Sheena was seen for her second monitoring visit. She seems very compliant and reports that it “is a breeze” to wear the aligners. First I like to use magnifying loops to closely inspect each attachment for an intimate fit with the reservoir it should fit. Sheena’s attachment fit perfectly. Next, I like to evaluate that the patient is comfortable with aligner removal, so we will ask the patient to remove the aligners so that we may observe the movements and evaluate the contacts.

Sheena returned for her first monitoring visit all smiles and reported that she had not experienced any problems. She found the aligners easy to seat and easy to remove. No discomfort was reported during aligner wear, and in fact, she reported that it was as if there was “nothing in my mouth”. She loves the esthetics of Invisalign!

Let’s take a look at the attachment rationale for Sheena.

The following attachments were placed automatically according to Align’s standard protocols:

Generally, vertical attachments serve two purposes. First they provide retention for the aligner and second they aid in movement control for rotation. Close monitoring at each patient appointment is necessary for attachments, especially the rectangular option as unintended forces will be applied to the tooth, if the attachment “slips” out of the plastic reservoir of the aligner (Figure 1).

Let’s outline the basic steps to deliver Sheena’s Invisalign case, with a focus on the attachments!

1. As there were several attachments, first try in the aligner “template” to ensure an intimate fit to the teeth (see figure 1- We check the fit closely to be sure that the teeth fit intimately in the template. Check the occlusal of the attachment template to evaluate that there is no space between the teeth and the occlusal of the template).

Let’s review our initial treatment plan for Sheena: