Invisalign

Invisalign was developed to do away with many of the detriments that traditional fixed braces pose to the patient. No more brackets or metal, it is not only more aesthetically pleasant for the patient, but it can also prevent some of the pain associated with traditional braces.

 

There are several brands of clear aligners on the market today. However, Invisalign, a product of Align Technology, remains the gold standard. Founded in 1997, Align Technology has revolutionized the orthodontic industry not only by creating a new, less obtrusive way to straighten teeth, but by expanding the market for orthodontic services by appealing to adults.

 

Interestingly, the idea for Invisalign did not come from the field of orthodontics. Founders Zia Chishti and Kelsey Wirth were associates in the graduate school of business at Stanford University. Chishti had undergone conventional orthodontic treatment and noticed that if he neglected to wear his clear plastic retainers for a few days, his teeth would shift slightly. Then, when he put them back in, his teeth moved back into place. After doing some research, Chishti and Wirth learned that the idea of using clear trays to move teeth had been discussed as early as 1945, but since no adequate technology existed to manufacture the product, nothing had come of it. So that is what they set out to do.

 

Recruiting two more associates, Chishti and Wirth developed a software program that designs a series of aligners which incrementally guide teeth into the correct position under the direction of an orthodontist. The aligners are manufactured using 3-D printing technology and shipped to the doctor’s office to be delivered to the patient. Patients receiving clear aligner therapy see Dr. Dixon every six weeks to receive a new series of aligners and to ensure proper fit and treatment progression.

 

In 2000, Align technology embarked on the most wide-reaching and aggressive marketing campaign ever of orthodontic services to the general public. Because clear aligners do not address issues with a growing jaw, the campaign targeted adults specifically. Since the marketing of Invisalign, the number of adults receiving orthodontic treatment has steadily risen. In 2012, the  New York Times reported that the number of adults undergoing orthodontic treatment rose 58% from 1994 to 2010, up from 680,000 to 1.1 million, according to data collected by the American Association of Orthodontists. Recognizing this trend, the AAO began running its own series of advertisements aimed at adults. Then president, Michael B. Rogers, was quoted as saying, “We’re trying to emphasize the adult market and how good they’re going to look and how much self confidence that’s going to create.”

 

With increasing public demand, orthodontists quickly adapted the new technology. According to a 2000 New York Times article, Align reported that only two years after the patent had been secured, roughly half of the nation’s orthodontists had attended a training seminar or purchased equipment required for providing Invisalign, “an astonishingly rapid technology deployment for such a conservative industry,” the reporter remarks.

 

Nearly two decades later, clear aligner therapy has proven itself to be a viable alternative for some people seeking straighter teeth. It cannot replace metal brackets, however. As previously stated, clear aligners do not address the complexity of a growing jaw or resolve any type of malocclusion. For this reason, only patients with fully grown dentition and no underlying jaw problems are good candidates for Invisalign. The ideal candidate for Invisalign has mild to moderate crowding issues and an otherwise functional bite.

 

The main advantage of clear aligners is that they are hardly noticeable. Many people who would balk at the idea of wearing metal brackets are comfortable wearing transparent aligners. Another advantage is that they are removable, making it much easier to maintain good oral hygiene. Patients can also remove their aligners while eating, thereby avoiding the restrictions of traditional braces, and can remove them if desired for important social events or photographs.

 

The main disadvantage of clear aligners is the expense. Align charges a substantial lab fee to providers who use their services, and this fee inevitably gets passed on to patients. Many providers, including Dr. Dixon, will finance the cost of treatment in order to make it affordable, but patients should expect the overall cost of Invisalign to be higher than metal or ceramic brackets. In addition, orthodontic insurance policies typically do not cover the extra costs associated with Invisalign. The other disadvantages are that, as mentioned, the types of cases Invisalign can treat are limited, and because the aligners are removable, it may be harder to maintain the willpower to keep them in long enough each day to be effective. Overall, however, we have seen great success with both adults and teens who have chosen Invisalign therapy.

 

There are several competitors to Invisalign on the market today and with increasing competition, we expect prices to come down. With the popularity of clear aligners, dental manufacturing companies are developing alternative software and technology which will allow doctors to produce aligners at local labs or even in-house. Look for more innovation in this industry in the near future.

To determine whether Invisalign is an appropriate treatment course, it is necessary for an orthodontist to perform a thorough evaluation to determine both, the pros and cons to use.

 

Pros

 

Many of the advantages of the Invisalign treatment plan are obvious. One most crucial being that it is invisible to the outside world. That can lessen the impact of social unease and lead to better patient compliance. Clinical trials have been done since Invisalign was introduced in 1998, which have shown that it has advantages to the health of teeth and gums. Studies have demonstrated that it leads to less tissue inflammation when compared to traditional braces. Because regular dental habits are still possible, it can lead to less periodontal disease and/or bone loss.

 

With traditional braces, there is a higher risk for gingivitis inflammation and plaque accumulation, which can lead to periodontal breakdown. Even with preventative therapy during traditional fixed brace therapies, Invisalign causes less overall disruption and damage to the gingivitis.

 

It has also been shown to be just as effective at correcting for malocclusion as traditional brace therapy. It works effectively to relieve anterior space issues and to correct posterior cross-bites and deep overbites. The major advantage Invisalign has is that it does so with better esthetics and results in excellent stability once the malocclusion is corrected for.

 

Studies have also shown that clear aligners, such as Invisalign, can help to create better periodontal health and tooth positioning when there is a need for restorative procedures. It also may help to eliminate the need for certain restorative procedures for the patient altogether.

 

The biggest advantage to clear aligners is the decreased risk for root resorption over traditional brace therapy. The amount of force placed upon the teeth is both lessened and more dispersed with clear aligners, and, therefore, can provide a more desired movement course than traditional fixed orthodontic appliances. More torque employed by traditional brace therapy can lead to an increase in the risks associated with root resorption. However, as a consequence, mobility may be slowed. For extreme cases where larger movements are required, patients may benefit more from traditional fixed appliances even with increased risk for root resorption.

 

Cons

 

The biggest con to using clear aligners is that the treatment efficacy is highly determined by patient compliance. Since the appliance can be removed at will, that can slow down treatment. There are also times when Invisalign has limitations. In cases that require the movement of roots, like premolar extraction where space closure and root paralleling are desired, traditional fixed appliances may serve the patient better.

 

Clear aligners are best for situations that necessitate tipping movements. Therefore, even if Invisalign is chosen, there may come the point where traditional fixed therapies may be necessary. Clear aligners also may require a longer treatment course due to the ease of torque.

 

The type of orthodontic treatment a patient chooses should be decided upon by weighing both the pros and cons. Each case is different and will require consideration of various consequences and risks.

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