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Active Aligners perfect for teens

Active Aligners Teen
Candidacy – Case Selection:

Is Your Teen Patient a Candidate?

  • Only fully erupted permanent dentition (no primary teeth or erupting teeth)
  • Ensure enough clinical crown is available to support the aligner and facilitate movement
  • X-rays (Ceph or Pan) is a critical tool to ensure no impacted, non-erupted or missing, or ankylosed teeth and to assist in the diagnosis of  developmental concerns that may be needed to take into consideration for treatment planning and candidacy
  • Patient needs to be committed, motivated and responsible – compliance is key
  • Ideal cases are where space can be created through expansion and proclination, with limited IPR. Mild to moderate crowding is acceptable. Avoid severe malocclusions.
  • Avoid Cases with deep curves of Spee in the lower arch (ie lower incisors over erupted)
  • Avoid Possible over advancement of the lower incisors
  • Avoid iatrogenically induced gingivalrecession especially in the lower anterior region
  • Avoid larger open bites extending beyond the anterior segments

Tips for Treating Teens

  • Check the amount and stage that IPR is required.
    Make use of an IPR gauge.
  • Manage expectations:
    • Both parents and teens need to be committed, motivated and responsible
    • Some discomfort might be experienced during initial changes, but it is much less than traditional braces
    • Wearing aligners consistently is the best predictor of a successful outcome
    • Retention – explain that this stage is as important to prevent relapse
  • Pay attention to the placing of composite attachments.
  • Retention is non-negotiable.
  • Instructions to the treatment planners, and case review, are extremely important.
  • To help with compliance by making aligners easier to remove and replace initially before engagers are placed, consider requesting that treatment planning makes provision for adding
    engagers at stage 3 of treatment.
  • Emphasize the importance of using chewies to make sure the aligners seat properly.
Active Aligners for Teens

The Pros

  • Final outcome is predetermined thanks to CAD (computer aided design) and individualized treatment planning. Outcomes are predictable.
  • Due to teens being in a period of active growth, treatment is faster and more efficient. Recent studies have shown that aligner treatment is usually faster than traditional braces
  • Trays are all delivered together to you, the dentist. A patient therefor does not need adjustments every couple of weeks but simply need to change trays every 2 weeks (or can be sooner at Doctor discretion and patient compliance) with follow up appointments every 6 weeks – this means less chair time for you and your patient
  • More flexibility in food choices allowing for healthy eating habits to be maintained
  • No cutting of lips and cheeks by brackets – more comfortable
  • Allows for better and more convenient oral hygiene, plaque control (limits the risk of white spots and gingival inflammation), periodontal health (less irritation of soft tissue) and overall comfort
  • Transparent – allows for greater self-confidence
  • Fewer emergencies if compared to traditional braces – no need to skip school due to broken appliances or injury during contact sports (a
    gum guard may be worn over the aligners if need be)

The Cons

  • Removeable – they need to be worn up to 22 hours a day. If not, traditional braces may be a better option.
  • Can be lost –however, replacement aligners are prioritized for manufacture
  • If not seated correctly, correct movements will not happen – monitoring is essential 
  • Quality of impressions cannot be over-emphasised. Aligners need to fit 100%
  • Once the occlusion has settled, a second phase may be required for the final alignment
  • Some teens prefer traditional braces with colourful accessories