As Invisalign* treatment has evolved, some attachment designs, such as the rhomboid, have been degraded in favor of the more positive lock in provided by horizontal and vertical rectangular attachments. Still, the problem of proper and efficient placement of these attachments remains
The most challenging steps in the process are injecting the correct amount of bounding material into the reservoir of the attachment template, placing the template in the mouth without creating excessive flash, and positioning the template for the optimal fit between attachment and aligner. This article describes a simple indirect technique that ensures precise attachment placement with little flash.
Procedure
11 1. Inject Compose-it microhybrid flowable composite** into the template (A
). The viscosity of this material is ideal for eliminating voids. 2. After tapping the template with an instrument to even out the surface (B), light-cure the composite.
3.
3.
3. 3. Apply the bounding liquid conservatively to the attachment (C) and the tooth.
4. 4. Place the template in the mouth, holding the attachment against the tooth with a ligature director (D). If the reservoir is slightly underfilled, the hard attachment can be pushed against the tooth for proper adaptation.
p Light-cure the liquid interface. Any residual adhesive, which should be minimal, can be cleaned up with finishing burs.
5 5. Create a gingival slope for easier removal of the aligners, as advocated by Womack*1 (E)
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1. Womack, W.R.: Four-premolar extraction treatment with Invisalign, J. Clin. Orthod 40:493-500, 2006. Reprinted Journal of Clinical Orthodontics October 2008 By Dr. Paul Rocke
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