Choosing attachment for “in office” aligners

Vol. 15 – Number 60 – 2022 Aligners in Orthodontics Page 108-118 Choosing attachment for “in office” aligners Caroline Pelagio Maués Casagrande1 Luísa Schubach da Costa Barreto2 Carlo Marassi3 Lincoln Issamu Nojima4 José Augusto Mendes Miguel5 Abstract Choosing attachments is one of the available strategies to increase the pressure area of the aligner with the tooth, creating greater retention and generating additional force vectors in the direction of the desired movement in the virtual planning with “in office” aligners (IOA). They should be considered as important auxiliary elements of this orthodontic modality, obtaining greater predictability and security for the orthodontic treatment. Thus, the aim of this article is to provide information on the use of the most commonly used attachment for virtual IOA planning, according to the desired tooth movement. The aligner covers the entire tooth surface and, with that, this device has a unique ability to apply compressive forces in all directions. However, observing its disadvantage of tension and deformation of the plastic material, it is verified the need to include an attachment with pre-adjustment different requirements and biomechanical concepts. Illustrative simulations were carried out in the Archform software (San Jose, USA), according to the types of attachmentes and their characteristics to favor the planned movement. Crucial points such as format, size, location, orientation, and dental anatomy influence the efficiency of the aligner, and were addressed for the respective conduct of choosing the attachmentes in varied movements. Thus, in order for the orthodontist to be more assertive with the desired tooth movement, it is essential to know the types of attachment and their main clinical indications. Descriptors: Clinical protocols, removable orthodontic appliances, Orthodontics. 1 PhD student in Dentistry – concentration area in Orthodontics – UERJ, Master in Orthodontics – UERJ, Specialist in Orthodontics – UERJ. 2 PhD student in Orthodontics – UERJ, Substitute Professor in Orthodontics – UFRJ, Master in Orthodontics – UFRJ, Specialist in Pediatric Dentistry – UFF. 3 Specialist in Orthodontics – USP Bauru, Orthodontist in Private Practice, Rio de Janeiro. 4 Associate Professor of Orthodontics – UFRJ, Director of the Brazilian Board of Orthodontics and Facial Orthopedics. 5 Associate Professor of Orthodontics and Coordinator of the Master’s Program in Dentistry – concentration area in Orthodontics – UERJ, Diplomate of the Brazilian Board of Orthodontics and Facial Orthopedics. DOI: 10.24077/2022;1560-0143558