Welcome to the strange world of orthodontics. As a common man one hardly seems to know what is going on behind the scenes while our teeth are getting straightened either by metal braces or invisible braces (clear aligners as they are called). There are many options you can choose from while you decide to straighten your crooked teeth. You can go for metal braces, ceramic braces, lingual braces or invisible braces. If you are a teenager or a young adult, you might be slightly apprehensive to use metal braces for aesthetic reasons. Most young or older adults these days choose to opt for clear aligners as they don’t show. One such company which has been in the aligner market for the longest time is Invisalign (Invisalign Facts). They may be one of the oldest in this domain but to remain at the top of the spectrum they do make a lot of claims which if you see closely will reveal the truth behind them.
Invisalign Facts : Layers in the sheet-Really?
One such claim is the layering pattern on their aligners. The company claims that the layering pattern comes from the x number of layers on the sheet. Can someone apply some common sense here? A thermoforming blank may have a trillion layers or a galaxy of designs, but when you heat the blank upwards of 100 degrees centigrade, will any polymer retain that design? NEVER
It goes without saying that all such claims are nothing but marketing gimmicks to which people easily fall prey. Any pattern that is visible on a finished aligner is actually what gets transferred to the thermoforming blank (sheet) from the 3D printed model. The layering effect caused by the 3D printing technology on the dental model is transferred to the sheet during the process of thermoforming because heat and pressure transfer the pattern on the model to the sheet.
The layering pattern may seem attractive on the aligner but there is a downside to it. The more the layers on the 3D printed model, the lesser the accuracy of the 3D printing. Each layer on the 3D printed model denotes its printing precision. As research says that more precise the 3D printed model, higher the efficacy of the aligner.
It does make a lot of sense when we are incorporating movements of few hundred microns per aligner, that the 3D printed model be precise to the closest micron.
India being such a price sensitive market, who cares about quality and precision even if it is a medical device.
We do damn care about a heart stent because it poses a higher life risk but when it comes to teeth they never fall under emergency or life-threatening treatment category.
Companies like Invisalign are making a huge buck by fooling the common-sense lacking practitioners.
Why charge so much?
There are hundreds of aligner companies globally who are doing a good job by providing an effective treatment option. Invisalign is charging a premium for the same service and quality that the other companies are providing at a much reasonable price. It is all a marketing gimmick being practised by Invisalign to charge a hefty premium. Aligners are not a desifgner product which should have any exclusivity, rather it is a medical device meant for correction of dental malocclusions and should be well within the reach of each and every patient.
The Blue Dot and its truth
There are many issues that a treating doctor may have to face while treating a case with clear aligners. The largest concern dentists have to face is patient compliance as aligner is a removable device. It is extremely difficult to ensure and assess patient compliance. Although Invisalign aligners have a blue dot on the aligners which is for the purpose of assessing patient compliance. The blue marker fades away after 2 weeks if the patient has continuously worn the aligners for 22 hours each day. But this compliance indicator is not an objective indicator of patient compliance. This indicator can be tweaked by keeping the aligner in a warm water (35 – 55 degrees centigrade) for a few hours. The blue dot also loses its colour in a solution of acidic aerated soft drinks. Cleaning the aligners in a dishwasher using dishwasher cleaning tablets also makes the blue dot lose colour. Therefore, these compliance indicators are not at all objective in the true sense.
Aligner fitting, breakage and tracking issues
Patients using the Invisalign system also face fitting and tracking issues as any other aligner company. These issues are never brought forth by the company. There are breakages and uneven finishing issues also. All aligner systems are prone to all the above issues, but to think that Invisalign patients do not face any problems ever would be a farfetched statement.
Treatment plans made by technicians
When it comes to treatment planning, which is the key to a successful aligner treatment, Invisalign relies on trained technicians to plan their cases. Whereas orthodontic planning requires a lot of orthodontic knowledge and expertise to plan a case successfully. Lot of aligner companies rely on the expertise of orthodontists to plan the cases.
So we can finally conclude by saying that Invisalign Facts may be the largest aligner company today because they started 20 years ago and definitely have the first movers advantage but other aligner companies are also providing equally efficient treatment options at a much reasonable price. All is not true about Invisalign as it seems to be. Keep your senses intact before you fall prey to the marketing gimmicks of the bigwigs.