22Aside from aesthetic advantages,there is data to suggest theimprovement of periodontal tissues during this type of treatment.23, 24This makes sense due to the verynature of the system and the patient’s ability to remove the appliance foroptimal daily plaque biofilm removal.25Often resin buttons are added tofacial surfaces of teeth, to assist in tooth movement; resulting in the need forthe dental hygienist to be aware of their location to evaluate plaque controlas well as to not remove those during scaling.This technology has given rise to some controversy over the clinical research, asmany of the published papers are case reports. Concerns over final outcomes tocorrect malocclusion and potential higher relapse with Invisalign have also beenreported.26, 27 In addition, because of the ease of removal, patient compliancewith aligners must be carefully monitored. As with any system that relies uponthe patient, non-compliance is an issue and can delay treatment.26Other commercially available aligner systems include NuBrace() and the Red,White & Blue system ()recommended for replacement of certain retainer devices.This technology hasconfirmed that adult patients are not only interested, but also willing to pursue orthodontic treatment, especially if it is aesthetically pleasing.What is wrong with conventional ligation?81• Failure to provide and to maintainfull archwire engagement• High friction• Elastic ligation loses its elastisityover time (and therefore tooth con-trol) and they are sometimes lost• Potential impediment to oral hygiene•Wire ligation is very slowInvisalign®Before Invisalign®After – 9 months treatment time/19 aligner setsInvisalign®Aligner PlacementPhoto courtesy of Dr. R. SilbersteinPhoto courtesy of Dr. R. SilbersteinPhoto courtesy of Align Technology
CDHA Journal Vol. 23 No. 211LifeLongLearningBio-Adaptive TherapyWhile fixed appliances have been readily available for decades, the use ofappliances with lighter forces that work in natural harmony with the body –or bio-adaptive therapy – isgrowing in popularity. It hasbeen well understood andaccepted that light forces willeffectively and quickly moveteeth.28The challenge hasbeen to develop a fixed appliance that will allow lightforce action with minimal friction and moderate force asseen when archwires are ligated to fixed appliances.The premise of bio-adaptivetherapy, as defined and facilitated through the Damon®System of brackets, archwiresand treatment philosophy fromOrmco Corp. (Orange, CA),takes into account thisopportunity to achieve idealtooth position and facial harmony while keeping vascular integrity of thealveolar cortical plate.“Optimum force levels for orthodontic tooth movements should be just high enough to stimulate cellular activity withoutcompletely occluding blood vessels in the periodontal ligament”.