We talk a lot about ‘the smile’ in our communications, particularly with regard to the uptake of clear aligners by younger generations. However, while aesthetic reasons still continue to be the biggest driver for demand, advances in our understanding of the broader and more long-term dental implications show that clear aligner therapy is continuing to change the shape of comprehensive, functional treatment plans, something which is seen across all age groups. As highlighted at the 2019 Align Technology Growth Summit in Berlin, the application of clear aligner therapy continues to evolve at rapid pace.
Bringing together world-class dentists as keynote speakers as well as networking sessions, the Summit provided evidence of orthodontic work that dentists are now carrying out themselves by integrating Invisalign technology into their treatment plans. Across the span of case studies presented one over-riding treatment philosophy stood out; that of Invisalign providers being able to deliver an approach that is ‘minimally invasive with maximum results’.
Dr Edouard Nègre from France explained to delegates how he had refused to give a patient the traditional veneers they had sought. He knew that by using clear aligners at the initial stages, he could preserve healthy tissue and minimise damage to their teeth. The outcome? This was a patient who had been set on having traditional veneers but instead completed Dr Nègre’s proposed treatment plan and were delighted with the results.
Finnish dentist, Dr Hannu Vesanen, was also unequivocal about his advocacy of pre-restorative alignment. He told delegates: “I now do a lot of minimal preparation veneers.”
As Vesanen explained, there are multiple benefits of using clear aligners for preparation. “They’re much less invasive and I much prefer to do restorations on enamel rather than dentin. It means minimal loss of healthy tissue; preparation is easier and faster; it achieves nicer looking results with better functioning occlusion, and you can bring tissues to where they belong. My levels of case acceptance are much higher, and I find these treatment models are motivating for my staff.”
Dr Mark Sebastian, who specialises in implant dentistry and periodontics at his dental practice in Germany, also affirmed the opportunities for being less invasive by offering Invisalign technology as part of the solution. He spoke in detail about seeing positive outcomes for patients whose treatment would have involved implant or bridge work years ago.
There is also growing expertise on the use of aligners to resolve malocclusion and bruxism, and their role in preventative care regarding the potential clinical consequences of bone loss and mesial drift in later years. In April 2018 Align Technology extended G5 Precision Bit Ramps to Vivera Retainers, thereby launching the first retainers in the market that can be customised to provide additional support after deep bite correction. For dentists, this built on the clinical success combining Precision Bite Ramps which were introduced in 2014, with Invisalign clear aligners for deep bite patients.
Dr Christopher Orr, a prominent cosmetic and aesthetic restorative dentist in the UK, shared a case history at the Summit of a 56-year-old patient with bruxism. He concluded: “This patient’s muscles were not happy, so we needed to make a ‘global’ solution, looking to restore stability and correct the contact of the teeth.” Orr added: “Additionally, the treatment could make the patient look 10-15 years younger with the smile line lining up, which tends to represent youth.”
Clear aligner technology along with digital scanning using iTero, ClinCheck and SmileView has been a game changer for dentists, improving clinical skills, practice workflow and developing an optimal patient journey. Innovations continue to enable providers to increase levels of expertise and to provide treatment plans around the key components of aesthetics, function, structure and biology with ‘reverse engineering’ and ‘futuristic treatment goals’ now central to their patient care.