Invisalign Clear Aligners İstanbul

Scientific editor and clinical lead: Prof. Dr. Mehmet Oğuz Öztoprak – Specialist in Orthodontics and Dentofacial Orthopedics
Last updated: 23 July 2026

Clear aligner treatment is a treatment method that uses custom-made, removable and transparent orthodontic aligners to move the teeth gradually in previously planned directions.

Invisalign is one of the systems used in clear aligner treatment and one of the commercial brands known worldwide. However, the name Invisalign and clear aligner treatment are not the same concept. While Invisalign refers to a specific production and planning system, clear aligner treatment is a general orthodontic method that can be applied with different manufacturers.

The success of the treatment is not determined only by the aligner brand. Correct orthodontic diagnosis, the evaluation of root and bone borders, the adjustment of the digital plan by the dentist, the selection of suitable attachments and auxiliary mechanics, the patient using the aligners for enough time and the post-treatment retention process are all important together.

Clear aligners are not just aesthetic appliances that make the front teeth look straight. In suitable cases:

• Tooth crowding,
• Gaps between the teeth,
• Deep bite,
• Open bite,
• Crossbite,
• The forward or backward inclination of the teeth,
• Some jaw constrictions,
• Midline differences,
• Post-treatment relapse

can be addressed as part of the orthodontic plan.

Nevertheless, not every tooth movement is equally predictable. In particular, marked rotations, extrusion, root movements, advanced skeletal jaw disorders and serious bite problems may require additional attachments, elastics, mini-screws, partial fixed mechanics or surgery. It should not be assumed that the movements of clear aligners planned in a digital environment will be realized exactly in the real oral environment. There are systematic evaluations showing that some movements can be realized at a lower rate than planned.

At Dentapolitan, clear aligner treatment is planned not merely as ordering aligners, but as an orthodontic treatment process in which the facial, jaw, dental, root, bone, occlusion, airway, gum and jaw joint findings are, when needed, evaluated together.

What is Invisalign?

Invisalign is an orthodontic treatment system applied with a series of transparent and removable aligners custom-made for the patient’s teeth.

Each aligner performs part of the limited movements determined in the digital treatment plan. The patient moves to the next aligner according to the change schedule recommended by the dentist. Thus, the teeth are moved not all at once, but in controlled stages.

Within the Invisalign system, the following elements can be used depending on the treatment:

• Clear aligners
• Tooth-coloured attachments
• Elastics
• Special force areas on the aligner
• Bite supports called bite ramps
• Precision cuts for elastics
• Interdental adjustment
• Temporary tooth images called pontics
• Mandibular advancement features
• End-of-treatment retention aligners

Therefore, Invisalign treatment does not always consist only of flat aligners without attachments.

How does clear aligner treatment work?

Orthodontic tooth movement occurs by applying force of suitable intensity and direction to the teeth. This force creates biological remodelling in the periodontal ligament and bone tissue surrounding the tooth.

A clear aligner grips the tooth surface and applies force in the planned direction of movement. However, for the aligner to be able to push or rotate a tooth, it must create enough retention and a force couple.

For this reason, attachments are placed on some teeth. In some cases, additional force sources such as elastics or mini-screws are used.

In the treatment plan, it is not enough for only the tooth crowns to look straight on the screen. The following must also be evaluated:

• The position of the tooth roots
• The bone borders
• The inclinations of the teeth
• The contact between the teeth
• The occlusion of the lower and upper teeth
• Jaw movements
• The gum level
• The sequence of tooth movement
• The anchorage requirement

Are a clear aligner and Invisalign the same thing?

No.

Clear aligner treatment is the general orthodontic method carried out with removable transparent aligners.

Invisalign is one of the commercial systems using this method.

