When completing Invisalign and clear aligner cases, it’s crucial to know when you need additional attachments on the incisors – and if the teeth are incredibly slippery and hard to grab, this may well be needed for your needs. In line with this, we’ve outlined some key things you need to know to help.
When You Need Additional Aligner Attachments in Invisalign / Clear Aligner Cases
If you are trying to intrude, extrude, or rotate the incisors, there’s a good chance that these will be incredibly slippery. In this scenario, you may need a handle or additional attachments on the teeth to keep everything in place.
When Do I Need Additional Attachments?
It’s not always clear if you should add additional attachments, but the best way to determine this is often to work the case up to ideal. Then, using the double it philosophy, get the movements, and check the tooth movement table. If this shows extrusions or rotations on the incisors, it may be worth adding an extra attachment.
Premolars and canines usually have a height of contour, which helps ensure they generally have better attachment anyway. For these, you may want to rely more heavily on the TMA alongside the TMT. This allows you to complete a movement assessment; if this shows a complicated movement, usually with a black or blue dot, you’ll almost certainly want to add an attachment (unless it’s an intrusion case).
However, if the case is borderline but does require extrusion or rotation, it isn’t always clear whether you should use extra Invisalign or clear aligner attachments. If the score is around 0.05, you probably won’t need extra, but 0.5 scores may need more attachments (or monitor the tooth to see whether it moves as expected or if it goes off track, in which case, you’ll need an extra attachment).