Factors Affecting Attachment Loss in Clear Aligner Treatment

Bezmialem Vakif University

Status: Completed

Conditions: Crowded Teeth; Attachment; Malocclusion

Treatments: Device: Clear Aligners with Composite Attachments

Study type: Interventional

Funder types: Other

Identifiers

NCT07352644

2022/19

Details and patient eligibility

About

This prospective clinical study evaluated the incidence of composite attachment loss in patients undergoing clear aligner treatment and identified patient-, tooth-, and treatment-related factors associated with attachment debonding. Twenty-one patients were followed for six months, and attachment failures were recorded at routine visits. Outcomes were compared according to attachment type (conventional vs. optimized), attachment size, tooth type, dental arch, and patient-related factors.

Full description

Composite attachments are integral to clear aligner therapy for improving force delivery, retention, and control of complex tooth movements. Despite their biomechanical importance, attachment loss remains a common clinical challenge and may compromise treatment efficiency and predictability. In this prospective study, attachments were bonded following the manufacturer's protocol using a high-viscosity composite. Patients were followed for six months, and attachment failures were documented with respect to type, size, tooth position, and patient-related behaviors. The primary objective was to determine the incidence of attachment loss and to identify factors associated with debonding, thereby contributing to clinical strategies that may reduce attachment failure and enhance treatment outcomes.

Enrollment: 4 patients

Sex: All

Ages: 12+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

Permanent dentition. Mild to moderate crowding. No history of previous orthodontic treatment with fixed appliances or clear aligners

Exclusion criteria

Poor oral health. Bruxism. Crown restorations. Dental fluorosis. Enamel hypoplasia or other structural abnormalities affecting attachment bonding

Trial design

Primary purpose: Treatment

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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4 participants in 1 patient group

Clear Aligner Treatment

Experimental group

Description:

Participants received clear aligner therapy (Invisalign®) with composite attachments bonded according to the manufacturer's protocol. Both conventional and optimized attachment types were used as part of the planned orthodontic treatment, and attachment loss was prospectively evaluated over a 6-month follow-up period.

Treatment:

Device: Clear Aligners with Composite Attachments