Different clear aligner systems can differ in the following respects:

• The material used
• The digital planning software
• The aligner production method
• Attachment options
• Child and adolescent treatment features
• The scope of the treatment packages
• Additional aligner or refinement conditions
• The dentist control system
• Manufacturer support

However, the most expensive or best-known brand cannot correctly treat a misdiagnosed case. The main determinant of the treatment is the orthodontic diagnosis and the biomechanical plan created by the dentist.

In which situations can clear aligner treatment be applied?

Clear aligner treatment can be considered in the following problems:

• Mild, moderate or selected advanced crowding
• Gaps between the teeth
• Front teeth inclined forward
• Front teeth inclined backward
• Deep bite
• Open bite
• Single-tooth or segment crossbites
• Some posterior-region crossbites
• Midline differences
• Closure of extraction spaces
• Distalization of molars
• Intrusion or extrusion movements of the teeth
• Relapse after previous orthodontic treatment
• Preparation of the teeth before an implant or prosthesis
• Orthodontic adjustment before and after orthognathic surgery
• Eruption and space management in children
• Selected orthodontic problems during growth in adolescents

The area of use of clear aligners has expanded over the years. However, the treatment being applicable does not mean that every case can be solved only with aligners and without additional auxiliary mechanics.

Is Invisalign only used in mild cases?

No. Clear aligners are not used only for mild front-tooth crowding.

With experienced orthodontic planning, they can also be used in more comprehensive cases. However, as the case becomes more complex, the need for the following applications can increase:

• More attachments
• Elastics
• IPR
• Tooth extraction
• Mini-screws
• Partial fixed brackets
• Phased treatment
• Additional scanning and refinement
• Jaw surgery

Some complex movements can be more efficient or more predictable with fixed orthodontic mechanics. The choice of treatment method should be made not only according to the patient’s request of “I don’t want braces”, but according to the biological and mechanical requirements.

Who can clear aligners be applied to?

Treatment can be applied to children, adolescents, adults and suitable older patients.

Age alone is not decisive. The health status of the teeth and supporting tissues, growth potential, the orthodontic problem and the patient’s compliance with aligner use should be evaluated.

Clear aligners in children

In children in the mixed dentition period, with selected systems the following can be planned:

• Creating space for tooth eruption,
• Managing crowding,
• Some arch expansion movements,
• Correction of anterior crossbites,
• Guidance of erupting permanent teeth.

However, in children the regular use of the aligners requires family and child cooperation.

Clear aligners in adolescents

In adolescents, crowding, gap and bite problems can be treated. Some aligner systems can have indicators that help track the use time.

If there is a jaw-relationship disorder during growth, a treatment plan should be made not only for tooth alignment, but also for facial and jaw development.

Clear aligners in adults

In adults, they are often preferred because of the aesthetic advantage.

However, since gum recession, bone loss, missing teeth, implants, old veneers, jaw joint complaints and tooth wear can be seen more frequently in adult patients, the planning can be multidisciplinary.

Who may clear aligner treatment not be suitable for?

In the following situations, treatment may be postponed, a different method may be chosen or additional applications may be needed:

• Active and uncontrolled gum disease
• Advanced bone loss
• Untreated decay
• Very insufficient oral hygiene
• The patient being unable to wear the aligners for enough time
• Constant loss of the aligners
• Advanced skeletal jaw disorder
• Facial and jaw problems requiring surgery
• Very complex root movements
• Some impacted teeth
• Uncontrolled jaw joint and muscle complaints
• Serious bruxism and aligner damage
• Unrealistic expectations of time and outcome

Some of these situations are not absolute contraindications. For example, a clear aligner can be applied after gum treatment or with auxiliary orthodontic mechanics.

What examinations are done before clear aligner treatment?

Treatment should not be planned only with a digital intraoral scan.

In a comprehensive orthodontic evaluation, the following can be examined:

• The patient’s main complaint
• Medical and dental history
• The frontal and profile appearance of the face
• The position of the lips
• The relationship of the lower and upper jaw
• The smile line
• The alignment of the teeth
• The number and eruption status of the teeth
• The amount of crowding or spacing
• The occlusion of the lower and upper teeth
• Gum and bone health
• The jaw joint and chewing muscles
• Clenching and wear findings
• Mouth breathing and tongue position
• Previous orthodontic treatments
• The patient’s capacity to wear aligners

When necessary, panoramic radiography, cephalometric radiography, intraoral radiographs, three-dimensional imaging, digital intraoral scanning, photographic records and jaw movement/occlusion records can be used.

Not all radiographs should be taken for every patient. The imaging method should be selected according to the clinical requirement.

What is iTero digital intraoral scanning?

iTero is one of the intraoral scanning systems used to take a three-dimensional digital record of the teeth and intraoral tissues.

Digital scanning can reduce the need for conventional impression material, create a three-dimensional model of the teeth, provide data for treatment planning, facilitate the comparison of changes during treatment and be used in the production of aligners and retainers.

However, a digital scanner does not make a diagnosis on its own and does not determine the treatment plan. Roots, bone borders, jaw relationships and biological risks cannot be evaluated only with a surface scan.

What is ClinCheck?

ClinCheck is the software in the Invisalign system in which tooth movements are digitally planned and displayed in stages.

In this system, the target positions of the teeth, the sequence of movement, the number of aligners, attachments, IPR amounts, elastic use and bite targets can be planned.

The first automatic plan on the screen should not be accepted as the final treatment plan. The orthodontist should adjust the plan according to the clinical goals and, when necessary, send a revision request to the manufacturer.

Does the digital simulation guarantee the treatment result?

No.

The digital image shows the planned movements. The real tooth movement, however, is affected by the following factors:

• The patient’s aligner use time
• Root and bone structure
• Age
• Periodontal health
• The type of tooth movement
• Attachment design
• Aligner fit
• Biological response
• Compliance with elastic use
• Changing the aligners on time

In particular, rotation, extrusion, root torque and some vertical movements can occur differently than planned. For this reason, clinical check-ups and, when necessary, additional scanning are done during treatment.

Instead of “how the teeth will definitely look at the end of treatment is shown on the first day”, it should be said “the targeted tooth movements and the possible end-of-treatment appearance can be planned digitally”.

What is an attachment?

Attachments are small tooth-coloured composite protrusions temporarily applied to the tooth surface.

Their purposes can be to help the aligner grip the tooth better, create rotation, intrude or extrude the tooth, help root movement, provide anchorage and prevent the aligner from coming off.

The shape, number and position of the attachments vary according to the patient. Especially on front teeth, they can be noticed in certain light conditions.

At the end of treatment, the attachments are removed and the tooth surface is polished. Despite the use of correct technique, temporary roughness or a colour difference can occur on the surface.

What is IPR?

IPR is the controlled removal of a very limited amount of enamel tissue from the contact surfaces of the teeth.

It can be used to create space for crowding, balance the shapes of the teeth, reduce the black triangle appearance, adjust the size harmony of the lower and upper teeth and allow the teeth to move in a more controlled way.

IPR is not the random filing of teeth. Its amount must be determined according to the digital and clinical plan.

When done within suitable limits, it can be a controlled orthodontic procedure. However, removing more enamel than necessary can create sensitivity, loss of contact or an anatomical shape disorder.

Are teeth extracted in clear aligner treatment?

In some patients, treatment without extraction is possible. In some patients, tooth extraction may be needed because of advanced crowding, the teeth being too far forward, the lips not being able to close, root and bone borders, the facial profile and the bite targets.

The use of clear aligners does not mean that the treatment will necessarily be done without extraction.

The extraction decision should be made not only according to the amount of space in the mouth, but according to the face, profile, roots, bone structure and long-term stability.

Can the jaw be expanded with a clear aligner?

With aligners, expansion in the dental arch can be achieved in some patients. However, “expansion” covers different mechanisms: outward tipping of the tooth crowns, bodily movement of the teeth, adjustment of the arch shape, dentoalveolar changes during growth in children and skeletal palatal expansion.

In an adult patient, the arch expansion obtained with a clear aligner is not always a real skeletal upper-jaw expansion.

In advanced upper-jaw constriction, methods such as rapid maxillary expansion, mini-screw-supported expansion or surgically assisted expansion may be needed.

Can lower jaw retrusion be treated with a clear aligner?

In selected child and adolescent patients during growth, aligners with mandibular advancement features or different functional appliances can be used.

However, the effect of these treatments depends on the patient’s growth potential, the degree of jaw retrusion, compliance with use and the skeletal and dental components.

In adults, clear aligners do not grow the lower jawbone forward. They can adjust the position of the teeth and the bite relationship. In advanced skeletal retrusion, orthognathic surgery or different treatments may be needed.

Can open bite be treated with a clear aligner?

In suitable cases, open bite can be treated with clear aligners.

In planning, tongue position, mouth breathing, habits such as finger sucking, the height of the back teeth, the position of the front teeth and the skeletal jaw relationship should be evaluated.

Only extruding the front teeth does not always solve the underlying cause of open bite. Tongue and airway functions can affect the post-treatment stability.

Can deep bite be treated with a clear aligner?

Yes, in selected cases deep bite can be corrected.

In treatment, intrusion of the front teeth, vertical control of the back teeth, adjustment of the front-tooth inclinations, the use of bite ramps and lower/upper arch coordination can be planned.

However, the rate at which the planned front-tooth intrusion movement is realized varies according to the case. For this reason, clinical follow-up and, when necessary, refinement may be needed.

Do the tooth roots move with a clear aligner?

Yes. In orthodontic treatment, not only the visible tooth crowns but also the roots move.

However, root movements require correct attachments, sufficient counter-force, a suitable movement sequence and the evaluation of the bone borders.

In the digital model, only the crowns being aligned straight does not mean the roots are in the ideal position. Root control is important especially in extraction cases, in opening space before an implant and in advanced rotations.

How is clear aligner treatment done?

1. Orthodontic examination

The face, jaws, teeth, bite and oral health are evaluated. The patient’s main complaint and expectations are listened to.

2. Taking the records

A digital intraoral scan, photographs and necessary radiographs are taken.

3. Determining the diagnosis and treatment goals

It is determined whether the problem is only tooth alignment or also includes jaw and facial relationships.

4. Digital treatment plan

Tooth movements, attachments, IPR, elastics and treatment stages are planned.

5. Adjustment of the plan by the dentist

The automatic suggestion of the software is changed according to the clinical goals. Root positions, bone borders, bite and stability are evaluated.

6. Production of the aligners

A custom aligner series is prepared according to the approved plan.

7. Application of attachments and auxiliaries

Attachments are placed on the necessary teeth. If IPR or elastic use was planned, it is applied at the relevant stage.

8. Use of the aligners

The patient wears each aligner for the time determined by the dentist. The change interval does not have to be the same for every patient.

9. Clinical check-ups

The fit of the aligners to the teeth, the realization of the movements, gum health and patient compliance are evaluated.

10. Additional scanning and refinement

If the planned movements are not complete or the bite needs detailed adjustment, a new scan is taken and additional aligners can be prepared.

11. Retention

After the active treatment is completed, a retainer is applied to maintain the new positions of the teeth.

How many hours a day should the aligners be worn?

In most full-time clear aligner treatments, the aligners are required to be worn for approximately 20–22 hours.

The aligners are usually removed while eating, while drinking beverages other than water, while brushing the teeth and while using dental floss. However, the dentist may recommend a different protocol.

Insufficient use can lead to the aligner not fitting the teeth fully, the tooth movements falling behind, being unable to move to the next aligner, the treatment lengthening, the need for additional aligners and the treatment goals not being fully realized.

If the patient cannot use the aligners regularly, fixed orthodontic treatment may be more suitable.

How many days is each aligner worn?

The aligner change interval can vary according to the patient and the treatment stage. Common schedules are 7-, 10- or 14-day change intervals.

The factors affecting the change time: the patient’s age, the type of tooth movement, the aligner use time, the periodontal condition, the fit of the aligner, elastic use and the treatment plan.

Aligners should not be changed more quickly without the dentist’s approval.

Are chewies used in clear aligner treatment?

Chewies or similar seating aids can help the aligner seat better on the teeth and attachments.

However, a chewie does not replace insufficient aligner use, does not correct an incorrectly produced or ill-fitting aligner and does not eliminate the need for dentist control. Excessive or incorrect use can cause fatigue in the jaw muscles.

What should be done if the aligner does not fit the tooth fully?

Areas where the aligner stays away from the tooth or marked gaps can indicate a loss of tracking.

Possible causes: insufficient use, moving to the aligner change early, attachment loss, the planned movement not being realized, deformation of the aligner, a production or fit problem.

The patient should contact the orthodontic team instead of moving to the next aligner on their own.

What is refinement?

Refinement is the preparation of additional aligners by taking a new digital scan after the first aligner series is completed.

It may be needed for the following reasons: some tooth movements remaining incomplete, detailed adjustment of the bite, incomplete rotation, correction of the midline, evaluation of the patient’s aesthetic expectation and a loss of tracking due to aligner use.

Refinement does not mean the treatment has failed. In clear aligner treatment, the plan may need to be updated according to the biological response.

However, it should not be assumed that unlimited additional aligners will be made. The scope of the treatment package and the conditions for additional aligners should be explained at the start.

How long does clear aligner treatment take?

A fixed interval of 3, 6, 12 or 18 months valid for everyone cannot be given for the treatment time.

The factors affecting the time: the type and severity of the problem, the number of jaws to be treated, the extraction requirement, the tooth movements to be done, the patient’s age, bone and gum health, compliance with aligner use, elastic use, broken or lost aligners, the need for refinement and the detailed adjustment of the bite.

While a mild relapse can be treated in a few months, cases involving extraction, jaw relationship or comprehensive bite correction can take longer.

The treatment time should not be finalized by looking only at the initial number of aligners.

Do clear aligners cause pain?

When each new aligner is put in, pressure, sensitivity or a feeling of tightness can be felt in the teeth.

This discomfort is usually more marked in the first days. However, severe pain, intense pain in a single tooth, the aligner edge cutting the tissue, excessive movement in a tooth or a marked worsening in the jaw joint should not be considered normal and should be evaluated.

There are studies reporting that clear aligners can cause less discomfort in the early period than fixed orthodontic appliances; however, they cannot be said to be painless.

Do clear aligners affect speech?

When the aligners are first put in, a temporary difference can occur especially in the “s”, “sh” and “z” sounds.

Most patients adapt within a few days. However, the aligner thickness, the coverage of the palate region, the patient’s speech habits and professional voice use can affect the adaptation time.

It can be useful for patients who are announcers, teachers, singers or who give intensive presentations to evaluate this situation before treatment.

Can food be eaten with aligners?

Most clear aligners should be removed while eating.

Eating with an aligner can cause the aligner to crack, become deformed, stain and food to become trapped under the aligner.

Except in some special protocols, the patient should consume food and drinks other than water with the aligners removed.

Can coffee or tea be drunk with aligners?

Consuming hot or coloured beverages while the aligner is in is not recommended.

Hot beverages can affect the shape of the aligner. Coffee, tea, red wine and similar beverages can cause staining. Sugary or acidic beverages staying under the aligner for a long time can increase the risk of decay and enamel erosion.

How are clear aligners cleaned?

