Is tackling complex cases with aligners asking for trouble?

Clear aligners have come a long way. Once the preserve of the 2mm diastema or subtly rotated central incisor, there is now a huge range of clinical conditions that can be successfully treated to a really high standard with clear aligners. But sometimes it may not be the right option and so knowing when these cases come through the door, and alternative treatments might be considered, is essential.

Decoding complexity in orthodontic cases

But what makes a complex case ‘complex’? This is where a careful appraisal of the overall malocclusion and the formulation of a sensible and realistic treatment plan is so important. It’s only by doing this that the degree of complexity of the malocclusion can be accurately judged.

·      Is the overjet so large because of the jaw position?

·      What’s the best way to manage the spaces from so many missing teeth?

·      How can space be found to relieve this amount of crowding?

·      Will aligners really correct that crossbite?

And it’s not just the characteristics and extent of a malocclusion that determine complexity. A clinician’s experience, patient compliance, patient expectations - treatment complexity is multifactorial.

A recent study investigated the different perceptions of case complexity between orthodontists, GDPs, orthodontic trainees and dental students. The study concluded that orthodontists and orthodontic trainees “…had better judgments for evaluating orthodontic case complexity…additional orthodontic education and training have an influence on the ability to recognise case complexity”.¹

Strategic decision-making with Aligner Intelligence

This is where Aligner Intelligence is on hand to help out. When a case is uploaded, orthodontic specialists will make a full appraisal and plan the treatment. There’s also a very useful option to check if a case is even suitable for aligners. We will highlight if the case is too complex and that compromises will need to be made to the final result or when aligners are, perhaps, not the best treatment option at all.

Blindly persisting with a case that is too complex for aligners or too complex for the clinician to manage alone could very easily lead to an unsatisfactory result, a disappointed patient or even litigation. According to Kevin Lewis, Special Consultant, BDA Indemnity, “the fastest growing source of orthodontic complaints has been the involvement of non-specialists in treatment using clearaligners”.²

Our commitment to your clinical development

Aligner Intelligence is committed to helping clinicians to develop their expertise in aligner treatment so that, ultimately, they will feel confident to identify, take on and successfully treat complex cases themselves.

¹ Heath EM, English JD, Johnson CD, Swearingen EB, Akyalcin S, Perceptions of orthodontic case complexity among orthodontists, general practitioners, orthodontic residents, and dental students, Am J Orthod Dentofacial Orthop. 2017 Feb;151(2):335-341. doi:10.1016/j.ajodo.2016.06.045.

² Lewis K, Handling orthodontic complaints, Ortho Update 2023; 16: 169-173