Ever since the Positioner first appeared in 1944, it has been possible to provide orthodontic treatment by using plastic, removable braces. Since then, both the Positioner, that resembles a sports mouth-protector, and the thinner, transparent Aligner have been continuously improved. The very first feasible treatment procedure using a thin, transparent aligner was described by Sheridan as early as the 1980’s and was called it the Essix Retainer.

At the end of the 1990’s, the American company Align Technologies introduced, under the name of Invisalign, a perfected, orthodontic treatment procedure using transparent, removable braces. The only real new thing about this was that a lot of them were produced by computer using just one tooth impression taken right at the start of the process. Whereas with the old aligner system, new impressions had to be taken again and again to achieve any significant movement of the teeth. Because US patent law is so peculiar, the Align company has been able to achieve almost a worldwide monopoly on aligner treatment with no more than three aligners taken from a just single impression. Competitors are regularly sued so that their own patents can be removed from the market. This is rather strange for something that has been common knowledge for centuries…

Aligners are generally used for the cosmetic treatment of adults because they are virtually invisible even when the person is speaking or laughing and they do not usually impede speech. However, like all removable braces, they do have a limited effect and are therefore only really suitable for moderate treatment procedures. Since they were introduced onto the German market in 2001, they have been used more and more for sensible, tried and tested treatment procedures. However, as a result of a revised verdict from the German Association of Orthodontists in 2004 that the aligner is a suitable orthodontic treatment method, it is not accepted by any of the public health insurance companies and is only grudgingly accepted by the private ones.

Although aligners are certainly not invisible, they are hardly noticeable; this patient is pictured on one side wearing an aligner and, on the other side, without an aligner– you have to look closely to see which picture is which