What are refinement aligners?

Marlon Moldez, DMD, MS, MSc, PhD


Orthodontists create treatment sequences to align the teeth and correct the bite through software programs designed to fabricate a series of aligners through digital printing. According to a prospective follow-up study, aligners are programmed to exert a pushing force to align teeth with a mean accuracy rate of 50%. Therefore, orthodontists must incorporate refinement aligners to achieve 100% correction.

Patients undergoing aligner therapy must fully seat the aligners into the dental arch (by biting chewies) and faithfully wear the aligners 22 hours per day to achieve at least 50% correction. Tooth mobility is excessive, or tooth movement is incomplete if the patient switches to the next aligner too quickly (i.e., less than seven days). In addition, chronic clenching can result in the deformation of aligners, which, in turn, amplifies tooth alignment inaccuracies.


Like other orthodontic treatments, clear aligner therapy is a collaborative effort between the doctor and the patient. The doctor plans and supervises treatment, but the treatment outcome depends on patient performance. Excessive refinements may indicate poor patient compliance, persistent parafunctional oral habits, or inherent aligner inaccuracies.

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