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Clear Aligner Therapy


Clear Aligner through CA Digital offer a complete solution for the doctors that want to digitalize their offices. In fact from one scan (directly from the patient with an intraoral scanner or scanning the plaster models), the CA Digital software can offer:

• digital or printed study models

• digital storage of the models

• diagnosis including study and radiographic analysis

• set-up models and correction of the set-up models

• Aligners therapy (CA Clear Aligner)

• Indirect labial or lingual bonding (Individua)

• CAD-CAM Retainers (Memotain)

In this article the author will focus only in the CA Clear Aligner Therapy characteristics due to the extension of this paper.

Characteristics of the CA Clear Aligner Therapy

1- CA Clear Aligner prepare 1 to 3 steps from one digital or traditional impression

As we don’t manufactures all the aligners from the first impression, we can:


• Make the control of the treatment periodically and not only at the end of the treatment. This characteristic allows u


s to reduce the treatment time and avoid the final refinements of the cases. The system is a continuous control of the evolution of the case called PTMA (Plan – Treat – Monitor – Ac


tive) that means that we active the treatment according to the evolution of the case. Also, we can adapt the treatment to the possible relapse due to the fault of use of the aligners, adap


t to the changes in the mouth during the mixed dentition and to the stripping changes.

2- We use three different thickness of aligners

One step includes 3 aligners adapted to the same set-up but with different thickness (soft, medium and hard) that activates the treatment every week. As we change the aligners every 5 to 7 seven days according to the individual evolution, we maintain a good range of dental movement.

3- CA Clear Aligners cover 2mm of the gingival tissues.

In 2013, in the University of Nevada


, they published that the aligners with no attachment and scallop margins has significant less retention. Less retention means less anchorage and less effectiveness in the dental movements. Covering 2mm of the gingival tissues we increase the aligners’ retention without the use of attachments. On the other side, the Clinical Centre of Munich demonstrated that the extension of the aligners gets less inclination in the dental movements because the force application is near of the dental centre of rotation. In this way we get a better effectiveness of the movement but as the changes in the soft tissues are not so predictable we cannot prepare all the aligners from the first impression.




4- We use a lot of tools or aids in the CA Clear Aligner Therapy to reduce the treatment time and increase the efficiency of the appliances.

a- CA Vector Screws for transversal expansion (anterior (CA Vector 40), posterior (CA Vector 50) or lateral-oblique (CA Vector 30)), Screws for distalization (CA Distalizer Kit), to close spaces (CA Tractive Screw) and for individual movements (Piston Screws).

b- CA Tip Pliers. We have 4 cold pliers to activate the aligners (1- to increase the retention, 2- for activation points, 3- for inclination activation, 4- for torque activation).



c- CA Power Grip. We have 9 different shapes to increase the effectiveness of the treatment (1- for forced extrusion and forced ; 2 and 3 for mesio-distal angulation; 4 and 5 for torque control; 6 and 7 for posterior build-ups and 8 and 9 for anterior build-ups),

d- plastic buttons as anchorage for elastics

To complete de system we have another tools like stripping kits, etc.




Case Report

In the pictures 1 to 5 we can observe a case with good occlusion of the posterior teeth but with crowding and rotation of the anterior teeth. The case was treated in 6 steps/months of treatment with stripping.

In the pictures 6 to 8 we can observe the CA Clear Aligner covering 2mm of the soft tissues and in the pictures 9-13 the stripping performed with the Progressive Stripping Technique.

In the following pictures we can observe the evolution of the case step by step:

• pictures 14 to 18, Progress 1

• pictures 19 to 23, Progress 2

• pictures 24 to 28, Progress 3

• pictures 29 to 33, Progress 4

• pictures 34 to 38, Progress 5


The final pictures can be observed in the pictures 39 to 43 and the fixed retention in the pictures 44 to 48.



Figures 14 to 18: Progress 1

Figures 19 to 23: Progress 2

Figures 24 to 28: Progress 3

Figures 29 to 33: Progress 4

Figures 34 to 38, Progress 5

Figures 39 to 43: Final pictures

Figures 44 to 48: Fixed Retention


Conclusions

The CA Clear Aligner is a complete system that includes individual characteristics that makes the difference with other systems. The system also includes special tools, like screws, pliers, plastic buttons and power grip that helps in the reduction of the treatment time and the effectiveness of the therapy.

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