The aligners should be rinsed with lukewarm or cold water, cleaned gently with a soft brush, cleaned with the aligner-cleaning products recommended by the dentist, not put in hot water and not scratched with hard and abrasive pastes.

When the aligner is removed, it should not be left in the open but stored in its box. Cleaning only the aligner is not enough. The teeth and interdental spaces should also be cleaned before the aligner is put back in.

Do clear aligners cause decay?

A clear aligner does not directly cause decay. However, sugary, acidic liquids and dental plaque staying under the aligner for a long time can increase the risk of decay.

The risk rises in the following situations: consuming sugary drinks with the aligner, putting the aligner back in without brushing the teeth, dry mouth, frequent snacking, insufficient fluoride use and an already high decay risk.

Being removable can facilitate oral care; but good oral hygiene does not happen by itself. Recent systematic evaluations report that periodontal indicators in clear aligners can be better than fixed appliances, but it is emphasized that this advantage depends on patient compliance and that part of the current evidence is of low certainty.

Does a clear aligner harm the gums?

Properly produced and clean aligners can mostly be used in harmony with the gums.

However, a sharp aligner edge, insufficient hygiene, gum disease, excessive force, movement of the tooth outside the bone border, uncontrolled IPR and an existing thin gum structure can affect the risk of gum recession or irritation.

Periodontal risk should be evaluated before treatment.

Does a clear aligner cause root resorption?

There is a risk of root resorption in all orthodontic tooth movements. Clear aligners are not completely free of this risk.

The factors affecting the risk: genetic predisposition, the previous root shape, the treatment time, the amount of movement, the applied force, previous trauma and having had previous orthodontic treatment.

In patients who need it, radiological follow-up can be done during treatment.

Do clear aligners make the teeth loose?

During orthodontic treatment, physiological mobility can increase in the teeth. This is related to the remodelling of the tissues around the tooth.

However, if there is excessive mobility, pain, gum inflammation, bone loss or a traumatic bite, an evaluation is needed.

Does a clear aligner correct the jaw joint?

Clear aligner treatment can help adjust the teeth and the bite. However, it cannot be said to definitively treat jaw joint diseases.

Jaw joint complaints can be related to many factors such as disc disorder, muscle pain, bruxism, trauma, degenerative change and the head-neck system.

Before clear aligner treatment is planned, if there is active joint pain, limitation in mouth opening or locking, a separate evaluation should be made. No generalization should be made that orthodontic treatment corrects or disrupts every TMJ disease.

Does a clear aligner treat clenching?

Clear aligners can create a protective interface over the teeth; but they do not treat the underlying cause of bruxism.

Some patients can clench or wear down the aligners. Severe bruxism can cause the aligners to crack, the attachments to break, jaw muscle fatigue and the movements to change.

During treatment, bruxism, sleep, airway, stress and jaw joint findings should be evaluated separately when necessary.

Invisalign or braces?

Both methods create orthodontic tooth movement. Neither can be said to be superior to the other in every case.

Advantages of clear aligners

• Can be less visible.
• Can be removed while eating.
• Brushing and floss use can be easier.
• Bracket- and wire-related emergencies are fewer.
• A digital movement plan can be created.
• Check-ups can be planned less frequently in some patients.

Limitations of clear aligners

• Highly dependent on patient compliance.
• Attachments can be visible.
• There is a risk of the aligners being lost or broken.
• Some movements can require more refinement.
• Treatment is disrupted in patients who frequently remove the aligners.
• Auxiliary mechanics may be needed in complex cases.

Advantages of fixed braces

• Cannot be removed by the patient.
• There is no compliance problem with use time.
• Can provide direct mechanical control in some complex movements.
• Can be more efficient in some cases.

Limitations of fixed braces

• Can be more visible.
• Oral hygiene requires more attention.
• Bracket- and wire-related irritation or breakage can occur.
• Certain food restrictions are required.

The treatment method should be chosen according to the case type, the patient’s life, hygiene, compliance and the orthodontist’s biomechanical goals.

