For information regarding engagers, refer to the following:
- What are Engagers (also known as Attachments)?
- Types of Engagers
- Engagers with ClearCorrect
- Protocols and Requesting Custom Engagers
What are Engagers (also known as Attachments)?
An engager is a small shape of composite material and is commonly placed on the tooth as part of clear aligner treatment to assist with certain tooth movements. Because some teeth are shaped or positioned in a way that can be difficult for an aligner to "grab" onto, small composite-resin bumps are placed onto the facial surfaces of the teeth so that the aligner has something to "engage" with.
ClearCorrect calls these shapes “engagers”, but they are also known as “attachments”. Whether to use, or not to use, engagers in a treatment plan is up to the clinician to decide.
Please refer to this article on how to properly place engagers.
Note on Engagers:
Engagers are an active area of research and development at ClearCorrect and elsewhere.
Many conceptual designs for engagers have been discussed in literature and professional forums, but when they are reduced to practice and the shape is thermoformed in the engager template, problems of adaptation and air gaps reduce the capability of many of these designs.
Without conclusive information and until the mentioned adaptation problems are resolved, ClearCorrect is happy to stick to simple horizontal and vertical engagers, in our available sizes and depths, which work well.
Types of Engagers
ClearCorrect offers two types of engagers in our treatment setups.
Generally used for:
Generally used for:
Engagers with ClearCorrect
The technician will suggest the shape, size and depth of each engager in the treatment setup, you do not need to specify unless you have a custom request.
When we send you a treatment setup, we are presenting our interpretation of your prescription and instructions for the course of treatment that you want to pursue for your patient—the recommendations shown are not absolute. It’s up to you to make any necessary changes to create a custom plan for treating each individual patient.
Engager preferences and timing can be discussed and adjusted according to what you want for your patient. Just let us know about your particular preferences when you submit your case or when approving the treatment setup.
A teal square on the treatment plan represents the addition of an engager.
On the treatment setup in ClearPilot™, if the engager is teal, it means it’s a new engager placement. If the engager is light teal, it means it’s a previously placed engager.
If you are submitting a case revision based on a prior step (not new impressions or scans), we’ll assume that the existing engagers are still on the teeth. You won’t receive a new engager template unless new engagers are needed.
Our default size for engagers is a 3-millimeter rectangular engager, beveled incisally in either a horizontal or vertical position.
To support teeth of different shapes and sizes (e.g., short clinical crowns, large incisors, etc.) you can select different size engagers; you can choose from 3 available sizes:
Our default depth for horizontal engagers is a 0.75 mm and 1.00 mm for vertical engagers, both beveled incisally.
To support user control of retentive/engagement forces you can select different depth engagers; you can choose from 2 available depths for each type of engager:
- Horizontal engagers: 0.75 mm and 1.00 mm
- Vertical engagers: 1.00 mm and 1.25 mm
What is the purpose of the engager beveling?
- To aid in the insertion of the aligner when engagers are present
- Inclined plane to allow more gradual insertion and removal vs “snap” fit
- Gentler forces
- Reduces need for aligner removal tool
ClearCorrect aligners are always beveled on the incisal edge, regardless of whether its a horizontal or vertical engager.
Protocols and Requesting Engagers
ClearCorrect's default protocols for Engagers:
- Horizontal and Vertical engagers are placed on the facial surface and at the center of the tooth, unless specified otherwise by the clinician.
- Engagers will not be placed near the gingival or incisal edge of the aligner, to ensure enough space to maintain aligner integrity.
- Horizontal engagers are placed on a tooth requiring more than 0.50 mm of extrusion.
- Horizontal engagers are placed on a tooth requiring more than 1.00 mm of intrusion.
- A vertical engager is placed for crown or root tipping requiring more than 25° of tipping of bicuspids, cuspids, or incisors.
- A vertical engager is placed on a tooth requiring more than 15° of rotation.
- Engagers will not automatically be placed on molars. If the clinician requests an engager on the molar, a horizontal engager will be placed unless specified otherwise.
- Engagers will not be placed on peg laterals, unless specifically requested by clinician.
- Engagers will not be placed on any type of prosthetic crown or implant.
- Engagers can be placed on the occlusal surface or a posterior tooth (posterior bite ramps or turbos) if requested by the clinician.
- Multiple engagers can be added to a tooth if requested by the clinician.
- Engagers will not be placed on the same teeth as cutouts unless specifically requested by the clinician.
ClearCorrect's default protocols for Engagers - Extreme Rotations:
(For highly rotated teeth - approximately 30°)
- Only one engager will be active at a time unless specifically requested to use two at a time by the clinician.
- If there is no room to place an engager, no engager will be placed until there is sufficient space on the facial surface to place the engager.
- Engager placement on any extensive rotation may be removed and replaced through the planned steps so as not to impact adjacent dentition.
- Engagers are not placed on the lingual surface unless specifically requested by the clinician.
ClearCorrect's default protocols for Engagers - Revisions:
- For revisions, engagers will start on the first step or on a “original step number”.
- Revisions submitted with new impressions will recommend new engagers, so all old engagers should be removed.
- In revisions, the clinician can request to keep the engagers.
- If the revision keeps old engagers, a new engager template will not be sent.
Requesting Custom Engagers
- Which tooth you want the engager placed on
- What size engager you want
- What depth engager you want
- If you want a horizontal or vertical engager