Aligner-Systeme in der Kieferorthopädie: ein aktueller Überblick

Zusammenfassung

Im kieferorthopädischen Alltag ist es keine Seltenheit mehr, dass die Patienten eine möglichst rasche und unkomplizierte, aber v. a. ästhetische Behandlung bevorzugen. Das ist zumindest der Wunsch des Patienten.

Daher wurden die Energien der letzten Jahre vermehrt auf die Entwicklung durchsichtiger Schienen zur Behandlung von Zahnfehlstellungen gelenkt, was zu einer Übersättigung des Marktes geführt hat. Bei Recherchen im Internet konnten im Jahre 2015 bereits 27 unterschiedliche Anbieter von Alignern gelistet werden.

Den Ursprung fanden die Aligner jedoch schon Jahre zuvor, beginnend mit dem Gedanken, kleine Zahnfehlstellungen wie rotierte Zähne oder geringe Engstände der Frontzähne zu beheben. Alle Schienen teilen als große Gemeinsamkeit, dass sie als durchsichtige, temperaturgeformte Plastikschiene den gesamten Zahnbogen umfassen, sonst können die Modelle der verschiedenen Anbieter allerdings sehr unterschiedlich ausfallen bzw. ausgestattet sein, entsprechend den Wünschen des behandelnden Arztes.

Auch heute gibt es noch Aligner-Systeme, welche sich explizit auf die Behandlung kleiner Zahnfehlstellungen und Irregularitäten spezialisiert haben, mit anderen Aligner-Systemen ist es jedoch möglich auch komplexe Zahnfehlstellungen zu behandeln.

Gerade um größere Zahnbewegungen durchführen zu können, werden von einigen Aligner-Systemen Attachments für die Behandlung geplant. Durch diese zahnfarbenen Knöpfchen, welche an der bukkalen Fläche des Zahnes angebracht werden, können Kräfte appliziert werden, die sonst nicht möglich wären.

Studien, welche die Wirkungsweise von Alignern allein oder den Vergleich mit fixen Apparaturen aufzeigen, wurden in der Literatur aufgrund fehlender Kontrollgruppen, fehlender Verblindung bzw. Randomisierung oder schlechter Methodik oft als mangelhaft beschrieben [1].

Abstract

In everyday orthodontic practice it is no longer uncommon for patients to prefer treatment that is as quick and uncomplicated as possible, but above all aesthetic. At least that is the patient’s idea.

Therefore, the energies of the last few years have increasingly been directed towards the development of transparent splints, so-called “clear aligners” for the treatment of misaligned teeth, which has led to an oversaturation of the market in recent years. When researching the internet, 27 different aligner providers were already listed in 2015.

However, aligners found their origin years earlier, starting with the idea of correcting minor forms of malocclusion, such as rotated teeth or small crowding of the front teeth. What all splints have in common is that they cover the entire dental arch as a clear, thermoformed plastic splint, but otherwise the models of the various providers can be very different equipped, according to the wishes of the attending dentist.

There are still some aligner systems who remain deliberately and explicitly specialized in the treatment of small tooth misalignments and irregularities whilst other aligner systems are able to target complex malocclusions. In order to carry out larger tooth movements, fixed attachments are planned on the buccal shelf of some teeth. Larger and more targeted forces can be applied to the tooth.

Studies that show a comparison of aligner systems with fixed appliances were unfortunately often described as inadequate due to a lack of control groups, a lack of blinding or randomization, or poor methodology.

Schlüsselwörter

Clear Aligner - kieferorthopädische Behandlung - Ästhetik - Invisalign

Key words

Clear Aligners - orthodontic treatment - aesthetics - Invisalign

Publication History

Article published online:
08 December 2021

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