An increasing number of patients seek orthodontic treatment with aligner therapy. Bodily tooth movement with aligner therapy is challenging when relying on aligners alone. Whilst there are limited reports of successful bodily molar movements of up to 1-2 mm in the literature, a very long treatment time, many refinements and a high level of patient compliance are expected. Moreover, the potential side effects of intermaxillary elastics must be considered in terms of shift of the anchorage teeth; this might be a severe problem especially in unilateral elastics applications with the potential for development of a midline shift, arch rotation and a jaw discrepancy, and transverse occlusal canting. To avoid this anchorage loss and the high demand on elastic wear, orthodontic mini-implants may be used. Currently, the alveolar process and the IZC region are still the most preferred insertion sites for mini-implants. However, due to a failure rate and the risk of root damage, insertion in these areas is far from satisfactory. Additionally, a bodily tooth movement is not granted. On the other hand, the anterior palate provides much better conditions for the insertion and stability of skeletal anchorage devices, as the amount and quality of the available bone is far superior. In this course, the combination of mini-implant-borne appliances and aligners is presented to achieve more predictable and faster results in aligner therapy.
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