How often are check-ups done in clear aligner treatment?

The check-up frequency varies according to the patient.

Usually, at check-ups the fit of the aligners, the condition of the attachments, the tracking of movements, elastic use, the IPR requirement, gum health, oral hygiene and the bite are evaluated.

Remote monitoring systems can support some check-ups; but they do not completely replace a clinical examination.

Can patients from another city or abroad have Invisalign?

In suitable cases, the check-up program can be arranged according to the patient’s travel conditions.

However, in situations such as attachment application, IPR, elastic cuts, the aligner not fitting, attachment loss, a gum problem, pain, additional scanning and end-of-treatment evaluation, a face-to-face check-up may be needed.

Delivering all the aligners at the start to patients coming from abroad is not always correct. The check-up and emergency plan should be determined in advance.

Can a filling or root canal treatment be done during treatment?

The necessary oral health procedures should be completed before treatment.

An emergency filling or root canal treatment can be done during treatment; but if the shape of the tooth changes, the existing aligners may not fit fully. A new scan or aligner adjustment may be needed.

Can Invisalign be done for patients with veneers or implants?

In suitable cases, it can be done.

However, implants do not move orthodontically; bonding an attachment to veneers may require a different surface treatment; bridges limit the independent movement of the connected teeth; missing-tooth areas should be arranged according to the prosthesis plan.

Clear aligner treatment can be applied before an implant to make the roots and the space ideal.

What should be done if the aligner is lost during treatment?

The patient should contact the dentist team. Depending on the situation, it may be necessary to go back to the previous aligner, move to the next aligner or order a new aligner.

Which option is applied is determined according to the treatment stage and the condition of the teeth.

What should be done if the aligner breaks?

In small cracks, the aligner can be used temporarily; but if the crack grows or the aligner does not grip the tooth, it may need to be replaced. A broken aligner should not be used by cutting it or gluing it at home.

Does treatment stop if an attachment falls off?

Every attachment loss does not affect the treatment to the same extent. The function of the attachment and the treatment stage are important. The patient should inform the clinic without waiting for the check-up. Some attachments need to be renewed in a short time.

What happens after Invisalign treatment ends?

After the active tooth movement is completed, the attachments are removed, the tooth surfaces are polished, the bite is evaluated, the necessary small corrections are made, a new digital scan or impression is taken and a retainer is prepared.

Treatment is not considered finished with the last active aligner. Retention is a mandatory part of orthodontic treatment.

What is a retainer?

A retainer is the retention appliance used after active orthodontic treatment to maintain the new positions of the teeth.

Its types can be a transparent removable retainer, a fixed lingual retainer, a Hawley-type appliance or the combined use of a fixed and a removable appliance.

The official patient information of Invisalign also states that a retainer should be used after active treatment to maintain the position of the teeth.

How long is a retainer used?

Since the teeth have a tendency to move throughout life, retention should not be seen as a short-term formality.

The use program can vary according to the patient: full-time in the first period, night use afterwards, and continuous night use in the long term can be recommended.

Using a fixed retainer does not mean that a removable aligner will never be needed.

Do the teeth become disordered again after treatment?

Yes, if a retainer is not used or there is a change in the supporting tissues, the teeth can move.

The factors affecting the relapse risk: the initial problem, tooth rotations, gaps, growth and aging, the gum and bone structure, tongue and lip forces, general age-related changes and retainer use.

A retainer reduces the relapse risk but does not guarantee that the teeth will never move forever.

What are the advantages of clear aligner treatment?

In suitable patients, the main advantages are:

• Aesthetic appearance
• Being removable
• Fewer food restrictions
• Easier application of brushing and floss
• Digital treatment plan
• Being an alternative in patients with a metal allergy
• Ease of use in sports and social life
• The absence of bracket- and wire-related injuries
• The different stages of the treatment being trackable digitally
• The possibility of less frequent face-to-face check-ups in selected patients

Nevertheless, the advantages depend on regular use of the aligners and maintaining hygiene.

