in the younger age group, including teenagers. The reason for this is that people of these ages have a strong perception of their appearance, aesthetics of their smile and therefore, refuse to opt for unaesthetic metallic and ceramic braces.
Clear aligners are a new-age orthodontic treatment option. Since their introduction, they have come a long way in terms of materials used, the technology of fabrication, software, attachments, protocols and guidelines, etc. However, even today, clear aligners have their limitations.
Clear Aligner Limitations
Clear aligners are a great treatment option for mild and moderate cases of tooth misalignment. Right from spacing, crowding, slight protrusions, etc., clear aligners have been able to successfully treat these cases. Before the aligner trays are custom-made for each patient, the entire treatment plan is designed using high-end software. This gives the patient an idea about how their treatment is likely to progress and how the result is going to be. However, despite immaculate planning, many tooth movements are unpredictable and can derail the aligner treatment at any time during its course.
It is in these situations where the efficiency of clear aligners is limited and requires the use of fixed orthodontic treatment. While clear aligners are used for mild anterior crowding, space closures, distalization of molars, etc., expansion of the jaws and surgical cases require fixed braces.
It becomes a challenge to provide patients with the aesthetics, comfort and convenience of clear aligners with the efficacy of fixed braces in severe cases. To bring the best of both worlds together, a hybrid approach has been suggested and is being studied.
A Hybrid Approach – The Best of Both Worlds
A hybrid approach combines clear aligners with a fixed orthodontic appliance to provide patients with effective and successful dental treatment and a smile they can proudly flaunt. Some advantages of the hybrid approach include:
- Reduced treatment time
- Better management of unpredictable teeth movements
- Wider use as it can treat most orthodontic cases
Let’s check out specific situations where the hybrid approach is particularly helpful!
One of the most common situations that are not recommended to be treated by clear aligners is rotations. The reason for this is that teeth rotations have a high chance of relapse if they are not aligned properly. Also, clear aligners bring about rotatory movements slowly. However, with a hybrid approach, a fixed appliance is placed on the tongue-side/front of your teeth that brings about greater predictability in the movement and is not visible due to its placement.
Once the de-rotation of a tooth has been achieved, the remaining part of treatment can be continued using clear aligners.
Clear aligners are extremely effective in bringing about the movement of teeth. However, their ability to bring about the bodily movement of teeth is not entirely predictable. Also, expanding the upper jaw to allow teeth movements and alignment is difficult with aligners.
Using a hybrid approach wherein a fixed palatal expander is used to achieve expansion of the upper jaw followed by clear aligner treatment is highly recommended and effective.
Treating Class II and Class III cases
Class II cases are those in which the upper teeth are forwardly placed with respect to the lower teeth by over 2.5 mm. While clear aligner treatments can treat these cases, but they often take longer as the process occurs more slowly.
To reduce treatment time and achieve greater movement in a shorter period, treatment is usually begun with fixed appliances and elastics, followed by clear aligner treatment.
Similar treatment is done in cases where the lower teeth are forwardly placed compared to the upper teeth.
To enable vertical movement of teeth
In many people, teeth need to be pushed vertically in or out to achieve proper alignment. However, these kinds of movements are not efficiently performed by clear aligners. When vertical movement is required for a few teeth, a hybrid approach using fixed appliances to achieve this movement followed by clear aligners is highly successful!
Clear aligners are, by far, the best orthodontic treatment option developed. They have successfully changed the perception of orthodontics in people’s minds from being painful and ugly to comfortable and invisible! However, its limitations are a real fact but can be easily overcome by using a hybrid approach of orthodontic treatment where fixed appliances are combined with aligners to give you the smile of your dreams.