Research Article| Volume 28, ISSUE 2, P45-52, June 2022

Essential factors in developing an efficient in-office aligner system

Published:October 26, 2022DOI:


      Aligner therapy has significantly changed from its inception in the 1970s. Mass produced CAD/CAM aligner fabrication process transformed aligner treatment in early years of the 2000s. Multiple aligner systems are available to treat patients with various complexity of care. Advances in digital software packages to move teeth along with access to user-friendly desktop 3D printers incentivized providers to revisit fabricating aligner in-office. Hence the outset of an in-office aligner (IOA) system. The components of an IOA system include all aspects of fabricating aligners, digital treatment planning, and delivery of the orthodontic care. Heterogeneity is currently one of the main attributes of an IOA system. Developing a standard protocol for an IOA system brings consistency to the orthodontic treatment outcomes with in-office aligners and allows assessment of treatment efficiencies with this aligner system. The first step to develop a standard protocol is to understand components of a system. This article reviews all components of an in-office aligner system. Additionally, the critical factors in each component are discussed in order to develop an efficient in-office aligner system.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Seminars in Orthodontics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Haouili N.
        • Kravitz N.D.
        • Vaid N.R.
        • Ferguson D.J.
        • Makki L.
        Has invisalign improved? A prospective follow-up study on the efficacy of tooth movement with invisalign.
        Am J Orthod Dentofac Orthop. 2020; 158: 420-425
        • Robertson L.
        • Kaur H.
        • Fernandes Fagundes N.C.
        • Romanyk D.
        • Major P.
        • Mir C.F.
        Effectiveness of clear aligner therapy for orthodontic treatment: a systematic review.
        Orthod Craniofac Res. 2020; 23: 133-142
        • Ercoli F.
        • Tepedino M.
        • Parziale V.
        • Luzi C.
        A comparative study of two different clear aligner systems.
        Prog Orthodont. 2014; 15: 31
      1. The global clear aligners market is projected to grow from $2.85 billion in 2021 to $10.04 billion in 2028 at a CAGR of 19.7% in forecast period, 2021-2028; Sep 2022.

        • Bowers L.N.
        • Ranpara A.C.
        • Roach K.A.
        • Knepp A.K.
        • Arnold E.D.
        • Stefaniak A.B.
        • Abbas Virji M.
        Comparison of product safety data sheet ingredient lists with skin irritants and sensitizers present in a convenience sample of light-curing resins used in additive manufacturing.
        Regul Toxicol Pharmacol RTP. 2022; 133105198
        • Tsolakis IA.
        • Gizani S.
        • Panayi N.
        • Antonopoulos G.
        • Tsolakis AI.
        Three-dimensional printing technology in orthodontics for dental models: a systematic review.
        Children (Basel). 2022; 9
      2. C. Li, Y. Chen, H. Pudleiner, K. Meyer, J. Nickel, and C. Pehlert. 2017. Multilayer dental appliances and related methods and systems. USPTO 9655691. US Patent, filed May 14, 2012, and issued May 23, 2017.

        • Kwon J.S.
        • Lee Y.K.
        • Lim B.S.
        • Lim Y.K.
        Force delivery properties of thermoplastic orthodontic materials.
        Am J Orthodont Dentofac Orthop. 2008; 133 (quiz 328.e1): 228-234
        • Gomez J.P.
        • Peña F.M.
        • Martínez V.
        • Giraldo D.C.
        • Cardona C.I.
        Initial force systems during bodily tooth movement with plastic aligners and composite attachments: a three-dimensional finite element analysis.
        Angle Orthodont. 2015; 85: 454-460
        • Hartshorne J.
        • Wertheimer M.
        Emerging insights and new developments in clear aligner therapy: A review of the literature.
        AJO-DO Clinical Companion. 2022; 2: 311-324