Boston University
Clear aligners are thin, transparent plastic trays that straighten teeth gradually and are a popular, more discreet alternative to traditional braces. To help the traOptionalys grip and move the teeth, dentists usually bond small tooth-colored bumps, called "attachments," onto the front or back surfaces of the teeth. Although aligners work well for many types of tooth movement, they are much less reliable at turning (rotating) teeth that are twisted out of position, especially rounded teeth such as premolars and canines. Teeth often turn less than planned or tip and shift in unwanted directions. As a result, patients may need extra sets of aligners or a period of conventional braces, which takes away the main reason many people choose aligners. This study will evaluate the clinical performance of the proposed occlusal attachment designed by the investigators, quantifying rotational correction along with any unintended movements of the target and adjacent teeth. The study is not designed as a device trial of the aligner system, but as an evaluation of a modified attachment configuration within routine clear aligner treatment. The Primary Objective is to determine the degree of rotational correction that can be achieved in rotated canines and/or premolars using clear aligners with occlusal surface attachments. The Secondary Objective is to assess any unintended tooth movements, including buccolingual tipping, mesiodistal translation and vertical displacement.
Inclusion Criteria: * Adults aged between 22 and 35 years, at the start of their orthodontic treatment, with fully erupted permanent dentition. * Presence of at least one maxillary or mandibular canines and/or premolar with a clinically significant rotation (\>10o) that is considered suitable for correction with clear aligner therapy. * Mild to moderate crowding or spacing compatible with comprehensive clear aligner treatment, with no need for extractions. * Good general and oral health without any active periodontal disease or untreated caries, requiring urgent care. * Patient complaint to w…
Standard clear aligner therapy using a commercially available system (e.g., Invisalign or equivalent) in which at least one rotated canine or premolar per subject will receive a conventional attachment placed on the occlusal surface and be designated as the index tooth for outcome assessment. No experimental materials will be used; only the attachment position differs from standard practice, and the aligners themselves are FDA- cleared devices manufactured according to existing protocols.