CATEGORY AUSTRALASIAN DENTIST 59 LINICAL the better fit of the aligner in case of multiple attachments. u Attachment loss: Optimal consistency of composite attachments is important during clear aligner therapy; otherwise, the teeth will not move desirably. Attachment loss can occur due to bond failure or patient incompliance. A recent study by Yaosen et al (2021), evaluated risk factors leading to attachment loss and concluded that attachment loss is more prevalent in molar teeth, and wearing aligners less than 18h a day as well as unilateral mastication. Since these factors are patient-related, they can be prevented. u Material of the aligner: Different thermoplastic materials such as polyester, polyurethane and polyethylene terephthalate glycol are utilized for the fabrication of aligners. Material composition of aligners might affect retention more than their thickness. As the aligner contacts both the tooth and the attachments to control the force applied to the tooth. Conclusion Aligner systems which lack the ability to incorporate bonded attachments can only generate limited tooth movement. Therefore, altering the aligner geometry by the software have increased the effectiveness of force delivery. Clear aligner need not be based on aligners alone, particularly for malocclusions of increasing complexity. More difficult movements, inter-arch changes and anchorage management requires the use of additional orthodontic techniques. As the complexity of required movements increases, attachments or altered aligner geometries (such as pressure points, bite ramps and power ridges) become increasingly necessary to provide better three-dimensional control of tooth movements and improved treatment outcomes. u REFERENCES Graber, Vanarsdall- Orthodontic Current Principles and Techniques (6th edition) S. Alami et al, Biomechanics of Aligners: Literature Review. Adv Dent & Oral Health. 2021; 13(4): 555872. Kazem Dalaie, Sanam Ghaffari, Importance of Attachments in Treatment with Clear Aligners: A Narrative Review. J Dent Sch2020;38(1):41-47. Karras et al, Efficacy of Invisalign attachments: A retrospective study, Am J Orthod Dentofacial Orthop 2021 Aug;160(2):250-258. Kanpittaya et al, Clear Aligner: Effectiveness, Limitations and Considerations, J Dent Assoc Thai Vol.71 No.4, 2021 Nucera et al, Effects of Composite Attachments on Orthodontic Clear Aligners Therapy: A Systematic Review, Materials 2022, 15, 533 Putrino et al, Clear Aligners: Between Evolution and Efficiency— A Scoping Review, Int. J. Environ. Res. Public Health 2021, 18, 2870 William. R. Profitt, Contemporary Orthodontics (6th edition). Dr Geoff Hall Specialist orthodontist Founder and Director of OrthoED, Smilefast, CAPS and Clear Aligner Excellence Tel: 03 9108 0475 geoff@orthoed.com.au OssMem OssMem Soft OssMem Hard Osstem Australia Suite 8, Level 5, Building C, Rhodes Corporate Park, 1 Homebush Bay Drive, Rhodes NSW 2138 E. info@osstem.com.au P. 02 9889 2675 Not allow in ltration of epithelial cells Allows in ltration of serum and nutrents Post OP 20 weeks after OP Biological compatibility Acceleration of new bone foundation by porosity Raw Material: Bovine Type 1 Collagen (New Zealand) Adhere to bone defect site Dissolved in approximately 8 -12 weeks Hydrate for 30 seconds Hold bone graft material rmly Excellent maintain volume Dissolved in approximately 20 seconds Hydrate for 120 seconds A dense collagen layer e ectively prevents the in ltration of soft tissue OssMem Soft OssMem Hard Ref.) Rabbit Model Text, Osstem Implant
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