Clear aligners with differentiated thickness and without attachments – A case report

BACKGROUND: Most clear aligner systems use straight or scalloped gingival margin aligners that are replaced weekly and that mainly use attachments to guide many movements. Yet in the literature some studies show the effectiveness of the aligner margin extended beyond the gingival margin, and divots instead of attachments and the biological advantage given by the use of aligners with differentiated thickness. MATERIAL AND METHODS: A female patient (23 years old) with a pronounced proclination of the upper and lower incisors and moderate crowding who was treated with aligners weekly replaced with differentiated thickness, divots, no attachments and a straight margin beyond the gingival margin. RESULTS: The therapy was carried out in 5 months and did not need any refinements. A total of 40 aligners were used (20 with soft thickness and 20 with hard thickness for each arch). CONCLUSIONS: Invisible aligners without attachments and with other therapeutic strategies such as divots and differentiated thickness are a valid alternative to traditional aligners that cannot be ignored. Key words:Orthodontics, clear aligners, appliances design.