Book review

Moving teeth with aligners is not new and has been used in various forms for decades. However, relatively recent developments have created systems that can now rival fixed appliances in their application. With a big increase in the number of aligner treatments now being witnessed, this text is a timely publication.

Although this book is entitled Aligner Orthodontics it almost exclusively relates to the Invisalign and does not describe other aligner systems. It is written by two well-known Invisalign providers based in Cologne, Germany who work in the same practice.

It is divided into five sections: diagnostics, biomechanics, treatment planning treatment, treatment of different malocclusions with aligners and the advantages of the Invisalign system. The first section relates to diagnosis and, as is often the case with this topic, is a marmite of a chapter (you will love it or hate it). It is detailed and with great emphasis placed on examination of the TMJ. This involves some interesting techniques, such as acupuncture of the earlobe to determine centric occlusion, and a ‘Prien adduction test’ where the patient lies in a supine position and the pelvis is manually fixed before manipulation of the thigh and knee. Clinicians in the UK may wish to consult their dental indemnifiers before considering such an examination. The second chapter on biomechanics of Invisalign is a brief but interesting contribution from John Morton, a well-respected biomechanical engineer working with Invisalign. The main section of the book relates to treatment of different malocclusions with Invisalign. This is very well illustrated with excellent clinical photographs and shows a number of cases treated to a high standard. The authors present interesting ideas and are to be complimented on the variety, complexity and quality demonstrated. My only gripe was that a large number of cases were treated for ‘craniomandibular disorders’, when there is little (if any) evidence that orthodontics cures or creates conditions such as this. They also use nebulous comments and terms such as ‘many patients with a class III relationship also have a tongue dysfunction…’ and ‘… craniomandibular disorder with headache and cervical spine syndrome’. The concluding chapter covers the advantages of the Invisalign system, including removal of the appliance for tooth cleaning, reduced risk of decalcification, fewer unscheduled visits, etc. Interestingly, it does not include the aesthetic advantage which must be one of the main reasons patients choose aligners over fixed appliances.