For information regarding tips and tricks for engagers, refer to the following:
Tips for Installing Engagers
- Trim off the section(s) of the engager template that don't have engagers.
- Try the engager template on before etching.
- Use air abrasion to prepare the surface.
- Poke a small hole in the engager void in the template.
- Prescribe engagers for later in treatment.
- Use a filled resin for engagers.
Trim off the section(s) of the engager template that don't have engagers.
Instead of using the entire engager template, you can trim off the sections that don't have engagers. The engager still gets placed accurately, but it's a lot easier to remove a smaller portion of the template.
Try the engager template on before etching.
Prior to etching any enamel surface, you can try the template on to see exactly where the engager will sit on the tooth.
Use air abrasion to prepare the surface.
You can use air abrasion with 50-micron aluminum oxide to lightly and quickly prepare the surface of the tooth. This will clean the surface prior to etching. Then etch for at least 20 seconds (only the area that was air-abraded). Then apply resin bonding and light cure.
Poke a small hole in the engager void in the template.
Prior to placing composite in the template, take an explorer or needle diamond bur and poke a small hole in the engager void in the template. This can help to:
- allow any air to escape and prevent a bubble, and
- reduce surface excess for easy clean up.
After seating the template and before light curing, wipe away any excess that comes through the hole.
Prescribe engagers for later in treatment.
To treat severe malocclusion, it often requires expansion/IPR and some improvement of the tooth positions to allow for easier engager placement. You can prescribe engagers to be placed later in treatment during case submission or when requesting changes to the treatment setup, to allow some correction to occur before having to place engagers.
Use a filled resin for engagers.
Engagers can wear down over time and sometimes need to be replaced. One tip to avoid this is to use a filled resin as it is usually more wear resistant than one that is unfilled.
Tips for Engager Templates
- Check that the engager is fully seated.
- Have the patient wear the engager template for a couple of days.
- Use petroleum jelly or mineral oil.
- Split the engager template mesio-distally.
Check that the engager is fully seated.
To ensure that the position of the engager matches up with the aligner, do a thorough check of the seating of the engager template before bonding.
Have the patient wear the engager template for a couple of days.
Sometimes, the engager template can be difficult to seat, which may lead to inaccurate placement of the engagers. One option is to give the patient the engager templates and instruct them to wear the templates (in place of their aligners) for 1-2 days before the appointment where engagers are being placed. When the patient comes to the engager appointment, the engager template is now seated and a good positioning of the engagers can be achieved.
Use petroleum jelly or mineral oil.
It can be difficult to remove the engager template, especially when placing multiple engagers and when bonding each side of the arch separately. Application of petroleum jelly or mineral oil usually helps to release the template from the engagers and is suggested as a best practice when placing engagers.
Split the engager template mesio-distally.
Removing the engager template after placing engagers can be difficult. When the engager is bonded correctly, the engager template will be formed tightly around the teeth, making it difficult to remove without disrupting the bond or scratching the engager. You can split the engager template mesio-distally and use a medium grit diamond bur, to thin out a few areas along the central fossae of the molars to help with the template removal.
Tips for Removing Engagers
Use a metal instrument to show where composite resin remains.
It can be hard to see if the entire engager has been removed sufficiently. The use of a metal instrument will usually show which areas have composite resin remaining.
Use a bond/bracket removing plier.
To avoid removing enamel when you remove engagers, you can use a bond/bracket removing plier.