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Clear Aligner Pliers and Use - Hu Friedy
Clear Aligner Pliers and Use - Hu Friedy
Clear Aligner Pliers and Use - Hu Friedy
Let’s be clear: enhancing aligner Some were cutting notches in plastic trays
treatments using scissors or nail clippers10 or attempting
As clear aligner treatments have evolved “Innovation is taking to adhere buttons to the trays — all unwieldy
and been progressively refined in the past endeavors.
15 years, more advanced applications and two things that
increasingly complex malocclusions have The Tear Drop
been addressed.1-4 In addition, there has already exist and There are occasions when orthodontic
been more interest in tackling some of the elastics are needed to assist with specific
specific limitations of moving teeth with putting them together tooth movements or growth modification
plastic.5-7 Obviously, the progress of orth- when using aligners. For instance, it may be
odontic treatment with traditional wires and in a new way.” beneficial to add elastic hooks or bonded
braces has been advanced throughout the buttons in different locations along the arch
past century, but the techniques associated – Tom Freston form on either the buccal or lingual. It would
with a sequence of aligners are relatively be beneficial to incorporate an elastic hook
recent phenomena. that cannot be dislodged from the aligner
Orthodontists with the most experi- and that only requires a simple one-step
ence and enthusiasm in using aligners have Adding intra- and intermaxillary squeeze of a pair of pliers to create. Most
worked diligently to improve the concept forces importantly, a hook that actually holds the
through better understanding of the limita- The Clear Collection instruments have elastic in place on the aligner.
tions involved in more advanced treatment streamlined and standardized some proce- The Tear Drop pliers (Figure 2) is an
planning, especially when using adjuncts to dures that orthodontists had already been instrument created for the purpose of
enhance the associated biomechanics.4,8-13 providing, while opening up more options adding a notch or hook at the gingival
The Clear Collection of instruments from for other methods to accentuate or refine margin of clear aligners. A standardized
Hu-Friedy (Chicago, Illinois, at www. treatment. In the past, attempting to add notch is easily cut in a single step, creating
hu-friedy.com) was developed with that aim intermaxillary elastics for correction of a teardrop-shaped “reservoir” to hold the
in mind; namely, to help to increase the utility Class IIs, IIIs, or midlines was problematic. elastic on the tray (Figure 3), thereby making
of aligners and expand the scope of appro-
priate applications (Figure 1).13
Figures 8A-8B: Aligner Chewies are held tightly been specific “lagging” teeth for 10-15 seconds. This process is repeated for 5 minutes, 2-3 times daily, especially when changing to a
new pair of aligner trays
A. B. C.
Figures 9A-9C: Bootstrap mechanics13 to forcibly erupt a “lagging” tooth using orthodontic elastics (9A-9B). The Hole Punch is employed to clear aligner plastic to permit the addition of
bonded buttons. The Tear Drop is used to cut notches in mesial and distal embrasures (9C-9F).
F. G.
REFERENCES
H. 1. Clements KM, Bollen AM, Huang G, King G, Hujoel P, Ma T.
Activation time and material stiffness of sequential removable
orthodontic appliances. Part 2: Dental improvements. Am J
Orthod Dentofacial Orthop. 2003;124(5):502-508.
2. Djeu G, Shelton C, Maganzini A. Outcome assessment of Invis-
align and traditional orthodontic treatment compared with the
American Board of Orthodontics objective grading system. Am
J Orthod Dentofacial Orthop. 2005;128(3):292-298.
3. Phan X, Ling PH. Clinical limitations of Invisalign. J Can Dent
Assoc. 2007;73(3):263-266.
4. Tuncay O. The Invisalign System. London: Quintessence
Publishing; 2007.
5. Kravitz ND, Kusnoto B, BeGole E, Obrez A, Agran B. How well
does Invisalign work? A prospective clinical study evaluating
the efficacy of tooth movement with Invisalign. Am J Orthod
Dentofacial Orthop. 2009;135(1):27-35.
6. Krieger E, Seiferth J, Marinello I, Jung BA, Wriedt S, Jacobs C,
Wehrbein H. Invisalign® treatment in the anterior region: were
the predicted tooth movements achieved? J Orofac Orthop.
2012;73(5):365-376.
7. Chisari JR, McGorray SP, Nair M, Wheeler TT. Variables affecting
orthodontic tooth movement with clear aligners. Am J Orthod
Dentofacial Orthop. 2014;145(4 suppl):S82-91.
