When your Invisalign treatment plan calls for anything other than tipping a tooth, then an attachment(s) are necessary.
There are different types of invisalign attachments that can be bonded on different positions of specific tooth depending on the intended movement: rotation, uprighting, mesialization, retrusion, intrusion, extrusion, tipping, and diastema closure.
There are three types of conventional attachments:
- The ellipsoid is seldom used now because of poor retention.
- The rectangular attachment is effective for additional retention and can be used to apply a couple (moment) to the teeth.
- The beveled attachment is still a good choice for extrusion although the newer optimized attachments are now more common.
But these attachments are rarely used today. Instead, the G3 concept in attachment-mediated tooth movement requires the inclusion of power ridges built into the aligner instead of buttons bonded to teeth.
These power ridges help provide additional force and control during tooth movement. G3 also uses optimized attachments that are designed to apply force in a particular direction to achieve the desired tooth movement.
With the advancements in the elasticity of the SmartTrack material used in aligners, a force applied to the active surface of an attachment can effectively move a tooth in any direction. However, it’s important to carefully consider anchorage, especially if the goal is to move teeth as a whole (bodily movement).
If there is not enough anchorage, there is a tendency for teeth to tip instead of moving as a unit. This means that achieving proper balance between force application and anchorage is crucial to ensure successful tooth movement with aligners and attachments.
8 Types of Invisalign Attachments
Conventional Invisalign aligner attachments come in various shapes and placements, each designed to serve specific purposes in orthodontic treatment.
Here are the different types of attachments commonly used:
Rectangular Attachments
Rectangular attachments have a flat, rectangular shape and are typically used for controlling tooth rotations and providing torque control. They are typically placed on the palatal surface of the teeth (facing inside) and help the aligners apply precise forces to guide the teeth into their desired positions.
Beveled Attachments
Beveled attachments have a slightly angled or sloped surface. They are often used for aligning teeth that require specific rotational movements or to help correct certain bite issues. The beveled shape allows the aligners to exert force in a controlled manner to achieve the desired tooth movement.
Ellipsoid Attachments
Ellipsoid attachments have a rounded or oval shape. They are particularly useful for controlling tooth extrusion or intrusion, which involves moving the tooth in a vertical direction—either pushing it down or pulling it up. They can also be bonded to the lingual (inside) surface for rotation. The ellipsoid shape helps distribute the force evenly and guides the tooth movement more effectively.
Horizontal Attachments
Horizontal attachments have a horizontal orientation and are used to provide controlled movement in a specific direction, such as moving a tooth mesially (towards the center of the dental arch) or distally (away from the center of the dental arch). They help achieve proper alignment and positioning of the teeth.
Vertical Attachments
Vertical attachments have a vertical orientation and are used to control vertical movements of the teeth, such as extrusion or intrusion. They are placed on the teeth to guide them up or down, depending on the treatment plan.
Tooth-Colored Attachments
Tooth-colored attachments are made of a tooth-colored composite material that blends with the natural color of the teeth. They are designed to be discreet and less noticeable, enhancing the aesthetic appeal of Invisalign treatment. These attachments provide the same functionality as other types but with a more subtle appearance.
Metal Buttons
Metal buttons are small metal attachments that are sometimes used in conjunction with aligners to enable the attachment of elastics or other auxiliary components. They provide additional support for specific tooth movements and help achieve optimal treatment results.
Power ridges
Unlike attachments, which are bonded to specific teeth, power ridges are incorporated directly into the aligner material itself. They are strategically placed in areas where extra force or torque is required to achieve the desired tooth movement.
However, it’s important to note that power ridges may not be suitable or effective for all types of tooth movements or complex malocclusions. In some cases, attachments may still be necessary to achieve optimal results. Orthodontists carefully evaluate each patient’s specific needs and treatment goals to determine whether power ridges, attachments, or a combination of both would be most appropriate.
Choosing the right attachment
There are five basic movements for a tooth, namely rotation, extrusion, intrusion, torque control of the crown, and root control. If multiple types of movement are desired, there is a hierarchy for applicable attachments that is based on the Invisalign data base.
The specific types of attachments used in an Invisalign treatment plan depend on the individual patient’s orthodontic needs and the desired tooth movements. The orthodontist or dentist will evaluate the patient’s case and determine the most appropriate type and placement of attachments to achieve the desired treatment outcomes.
Final Thoughts
Every optimized attachment comes with a set of rules based on the longterm experience of the manufacturer. Doctors can assess treatment progress, but changing optimized attachments is not an option. However, during a refinement (reboot) procedure, optimized attachments can be replaced with conventional ones if desired.
