Braces, buttons and elastics: Invisalign beyond the aligner

Invisible orthodontics works, as the vast majority of patients are already familiar with, through the use of aligners, transparent plastic sleeves worn by the patient that perform micro-movements in the teeth, thus improving alignment and correcting bite problems.

However, aligners are not always able to perform all these movements on their own, and therefore require a series of auxiliary elements. I am Raquel Lucasorthodontist in the dental clinic Vélez and LozanoI'm here to talk to you about fasteners, elastics and buttons, in other words, auxiliary elements.  


Attachments are the most commonly used auxiliary elements to complement invisible orthodontic treatment with aligners. They are reliefs of compositeThe size, shape and orientation of the aligners will depend on the movement we want them to help generate. They also serve to increase the anchorage of the aligner and prevent it from falling out, which also improves its effectiveness.

The attachments do not damage the surface of the tooth at any time, as they are adhered to it with biocompatible materials and are removed once the treatment is finished, or when required (sometimes it is necessary to change the attachments in the middle of a treatment depending on the movements required by each tooth). The composite with which they are made is the colour of the tooth itself, so they are hardly detrimental to aesthetics.

The attachments could be classified according to their purpose, such as rotation, extrusion or root control, among others, and thanks to technology Invisalign ClinCheckThe patient will be able to see where his or her ataches will be placed, the size of each one, and they can even explain why.

Thanks to a template provided by Invisalign, which is simply an aligner that is filled with composite in the clinic, the process of placing the attachments is quite simple and is usually the first step in starting invisible orthodontic treatment.

When these templates are ready, the patient's tooth surface is etched with a special gel, so that the composite parts are bonded. The template is then inserted as if it were just another aligner and the attachments are hardened by the polymerisation lamp, so that when the template is removed, they are stuck to the vestibular surface. Check that everything is OK, and this process is finished.

Elastics and buttons

When the meshing between the upper jaw and the mandible is not ideal, bite problems or malocclusion occur. Sometimes these situations cannot be successfully resolved using aligners and attachments alone, but they can be treated with invisible orthodontics.

Buttons are used for this purpose. These buttons, which can be metallic or aesthetic, depending on the position in which they need to be placed for treatment, are used to place the elastics, normally associated with the use of fixed orthodontics but successfully introduced in complex cases of invisible orthodontics to allow complicated cases to be treated with aligners.

In addition to the buttons, sometimes small notches are made in the aligner itself. This allows for more versatility when placing the elastics, which sometimes must be attached from the button to the notch, thus exerting tension at the ideal point, and sometimes from one button to another to generate movements that require both arches to be involved.

Elastics can come in different sizes and thicknesses, as we have already seen in an earlier section. previous blog postand are made of latex, rubber or similar materials.

It is thanks to aids such as these that invisible orthodontics has achieved its current levels of predictability and success, which has led it to its peak in terms of popularity among orthodontists.

I hope I have answered your questions on the subject, and you can always communicate with us through the usual social media channels and comment box.

Author: Raquel Lucas

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