I. Introduction

  • Dr. Amanda from StraightSmile Solutions is celebrating Christmas that came early in March.
  • Align Technology finally released something she’s been asking for for years: auxiliary hooks on the Invisalign Palatal Expander (IPE) for facemask use.
  • Smart orthodontists have been jerry-rigging this for decades. Now it’s official.

II. The Innovation

  • These are auxiliary hooks on the IPE, not on the aligner itself.
  • Why not on the aligner? Aligners are too soft to handle 8-16 ounces of extraoral traction force per side.
  • The IPE can handle that force. The aligner cannot.
  • Now you can do protraction facemask therapy directly off the expander.

III. What This Means Clinically

  • Before: Facemask patients needed traditional appliances (Kloehn-type, Nance with hooks, etc.).
  • Then switch to IPE later. Two appliances. Two fees. More chair time.
  • Now: One appliance does both. Expand AND protract simultaneously.
  • Saves money, saves time, saves hassle.

IV. Headgear vs Facemask – Know the Difference

  • Headgear = goes BACK. Retracts maxilla. Rarely indicated.
  • Facemask = goes FORWARD. Protracts maxilla. For Class III, a deficient maxilla.
  • These hooks support protraction facemask use forward movement only.
  • Very few patients need retraction. Dr. Amanda rarely uses it.

V. How to Use It

  • Follow standard facemask protocol: loosen sutures FIRST with expansion.
  • Don’t start protraction immediately. Wait until sutures are opening about one-third to halfway through expansion.
  • Verify with occlusal X-ray or CBCT if needed.
  • Then engage the facemask at 8-16 ounces per side.

VI. The Financial Win

  • IPE: ~$700. Facemask appliance: ~$150. Elastics, etc.
  • Previously: Two separate appliances = $1,100-1,200+.
  • Now: One appliance does both. Significant cost savings for patients and practices.
  • More cases become affordable. More kids get treated early.

VII. The Align Technology Relationship

  • Dr. Amanda acknowledges that Align has been “very kind” lately, no harassment for using screenshots.
  • They’re realizing she helps doctors do better Clinchecks, be happier, and spend more money with them.
  • Her Christmas wish for 2027? Let other scanners (Medit, 3Shape) work with Invisalign.
  • She could bring thousands of doctors in if they’d open that door.

VIII. The Bottom Line

  • This is a game-changer for Phase 1 Class III treatment.
  • Expansion and protraction in one appliance. Simplified mechanics. Lower cost.
  • Thank you, Align Technology. Now about that scanner compatibility…