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Writer's pictureDr. Niki Shah - Principal Educator

Your First Clear Aligner Cases

Updated: Feb 10

The most significant drawback with clear aligner treatment is also its biggest pro. Clear aligners are removable by the patient, providing them convenience and hygiene benefits… but they must be disciplined and wear them at all other times apart from eating, cleaning or a very important public meeting/speech. The first and most important step in assessing whether a patient is likely to be a good candidate for clear aligner treatment is to understand whether they have the discipline and commitment to follow the essential wear regimen. If the patient is not compliant to the prescribed wear time of 22 hours per day, the rest of this article regarding selecting complexity of malocclusions to treat, is redundant.


While aligners present a leap forward in treatment protocols and patient convenience, there are limitations to clear aligner treatment. Cases that require extensive tooth movement be it translational or rotational should be avoided. We advise to avoid bite correction cases or cases that may require root torque movements. Cases where teeth may have been extracted or crowding cases that require removal of teeth, we advise referring these cases to more experienced aligner clinicians or orthodontists.



As an up-and-coming Proligner provider it is prudent to walk to before you run by building your experience with simple cases. Some examples of candidates’ conditions that may be appropriate for a dentist to provide their initial clear aligner treatments to may be:

  • Minor anterior crowding or spaces

  • Orthodontic relapses

  • Single arch treatment with minor goals


Upon building your confidence with some successful simple cases, extend the complexity of malocclusions you treat have to moderate cases. Some examples are:

Proligner offers clear aligner day courses for dentists wanting to add clear aligner treatments to their treatment protocol skillsets. To add your interest in attending a course please let us know and we will keep you in the loop: Contact us.



Be aware of your limits when it comes to selecting patients for clear aligner treatment. Seek additional orthodontic and clear aligner education before taking on complex cases. While the use of clear aligner could potentially provide successful outcomes, before your skill comfortably matches the challenge, it is advised to refer candidates with the following complex conditions:

  • Short clinical crowns

  • Multiple missing teeth on a single arch

  • Dental prosthetics or implants

  • Un-erupted second molars

  • Poor oral hygiene

  • Active periodontal disease

  • Severe bruxism

  • Centric-relation and centric-occlusion discrepancies

  • Any complex type, method, or movement


To clearly identify a case’s complexity, please download the Movement Difficulty Classification Guidelines.


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