The application of in-office aligners in the combination treatment protocol

Abstract

Orthodontists often choose either braces or clear aligners when treatment planning. However, with combination (combo) treatment, which uses both fixed and removable appliances for the same case, orthodontists take advantage of what each treatment modality does best. Fixed appliances provide initial forces to initiate orthodontic tooth movement, while removable devices administer the finishing stages. Technology for in-office clear aligner therapy improves the practice workflow for combo treatments. Recent advances in design software reduce the time needed for treatment planning while enhancing patient communication and patient acceptance. In addition, 3D printing technology for clear aligner production improves the efficiency and expediency of combo treatment delivery. For those orthodontic practices with in-office fabrication capability, aligners are available immediately after debonding of fixed appliances, greatly enhancing efficiency of orthodontic care delivery. Most cases requiring extrusion, expansion or significant rotation can benefit from combo treatment. The clinical benefits of combo treatment coupled with improvements in orthodontic design software make this protocol increasingly attractive to implement. In-office production of aligners enhances these benefits by reducing costs and the possibility of same-day aligner delivery to patients.