Understanding the effectiveness of attachments in clear aligner therapy: navigating design, placement, material selection and biomechanics

1. Upadhyay M, Arqub SA. Biomechanics of clear aligners: hidden truths & first principles. J World Fed Orthod 2022;11(1): 12–21. Upadhyay M Arqub SA . Biomechanics of clear aligners: hidden truths & first principles. J World Fed Orthod 2022 ; 11 ( 1 ): 12 – 21 . Search in Google Scholar

2. Nucera R, Dolci C, Bellocchio AM, Costa S, Barbera S, Rustico L, et al. Effects of composite attachments on orthodontic clear aligners therapy: a systematic review. Materials 2022;15:533. Nucera R Dolci C Bellocchio AM Costa S Barbera S Rustico L Effects of composite attachments on orthodontic clear aligners therapy: a systematic review. Materials 2022 ; 15 : 533 . Search in Google Scholar

3. Jedliński M, Mazur M, Greco M, Belfus J, Grocholewicz K, Janiszewska-Olszowska J. Attachments for the orthodontic aligner treatment—state of the art—a comprehensive systematic review. Int J Environ Res Public Health 2023;20:4481. Jedliński M Mazur M Greco M Belfus J Grocholewicz K Janiszewska-Olszowska J. Attachments for the orthodontic aligner treatment—state of the art—a comprehensive systematic review. Int J Environ Res Public Health 2023 ; 20 : 4481 . Search in Google Scholar

4. Demir GB, Süküt Y, Duran GS, Topsakal KG, Görgülü S. Enhancing systematic reviews in orthodontics: a comparative examination of GPT-3.5 and GPT-4 for generating PICO-based queries with tailored prompts and configurations. Eur J Orthod [Internet] 2024; 46(2):cjae011. Demir GB Süküt Y Duran GS Topsakal KG Görgülü S. Enhancing systematic reviews in orthodontics: a comparative examination of GPT-3.5 and GPT-4 for generating PICO-based queries with tailored prompts and configurations. Eur J Orthod [Internet] 2024 ; 46 ( 2 ): cjae011 . Search in Google Scholar

5. Bichu YM, Alwafi A, Liu X, Andrews J, Ludwig B, Bichu AY, et al. Advances in orthodontic clear aligner materials. Bioact Mater 2023;22:384–403. Bichu YM Alwafi A Liu X Andrews J Ludwig B Bichu AY Advances in orthodontic clear aligner materials. Bioact Mater 2023 ; 22 : 384 – 403 . Search in Google Scholar

6. Karras T, Singh M, Karkazis E, Liu D, Nimeri G, Ahuja B. Efficacy of Invisalign attachments: a retrospective study. Am J Orthod Dentofac Orthop 2021;160(2):250–8. Karras T Singh M Karkazis E Liu D Nimeri G Ahuja B. Efficacy of Invisalign attachments: a retrospective study. Am J Orthod Dentofac Orthop 2021 ; 160 ( 2 ): 250 – 8 . Search in Google Scholar

7. Dasy H, Dasy A, Asatrian G, Rózsa N, Lee HF, Kwak JH. Effects of variable attachment shapes and aligner material on aligner retention. Angle Orthod [Internet] 2015; 85(6):934–40. Dasy H Dasy A Asatrian G Rózsa N Lee HF Kwak JH. Effects of variable attachment shapes and aligner material on aligner retention. Angle Orthod [Internet] 2015 ; 85 ( 6 ): 934 – 40 . Search in Google Scholar

8. Elshazly TM, Bourauel C, Aldesoki M, Salvatori D, Alhotan A, Keilig L, et al. Effect of attachment configuration and trim line design on the force system of orthodontic aligners: A finite element study on the upper central incisor. Orthod Craniofac Res [Internet] 2024;27:1–10. Elshazly TM Bourauel C Aldesoki M Salvatori D Alhotan A Keilig L Effect of attachment configuration and trim line design on the force system of orthodontic aligners: A finite element study on the upper central incisor. Orthod Craniofac Res [Internet] 2024 ; 27 : 1 – 10 . Search in Google Scholar

9. Ayidaga C, Kamiloglu B. Effects of variable composite attachment shapes in controlling upper molar distalization with aligners: a nonlinear finite element study. J Healthc Eng 2021;2021:5557483. Ayidaga C Kamiloglu B. Effects of variable composite attachment shapes in controlling upper molar distalization with aligners: a nonlinear finite element study. J Healthc Eng 2021 ; 2021 : 5557483 . Search in Google Scholar

10. Ferlias N, Dalstra M, Cornelis MA, Cattaneo PM. In vitro comparison of different Invisalign® and 3Shape® attachment shapes to control premolar rotation. Front Bioeng Biotechnol 2022;10: 840622. Ferlias N Dalstra M Cornelis MA Cattaneo PM. In vitro comparison of different Invisalign® and 3Shape® attachment shapes to control premolar rotation. Front Bioeng Biotechnol 2022 ; 10 : 840622 . Search in Google Scholar

11. Laohachaiaroon P, Samruajbenjakun B, Chaichanasiri E. Initial displacement and stress distribution of upper central incisor extrusion with clear aligners and various shapes of composite attachments using the finite element method. Dentistry J 2022;10:114. Laohachaiaroon P Samruajbenjakun B Chaichanasiri E. Initial displacement and stress distribution of upper central incisor extrusion with clear aligners and various shapes of composite attachments using the finite element method. Dentistry J 2022 ; 10 : 114 . Search in Google Scholar

12. Savignano R, Valentino R, Razionale AV, Michelotti A, Barone S, D’antò V, et al. Biomechanical effects of different auxiliary-aligner designs for the extrusion of an upper central incisor: a finite element analysis. 2019 [cited 2024 Mar 31]; Available from: https:// doi.org/10.1155/2019/9687127 Savignano R Valentino R Razionale AV Michelotti A Barone S D’antò V Biomechanical effects of different auxiliary-aligner designs for the extrusion of an upper central incisor: a finite element analysis. 2019 [cited 2024 Mar 31]; Available from: https://doi.org/10.1155/2019/9687127 Search in Google Scholar

13. Cortona A, Rossini G, Parrini S, Deregibus A, Castroflorio T. Clear aligner orthodontic therapy of rotated mandibular round-shaped teeth: a finite element study. Angle Orthod [Internet]. 2020; 90(2):247–54. Cortona A Rossini G Parrini S Deregibus A Castroflorio T. Clear aligner orthodontic therapy of rotated mandibular round-shaped teeth: a finite element study. Angle Orthod [Internet]. 2020 ; 90 ( 2 ): 247 – 54 . Search in Google Scholar

14. Costa R, Calheiros FC, Ballester RY, Gonçalves F. Effect of three different attachment designs in the extrusive forces generated by thermoplastic aligners in the maxillary central incisor. Dental Press J Orthod [Internet]. 2020; 25(3):46–53. Costa R Calheiros FC Ballester RY Gonçalves F. Effect of three different attachment designs in the extrusive forces generated by thermoplastic aligners in the maxillary central incisor. Dental Press J Orthod [Internet]. 2020 ; 25 ( 3 ): 46 – 53 . Search in Google Scholar

15. Papadimitriou A, Mousoulea S, Gkantidis N, Kloukos D. Clinical effectiveness of Invisalign® orthodontic treatment: a systematic review. Prog Orthod [Internet] 2018; 19(1):1–24. Papadimitriou A Mousoulea S Gkantidis N Kloukos D. Clinical effectiveness of Invisalign® orthodontic treatment: a systematic review. Prog Orthod [Internet] 2018 ; 19 ( 1 ): 1 – 24 . Search in Google Scholar

16. Dai FF, Xu TM, Shu G. Comparison of achieved and predicted tooth movement of maxillary first molars and central incisors: first premolar extraction treatment with Invisalign. Angle Orthod [Internet] 2019; 89(5):679–87. Dai FF Xu TM Shu G. Comparison of achieved and predicted tooth movement of maxillary first molars and central incisors: first premolar extraction treatment with Invisalign. Angle Orthod [Internet] 2019 ; 89 ( 5 ): 679 – 87 . Search in Google Scholar

17. Gomez JP, Peña FM, Martínez V, Giraldo DC, Cardona CI. Initial force systems during bodily tooth movement with plastic aligners and composite attachments: a three-dimensional finite element analysis. Angle Orthod [Internet] 2015; 85(3):454–60. Gomez JP Peña FM Martínez V Giraldo DC Cardona CI. Initial force systems during bodily tooth movement with plastic aligners and composite attachments: a three-dimensional finite element analysis. Angle Orthod [Internet] 2015 ; 85 ( 3 ): 454 – 60 . Search in Google Scholar

18. Rossini G, Schiaffino M, Parrini S, Sedran A, Deregibus A, Castroflorio T. Upper second molar distalization with clear aligners: a finite element study. Appl Sci 2020;10:7739. Rossini G Schiaffino M Parrini S Sedran A Deregibus A Castroflorio T. Upper second molar distalization with clear aligners: a finite element study. Appl Sci 2020 ; 10 : 7739 . Search in Google Scholar

19. Elshazly TM, Keilig L, Salvatori D, Chavanne P, Aldesoki M, Bourauel C. Effect of trimming line design and edge extension of orthodontic aligners on force transmission: An in vitro study. J Dent 2022;125:104276. Elshazly TM Keilig L Salvatori D Chavanne P Aldesoki M Bourauel C. Effect of trimming line design and edge extension of orthodontic aligners on force transmission: An in vitro study. J Dent 2022 ; 125 : 104276 . Search in Google Scholar

20. Ahmed T, Padmanabhan S, Pottipalli Sathyanarayana H. Effects of varying attachment positions on palatal displacement of maxillary incisors with clear aligner therapy: A three-dimensional finite element analysis. J Orofac Orthop [Internet] 2023; 84(3):178–88. Ahmed T Padmanabhan S Pottipalli Sathyanarayana H. Effects of varying attachment positions on palatal displacement of maxillary incisors with clear aligner therapy: A three-dimensional finite element analysis. J Orofac Orthop [Internet] 2023 ; 84 ( 3 ): 178 – 88 . Search in Google Scholar

