Journal of the American Orthodontic Society • March

ORTHOBITES Tips to Improve ALIGNER THERAPY TREATMENT By David W. Jackson, DDS, FAGD, IBO Fig. 1 Fig. 2 I used to give a presentation in my courses entitled, “Aligners: The good, the bad and the ugly”. I have quite honestly been less than enamored with this type of orthodontics. While I do not push it within my practice, I do offer it as an option. I continue to improve in my final results with aligner orthodontic cases. Knowledge is powerful, and I have been given addi- tional knowledge that has helped my cases tremendously. A lot of this knowledge has been given to me from my friend and fellow AOS member, Cheryl Bologna, DDS in Dearborn, Michigan. If you do not know Cheryl, you will in the very near future. Her article on ”Invisalign® Gems” appears in this edition of the journal. She is a tremendous speaker, great dentist, mother and wife, operates a huge dental practice, and is a true “Aligner Queen”! I have incorporated several of Cheryl’s pearls, along with a few of my own, into my patient’s aligner ther- apy to help improve the treatment and its outcome. First, when placing aligners, I instruct the company who fabricates the aligners not to perform any IPR 28 March/April 2010 JAOS initially. With traditional straight wire orthodontics, I always perform IPR at the end of treatment. Now, I simply instruct the company to expand and procline the teeth, then IPR as needed at end of treatment or in the refinement of the case. In other words, I “round-trip the crowns”. Secondly, I have the company place the attach- ments after the first or second aligner. This has allowed the patient to be able to insert the appliances with ease at first and loosens up the periodontal liga- ments. I place the attachments after tray 1 or 2. Third, I see the patient a bit more often and make sure they are having no issues with tray fit. When I first began using clear aligner therapy, I was seeing my patients every four to six months. I now see them every four to six weeks. Fourth, I really dissect the computerization of what the company has produced. I give very detailed instruc- tions and do not accept a case if it is not to my expecta- tions. Until you push the “roll-em” button, you can continue to refine per the computer. I laugh at myself