Why Many Commercial Aligner Protocols, Like Invisalign and Spark, Are Poorly Designed

Many orthodontic protocols designed for commercial brands like Invisalign or Spark may be poorly structured due to several key factors related to biomechanics, planning, and execution. Here are the main reasons based on technical and clinical information:

1. Lack of Detailed Biomechanical Analysis

   
   

   • Many orthodontists rely on generic 2D biomechanics approaches or outdated concepts such as the single center of resistance. In reality, 3D tooth movement is complex, involving force and couple moments, and depends on the interaction between forces and periodontal tissues​​​.

     
     

   • Without accurate force simulation, such as that provided by finite element analysis (FEA), movements like expansion, intrusion, or distalization may result in imprecise outcomes, such as unwanted crown tipping or excessive stress on the periodontal ligament​​​.

     
     

2. Inefficient Use of Attachments and Materials

   
   

   • Misplaced or poorly designed attachments lead to loss of control in complex movements. For example, root torque requires specific power ridges or rectangular attachments, while distalization needs rectangular beveled attachments to prevent tipping​​​.

     
     

   • Regarding materials, the elasticity and stiffness of the aligner do not always match the planned movement. For instance, a 0.6 mm PUR aligners may not provide sufficient force for certain movements without specific adjustments​​.

     
     

3. Errors in Planning Simultaneous Movements

   
   

   • Combined movements, such as posterior expansion and anterior protrusion, can lead to loss of tracking or bite imbalance if proper anchorage is not ensured.This becomes more challenging when automated tools are used without personalized adjustments in another specific softwares.

     
     

4. Limited Adaptation to the Patient’s Biological Needs

   
   

   • Cases with severe periodontitis or compromised bone require slower and more controlled movements (displacements of less than 0.1 mm per stage). However, generic protocols do not always adjust to these needs, increasing the risk of damage​​​.

     
     

5. Dependence on Standard Brand Protocols

   
   

   • Many commercial companies do not fully personalize treatments for individual clinical cases, resulting in reduced precision and predictability. Orthodontists who solely depend on these platforms do not always fine-tune the parameters in another specialized softwares.

     
     

Conclusion

To improve outcomes, a more rigorous and personalized approach is essential, using advanced tools such as FEA, tailored attachment designs, and materials optimized for specific biomechanical needs. Additionally, training in digital technologies and specialized software is key to reducing errors in planning and execution.

Furthermore, many orthodontists provide poor instructions to technicians, driven by their own ego, delegating treatment design entirely to them while issuing unrealistic orders. This approach often results in impractical and ineffective plans. Therefore, it is preferable for orthodontists to start designing and manufacturing their own aligners, allowing them to take full control of the treatment process and ensure better outcomes.