PEARLS:A Reimagined Button for Elastic Attachment to Clear Aligners

摘要

Although elastics can be attached to the brackets or archwires of fixed appliances, clear aligners require cuts to be made in the plastic, typically in the form of slits or windows. Initially, these cuts were placed by hand with scissors or hole punches. Some clinicians modified their ClinCheck setups so that the simulated gingival margins would mimic cutout windows. Align Technology began offering prefabricated Precision Cuts with its G3 release in 2010. Six options are currently available for elastic attachment: precut aligner hooks, stainless steel molar brackets, stainless steel lingual buttons, stainless steel Caplin hooks, composite resin buttons, and porcelain ceramic buttons. The precut aligner hooks are milled into the aligners at no additional cost and do not require additional chairtime for bonding. Their major disadvantage is that they can unseat the aligners from the teeth when heavier elastic forces are used. The plastic dovetail can also bend outward, potentially causing soft-tissue irritation or disengaging the elastic.