5 Ways to shorten the length of your aligner treatment!


 

5 Popular methods to shorten the time with aligner therapy (e.g., Invisalign®, ClearCorrect®):[1]

  • Modify your wear habits:
    • Drink non-water beverages while wearing your aligners
      • Aligners are removed less frequently
      • Fewer opportunities to forget to put aligners back in your mouth
      • Cost: it’s free – no extra fees!
      • Rinse aligners with water as soon as possible after you finish your drinks

 

  • Eat all meals while wearing periodontal aligners*
    • Increasing the ratio of wearing to not-wearing:
      • “7:1 ➜ 95:1” significantly enhances the efficacy of the aligners
    • Essential for those with bone loss and loose teeth (due to periodontal disease)
    • Cost: it’s free – no extra fees!

 

  • Use an oral vibration device 5-20 minutes/day (e.g., AcceleDent Aura®, [AcceleDent®], VPro5®)
    • 5-10 minutes 1-2 times each day (be sure to follow the manufacturer’s and doctor’s recommendation)
    • Cost: there is usually an extra fee for this technique.
    • Scant dental studies definitively confirm that they work as well as claimed by the manufacturers.

 

 

  • Bone Acceleration Surgical Therapy (BAST)[2]
    • Least invasive method (e.g., fewer holes poked through the gums into the bone)
    • Each treatment lasts 2-3 months
    • May require multiple treatments throughout the course of therapy
    • There are usually no extra fees for this procedure

 

 

Common wear protocols for aligner therapy

Hours/Day

Wearing

Hours/Day

Not-Wearing

Ratio No non-water drinks while wearing aligners Drinks while wearing aligners Eating meals while wearing aligners
20* 4* 5:1* *
21* 3* 7:1* * *
22*/** 2*/** 11:1*/** */**
23.75*** 0.25*** 95:1*** *** ***

 

* 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).

 

When one wears aligners for longer time periods/day, increasing the in-mouth/out-of-mouth ratio, certain tooth movements:

🗸 Become possible

🗸 Occur at a greater rate

🗸 Progress in a more predictable fashion

Some 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.

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!

 

Elliot Davis, D.D.S.: [email protected]

 

 

[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.