The power of precision—Clarity Precision Grip Attachments

It has been recognised that clinical outcomes may be undermined by the lack of correspondence between the digital representation of the planned attachment and the actual attachment when bonded to the tooth.^{2, 3} This lack of correspondence may be the result of voids, flash or distortion of the attachment template (Fig. 3). We have used finite element analysis simulations to show that both composite flash and displacement may have deleterious effects on the direction of applied force. It is important for attachments to be accurately positioned and precisely shaped (Fig. 4).

Customisation through 3D printing

In order to deliver accuracy and precision, an improved process was needed. Ideally, the attachment templates could be delivered preloaded with composite. The tiny dimensions and custom shapes of attachments make precise filling of the pockets difficult. It is also difficult to judge the amount of material required to adapt to the curvature of the tooth surface; it must be estimated from the surrounding surface of the template.

To address this, we leveraged 3D printing as a solution. This technology offers the ability to efficiently produce custom articles with complex shapes and intricate detail. In this case, it is used to deliver to the clinician pre-hardened customised attachments. The fully polymerised, pre-hardened Clarity Precision Grip Attachments are delivered in a thermoformed attachment tray that relies on an intuitive bonding procedure (Fig. 5).

The bonding procedure begins with the application of a bonding agent (3M Transbond XT Light Cure Adhesive Primer, Solventum) to the tooth-facing surfaces of the Clarity Precision Grip Attachments. The teeth are cleaned with a prophylaxis paste or etched and then prepared with a different bonding agent (3M Transbond Plus Self Etching Primer). The tray is fitted on to the teeth, and the bonding agents are polymerised by a 6-second exposure to an 3M Ortholux Luminous Curing Light or a 10-second exposure to a 3M Elipar curing light directly over each attachment. The tray is then removed from the mouth.

The attachments produced in this fashion are very well defined and free of composite flash after bonding (Figs. 6 & 7). The case shown demonstrates that the post-bonding results of Clarity Precision Grip Attachments closely mirror the precise shape and virtual placement in the digital plan (Fig. 8). To achieve optimal outcomes, it is crucial that the clinical reproduction of the attachments closely mirrors their virtual placement.

A comparison between attachments created via a conventional attachment template and Clarity Precision Grip Attachments shows that the 3D-printed attachments are cleanly defined and have less flash than the conventional attachments (Fig. 9). A direct comparison between a Clarity Precision Grip Attachment and a conventional attachment of the same planned shape and position, placed in the same patient and bonded by the same clinician demonstrates the defined edges of the Clarity Precision Grip Attachment (Fig. 10).

Engagement between aligner and attachment is also improved with attachments that are more precise (Fig. 11). In a comparison between a Clarity Precision Grip Attachment and a conventionally moulded attachment, engagement was computed for each attachment through physics-based computational simulations. The gap between the aligner and the attachment is more pronounced and misaligned with the conventional attachment compared with the more precise fit of the Clarity Precision Grip Attachment. The improved engagement may lead to the option of reducing the size and number of attachments when planning treatment. With improved engagement, clinicians may see improved outcomes.

The prescribed bonding protocol provides additional benefits, specifically the elimination of composite flash. This is enabled by using unfilled bonding agents, which support an intimate fit between the Clarity Precision Grip Attachments and the teeth. 3D printing easily produces a tooth-facing side that matches the patient’s anatomy, allowing thin bonding agents to be used in securing Clarity Precision Grip Attachments to the teeth (Fig. 12).

Engagement between aligner and attachment is also improved with attachments that are more precise (Fig. 11). In a comparison between a Clarity Precision Grip Attachment and a conventionally moulded attachment, engagement was computed for each attachment through physics-based computational simulations. The gap between the aligner and the attachment is more pronounced and misaligned with the conventional attachment compared with the more precise fit of the Clarity Precision Grip Attachment. The improved engagement may lead to the option of reducing the size and number of attachments when planning treatment. With improved engagement, clinicians may see improved outcomes.

The prescribed bonding protocol provides additional benefits, specifically the elimination of composite flash. This is enabled by using unfilled bonding agents, which support an intimate fit between the Clarity Precision Grip Attachments and the teeth. 3D printing easily produces a tooth-facing side that matches the patient’s anatomy, allowing thin bonding agents to be used in securing Clarity Precision Grip Attachments to the teeth (Fig. 12).

Conclusion

Through Clarity Precision Grip Attachments, we aim to solve what matters to our customers and change the course of aligner treatment for good. We leverage our legacy of groundbreaking innovation as a driver to find solutions for our customers and support them in creating beautiful, healthy smiles for patients. This latest innovation is a testament to the future of Solventum, addressing important healthcare challenges through the application of materials science, mechanical design and 3D-printing techniques. At Solventum, we are leaning into a future focused on enabling better, smarter, safer healthcare.