21. Fan D, Liu H, Yuan CY, Wang SY, Wang PL. Effectiveness of the attachment position in molar intrusion with clear aligners: a finite element study. BMC Oral Health [Internet] 2024;22(1): 1–8. Fan D Liu H Yuan CY Wang SY Wang PL. Effectiveness of the attachment position in molar intrusion with clear aligners: a finite element study. BMC Oral Health [Internet] 2024 ; 22 ( 1 ): 1 – 8 . Search in Google Scholar

22. Yokoi Y, Arai A, Kawamura J, Uozumi T, Usui Y, Okafuji N. Effects of attachment of plastic aligner in closing of diastema of maxillary dentition by finite element method. J Healthc Eng. 2019;2019:1075097. Yokoi Y Arai A Kawamura J Uozumi T Usui Y Okafuji N. Effects of attachment of plastic aligner in closing of diastema of maxillary dentition by finite element method. J Healthc Eng. 2019 ; 2019 : 1075097 . Search in Google Scholar

23. Gazzani F, Bellisario D, Quadrini F, Parrinello F, Pavoni C, Cozza P, et al. Comparison between different composite resins used for clear aligner attachments: an in-vitro study. Front Mater 2022;8:789143. Gazzani F Bellisario D Quadrini F Parrinello F Pavoni C Cozza P Comparison between different composite resins used for clear aligner attachments: an in-vitro study. Front Mater 2022 ; 8 : 789143 . Search in Google Scholar

24. Zhou X, Huang X, Li M, Peng X, Wang S, Zhou X, et al. Development and status of resin composite as dental restorative materials. J Appl Polym Sci [Internet] 2019; 136(44):48180. Zhou X Huang X Li M Peng X Wang S Zhou X Development and status of resin composite as dental restorative materials. J Appl Polym Sci [Internet] 2019 ; 136 ( 44 ): 48180 . Search in Google Scholar

25. Ferracane JL. Resin composite—state of the art. Dental Mater 2011;27(1):29–38. Ferracane JL. Resin composite—state of the art. Dental Mater 2011 ; 27 ( 1 ): 29 – 38 . Search in Google Scholar

26. D’Antò V, Muraglie S, Castellano B, Candida E, Sfondrini MF, Scribante A, et al. Influence of dental composite viscosity in attachment reproduction: an experimental in vitro study. Materials (Basel) [Internet] 2019; 12(23):4001. D’Antò V Muraglie S Castellano B Candida E Sfondrini MF Scribante A Influence of dental composite viscosity in attachment reproduction: an experimental in vitro study. Materials (Basel) [Internet] 2019 ; 12 ( 23 ): 4001 . Search in Google Scholar

27. Chen W, Qian L, Qian Y, Zhang Z, Wen X. Comparative study of three composite materials in bonding attachments for clear aligners. Orthod Craniofac Res [Internet] 2021; 24(4):520–7. Chen W Qian L Qian Y Zhang Z Wen X. Comparative study of three composite materials in bonding attachments for clear aligners. Orthod Craniofac Res [Internet] 2021 ; 24 ( 4 ): 520 – 7 . Search in Google Scholar

28. Specifically formulated for aligner attachments GC Aligner ConnectTM Experts in Orthodontics Features • Optimal durability • Excellent aesthetics • High wear resistance • Stain-resistant • Superior handling • Light-cure bonding Bonding Protocol. [cited 2024 Mar 12]; Available from: http://www.gcorthodontics.eu Specifically formulated for aligner attachments GC Aligner ConnectTM Experts in Orthodontics Features • Optimal durability • Excellent aesthetics • High wear resistance • Stain-resistant • Superior handling • Light-cure bonding Bonding Protocol. [cited 2024 Mar 12]; Available from: http://www.gcorthodontics.eu Search in Google Scholar

29. TPH Spectra® ST universal composite for aligner attachments | Dentsply Sirona USA [Internet]. [cited 2024 Mar 12]. Available from: https://www.dentsplysirona.com/en-us/discover/discover-by-procedure/tph-spectra-st-for-suresmile-attachments.html TPH Spectra® ST universal composite for aligner attachments | Dentsply Sirona USA [Internet]. [cited 2024 Mar 12]. Available from: https://www.dentsplysirona.com/en-us/discover/discover-by-procedure/tph-spectra-st-for-suresmile-attachments.html Search in Google Scholar

30. Kircelli BH, Kilinc DD, Karaman A, Sadry S, Gonul EY, Gögen H. Comparison of the bond strength of five different composites used in the production of clear aligner attachments. J Stomatol Oral Maxillofac Surg 2023;124(6):101481. Kircelli BH Kilinc DD Karaman A Sadry S Gonul EY Gögen H. Comparison of the bond strength of five different composites used in the production of clear aligner attachments. J Stomatol Oral Maxillofac Surg 2023 ; 124 ( 6 ): 101481 . Search in Google Scholar