8. Tuncay O. Clinical Reports & Techniques. 2005;6(2):1.
Figures 9D-9H: The Tear Drop is used to cut notches in mesial and distal embrasures (9C-9F). Orthodontic elastics are 9. Daher S. Techniques for Class II correction with Invisalign
and elastics. Align Technology, Inc. Web site. Published 2013.
stretched from the button to the teardrop notches or to another button on the opposite side of the tooth (9G-9H) Accessed April 11, 2015]. https://s3.amazonaws.com/learn-
invisalign/docs/06840000000GHgmAAG.pdf
anchorage during molar distalization or The instruments in the Clear Collection 10. Paquette D. Temporary Anchorage Devices in Combination with
Aligners 2009. Invisalign Web site. http://www.aligntechinstitute.
en masse movements when employing help the orthodontist to better customize com/files/ATEArchive/pdf/ate_110609.pdf
miniscrews (Figure 5).13 Cutting notches clear aligner treatments, enhance their 11. Boyd R. How successful is Invisalign for treatment of anterior
open bite and deep overbite? Presented at: American Associa-
and relieving the plastic to add buttons or desired biomechanics, and streamline the tion of Orthodontists Annual Session; May 5, 2013; Philadelphia,
PA. https://www.aaoinfo.org/system/files/media/documents/
brackets facilitate the application of these addition of adjunctive forces during the Boyd,%20Robert%20--%20Treatment%20of%20Deep%20
and%20Open%20bite%20with%20Clear%20Aligners.pdf
innovative mechanics. course of a series of aligners. For informa- 12. Dayan, W. Techniques for Posterior Intrusion with Invisalign
It is important to remember that in- tion on the use and applications of the Clear to Correct Anterior Open Bites. Techniques White Paper
2010. http://www.cityortho.ca/Portals/0/City%20Ortho-%20
discriminate alteration of the integrity of clear Collection, instructional videos are available Open%20Bite%20Blog.pdf.
13. Bowman SJ, Celenza F, Sparanga J, Papadopoulos MA, Ojima
aligners may reduce their structural strength on YouTube at https://www.youtube.com/ K, Lin J. Creative adjuncts for clear aligners, Part 1: Class II
or may impair the intended biomechanics watch?v=hrs2VfnImLY. treatment. J Clin Orthod. 2015;49(2):83-94.
14. Giancotti A, Ronchin M. Pre-restorative treatment with the Invis-
programmed into an aligner. align system. J Clin Orthod. 2006;40(11):679-682.
The Vertical
The control of rotations is often a
challenge with clear aligners. The Vertical
Figures 2A-2C: The Horizontal pliers are specifically designed to add individual root torque
Clear conclusions
The Clear Collection can assist in the Enhancing and accentuating chosen biomechanics helps reduce the
application of adjunctive forces to broaden
the variety of malocclusion problems known limitations of aligners and orthodontists’ occasional frustrations.
that may benefit from aligner treatments.
Enhancing and accentuating chosen biome-
chanics helps reduce the known limitations added dimension for individualizing specific REFERENCES
1. Kravitz ND, Kusnoto B, BeGole E, Obrez A, Agran B. How
of aligners and orthodontists’ occasional tooth movements in “real time” at the clinic well does Invisalign work? A prospective clinical study
frustrations. In this manner, the clinician can chair. evaluating the efficacy of tooth movement with Invisalign.
Am J Orthod Dentofacial Orthop. 2009;135(1):27-35.
more efficiently individualize treatment for The instruments in the Clear Collection 2. Krieger E, Seiferth J, Marinello I, Jung BA, Wriedt S, Jacobs
C, Wehrbein H. Invisalign® treatment in the anterior region:
each patient by altering the aligner trays help the orthodontist to better customize were the predicted tooth movements achieved? J Orofac
in a series by adding appropriate forces to clear aligner treatments, enhance his/her Orthop. 2012;73(5):365-376.
3. Chisari JR, McGorray SP, Nair M, Wheeler TT. Vari-
affect desired tooth movements. Specifi- desired biomechanics, and streamline the ables affecting orthodontic tooth movement with clear
cally, The Hole Punch and The Tear Drop addition of adjunctive forces during the aligners. Am J Orthod Dentofacial Orthop. 2014;145(4
suppl):S82-91.
instruments facilitate the addition of elastic course of a series of aligners. For informa- 4. Tuncay O. Clinical Reports & Techniques. 2005;6(2):1.
forces necessary for the correction of a tion on the use and applications of the Clear 5. Nicozisis JL. Tripping the plastic fantastic. Orthodontic
Products. 2013;Nov:28-34.
significant number of malocclusions. Much Collection, instructional videos are available 6. Humber P. Rotating canines using the Invisalign system.
like bending wires with orthodontic pliers, on YouTube: https://www.youtube.com/ Aesthetic Dentistry Today. 2013;7(1):30-34.