What are the risks and limitations of clear aligner treatment?

The possible risks are:

• Sensitivity and pain in the teeth
• Irritation related to the aligner edge
• Temporary speech change
• The attachments being visible
• Attachment loss
• Loss or breakage of the aligner
• Gum inflammation
• Decay and white lesion risk
• Gum recession
• Root resorption
• Temporary mobility in the teeth
• The planned movements remaining incomplete
• The need for additional aligners
• The treatment lengthening
• The bite not fitting fully
• Black triangle appearance
• Jaw muscle or joint complaints
• Relapse when a retainer is not used
• Effect on tooth vitality in rare cases

Clear aligner treatment is not risk-free because it is aesthetic and digital.

Why does a black triangle occur?

When crowded teeth are straightened, previously invisible triangle-shaped gum spaces can appear.

The risk can increase in the following situations: a triangular tooth shape, gum recession, bone loss, advanced age, the teeth initially overlapping and the contact point being far from the gum.

In treatment, IPR, bonding or periodontal options can be evaluated. However, not every black triangle can be completely closed.

Why does the price of clear aligner treatment vary?

The treatment fee is not determined only by the number of aligners.

The factors that can affect the price: the complexity of the orthodontic problem, single- or double-jaw treatment, the clear aligner system used, the scope of the treatment package, the estimated number of aligners, the attachment and elastic requirement, the extraction or mini-screw plan, the scope of refinement, the treatment time, the number of check-ups, the retainer type, preventive and additional dental procedures and child/adolescent/adult treatment.

The “pay as many aligners as there are” approach is not always correct. The real value is the diagnosis, the digital biomechanical planning, the clinical applications, the follow-up, the refinements and the retention process.

Why can Invisalign be priced differently?

In Invisalign treatment, the manufacturer can have different case scopes and packages.

The price can be affected by a mild or comprehensive treatment package, the additional aligner entitlement offered by the manufacturer, the treatment time, child or adolescent treatment features, whether a retainer is included and the scope of the dentist’s follow-up and planning.

When comparing the starting price, the following questions should be asked: Are the orthodontic records included? Is refinement included? For how many years can additional aligners be obtained? Is a retainer included? Are lost aligners charged? Are mini-screws or other auxiliary procedures included? Is the treatment planned by the dentist? How often will the check-ups be done?

An orthodontic-diagnosis and biomechanical-planning-focused clear aligner approach

In clear aligner treatment, the aim is not only for the front teeth to be aligned straight on the screen.

In a successful treatment, the facial and jaw relationships are evaluated; not only the crowns of the teeth but their roots and bone borders are examined; the bite targets of the lower and upper teeth are determined; the necessary attachments, IPR, elastics and auxiliary mechanics are planned; the digital simulation is adjusted biomechanically by the dentist; the real tooth movement is tracked with clinical check-ups; additional aligners and refinement are applied if needed; long-term retention is planned after treatment.

A clear aligner is not an automatic system that works independently of the dentist doing the treatment. Even if the same digital software and the same aligner brand are used, the diagnosis, the treatment goal and the clinical follow-up can create different results. If there is an aesthetic expectation after orthodontics, options such as teeth whitening, laminate veneers or aesthetic dentistry can be planned separately after the orthodontic treatment is completed.

At Dentapolitan, clear aligner treatments are carried out on the basis of orthodontic diagnosis and biomechanical planning; child, adolescent and adult patients are evaluated separately, the treatment plan is not left to the automatic software suggestion, and a personalized retention program is created at the end of treatment. Dentapolitan serves in Istanbul through its clinics in Bostancı, Ümraniye and Pendik.

This content has been prepared for general health information purposes. It does not replace an examination, diagnosis or a personalised orthodontic treatment plan.