August 14, 2021

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5 Ways to shorten the length of your aligner treatment

Shorten the time with aligner therapy. 

More information about Tinnisense Aligner Care.

Common wear protocols for aligner therapy: While wearing aligners

Hours Per Day
Wearing		 Hours Per Day
Not Wearing		 Ratio No Drinking Drinking Eating
20 *
4 *
5:1 *
Yes *
No
No
21 *
3 *
7:1 *
Yes *
Yes *
No
22 * / **
2 * / **
11:1 * / **
No
Yes *
No
23.75 ***
0.25 ***
95:1 ***
No
Yes ***
Yes ***

*  Invisalign®

“. . . Unless otherwise instructed by your doctor, you should wear your aligners for approximately 20 to 22 hours per day, removing them only to eat, brush and floss.” [3]

 

**  (Invisalign® ) and ClearCorrect®:

ClearCorrect® “Treatment time may exceed estimates. (and) . . . wearing aligners less than 22 hours per day. (may) . . . effect the quality of the end results.” [4]

 

***  An integral aspect of the protocol for those diagnosed with moderate and advanced periodontal disease who undergo orthodontic aligner or periodontal aligner therapy (e.g., arch reformulation therapy).

Wearing aligners for longer time periods/ day increases the in-mouth / out-of-mouth ratio

    • Certain tooth movements become possible
    • They occur at a greater rate
    • They progress in a more predictable fashion

Less common methods for orthodontic acceleration [5]

Interseptal alveolar surgery / Distraction osteogenesis

    • Distraction of the periodontal ligaments
    • Distraction of the dentoalveolar bone
    • Highly invasive surgery

Segmental osteotomy of the maxilla

    • Block of medullary bone is cut, separated and firmly
    • repositioned
      Highly invasive surgery

Corticotomy

    • Cortical bone is cut, medullary bone is not cut
    • Highly invasive surgery

Piezoincision technique

    • Piezoincision surgical blade creates a ditch in the buccal cortex between the roots of the teeth
    • Invasive surgery
  •  

Lasers

    • Low-level laser therapy is still at the very early stages of development
    • Not widely available
    • The best wavelength, duration and protocol for care are evolving
    • Study results have been inconclusive

Low-intensity pulsed ultrasound (LIPUS)

    • Aevo® System
    • Study results have been inconclusive

Local injection of biomodulators[6]

    • Inflammatory mediators are injected into the gums.
    • Goal is to stimulate desirable growth factors (e.g., cytokines) while inhibiting factors which would have an adverse effect on positive bone remodeling

Gene therapy

    • Individual proteins are created for specific therapeutic use.

The Bottom Line

  • Do not initiate or otherwise use any of these on your own, without professional supervision.

  • Confer with your licensed general dentist or orthodontist.

  • While treatment acceleration is not the right choice for everyone, there are solid choices that merit serious consideration for those who are interested.

  • Increasing the wear time per day, as well as other methods of acceleration, can decrease the number of days required to obtain all of the desired movements from each set of aligners. The fewer days that one needs to wear each set of aligners, the shorter the active component of therapy.

  • There are both free and fee based procedures that will help shorten the duration of your aligner therapy. With all procedures of this nature, compliance is essential.

  • Some procedures which have yet to have their efficacy proven or possess a definitive protocol may one day become a reasonable option, or even the preferred option.

  • Let me stress again. Please confer with your dental professional to make the selection that’s best for you or someone you care deeply for!

  1. G Nimeri, CH Kau, S Abou-Kheir, RCorona. Acceleration of tooth movement during orthodontic treatment —  a frontier in Orthodontics. Progress in Orthodontics:2013,14:42.
  2. T Kurohama, H Hotokezaka, M Hashimoto, T Tajima, K Arita, TKondo, A Ino, N Yoshida. Increasing the amount of Corticotomy does not affect orthodontic tooth movement or root resorption, but accelerates alveolar bone resorption in rats. European Journal of Orthodontics, Vol 39, Issue 3, 1 June 2017, p 277-286.
  3. Informed consent and agreement for the Invisalign® patient. Align Technology © 2013
  4. Patient informed consent form for the US. ClearCorrect® POL 0008-4.0
  5. M Shingade, R Maurya, H Mishra, H Singh, K Agrawal. Accelerated Orthodontics: A paradigm shift. Indian Journal of Orthodontics and Dentofacial Research. 2017 Apr,3(2):64-8.
  6. I Andrade Jr, AB dos Santos Sousa, G Concalves da Silva. New therapeutic modalities to modulate orthodontic tooth movement. Dental Press Journal of Orthodontics, Nov/Dec 2014, vol.19, (6) 123-133.
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