Invisalign aligners are clear dental trays that gradually straighten the dental arch. Unlike traditional braces, they are almost invisible.
In this article, we will discuss who Invisalign is suitable for and what advantages it offers from the perspective of evidence-based orthodontics. We will also explain how treatment with aligners is carried out at Yarema Dental Clinic in Kyiv, using a real patient case as an example.
Yarema Miklosh, Chief Medical Officer, Prosthodontist, Gnathologist
What Are Aligners?
Invisalign aligners are the brand name of the most well-known system of clear aligners (orthodontic trays) used for orthodontic treatment. They were developed by Align Technology in 1997. Invisalign aligners are individually manufactured for each patient based on 3D scans of the teeth and computer-assisted treatment planning. The trays are made from the flexible, transparent SmartTrack thermoplastic material, making them virtually unnoticeable on the teeth.
Like braces, Invisalign applies controlled pressure to the teeth and moves them in the desired direction.
Patients can remove the aligners before eating or brushing their teeth, which ensures a high level of oral hygiene and comfort in everyday life.
How Effective Are Invisalign Aligners in Complex Cases of Malocclusion?
Aligners are generally recommended for patients with mild to moderate dental misalignment. Most systematic reviews show that clear aligners (such as Invisalign) are most effective in treating mild to moderate malocclusions, while their effectiveness decreases in more complex cases. For example, a systematic review published in Dentistry Journal (2025) states:
“Current indications for clear aligner treatment include mild to moderate forms of malocclusion. Severe forms of malocclusion are considered a contraindication.”
A meta-analysis published in the Journal of Evidence-Based Dental Practice (2025) also concluded that aligners achieve results comparable to braces in straightforward cases; however, they are less effective in managing complex tooth movements, such as rotations, vertical movements, and root control.
When treating complex cases with aligners, outcomes are more difficult to predict, and additional auxiliaries or a combination of aligners and braces are often required. It is worth noting that the capabilities of aligners continue to expand every year. For example, the Invisalign system uses the ClinCheck digital treatment planning platform, which allows patients and orthodontists to review a three-dimensional model of tooth movement from the initial to the final position.
In addition, intelligent algorithms developed by Align Technology utilize extensive clinical data to optimize each tooth movement in a specific sequence and at the appropriate stage of treatment, helping to achieve more predictable outcomes.
According to the manufacturer, the patented SmartForce technology provides more predictable tooth movement compared to many other aligner systems. Special attachments—small composite protrusions that an orthodontist temporarily bonds to the tooth surface during aligner treatment—are used for more complex tooth movements. These attachments serve as additional anchorage points for the aligners and help control tooth movement more precisely.
However, the effectiveness of treatment depends greatly on the clinician’s expertise and on how closely the patient follows the prescribed recommendations.
What Are the Advantages of Aligners for Mild and Moderate Malocclusions?
Over 25 years of technological development, Invisalign has significantly expanded the range of cases that can be successfully treated with aligners. Today, clear aligners are used to correct dental crowding, gaps between teeth, as well as many mild to moderate malocclusions (crossbite, deep bite, open bite, etc.).
Clinical studies have shown that, in mild and moderate forms of malocclusion, clear aligners can provide results comparable to those achieved with fixed orthodontic appliances.
The evidence regarding treatment duration is mixed: some studies have found no significant difference between the two methods, while others have demonstrated slight variations in favor of one approach or the other, depending on the clinical case and the patient’s compliance with the orthodontist’s recommendations. Patient discipline is particularly important during aligner treatment. Braces cannot be removed by the patient, whereas aligners can; however, they will not straighten teeth if they are removed and not worn as prescribed.
The greatest advantage of aligners is their aesthetics. They are clear and thin, without metal brackets and wires, making them barely noticeable to other people.
In terms of comfort, aligners also tend to have an advantage. Systematic reviews and meta-analyses show that patients wearing clear aligners generally experience less pain and discomfort during the first days of treatment and require pain-relieving medication less frequently than patients wearing braces.
This is attributed to the absence of brackets and wires that may irritate the oral mucosa, as well as to the more even distribution of pressure on the teeth with each new set of aligners.
Many patients also report rapid adaptation to aligners and a high level of comfort while wearing them.
It is well known that fixed braces make oral hygiene more difficult, which can lead to plaque accumulation around the brackets and subsequent gingival inflammation. Aligners can be removed for brushing, making it easier to maintain a normal level of oral hygiene.
One study followed 100 patients who underwent orthodontic treatment with either Invisalign aligners or braces for more than six months. Patients treated with aligners demonstrated better periodontal health compared to those treated with braces. The gingival bleeding index was almost twice as low (7.6 versus 15.2), and plaque accumulation was lower, although the latter difference did not reach statistical significance.
Another meta-analysis of seven studies involving 368 patients found that aligner patients had lower gingival bleeding and plaque indices after 1, 3, and 6 months of treatment compared to patients treated with braces.
Another advantage of aligners is the reduced number of visits to the orthodontist. Patients change their aligner sets independently every 1–2 weeks, while follow-up appointments are typically scheduled every 6–8 weeks so the orthodontist can assess progress and provide new aligners. With braces, monthly wire adjustments are generally required. In addition, aligner treatment does not usually require emergency visits due to appliance breakage.
How Invisalign Treatment Is Carried Out at Yarema Dental
At Yarema Dental, treatment is provided by experienced orthodontists with expertise in aligner therapy. In particular, Dr. Mary Vardanyan is an officially certified Invisalign provider (Align Technology).
- Initial Consultation. During the first appointment, the orthodontist at Yarema Dental performs a comprehensive examination of the oral cavity, evaluates the bite, and takes the necessary photographs and radiographs. It is important to determine whether your case is suitable for aligner treatment. If so, the doctor will answer all your questions, explain the possibilities of Invisalign treatment, and outline the next steps. A digital 3D scan of the teeth is also performed during the consultation. This painless procedure replaces traditional dental impressions. A three-dimensional model of the patient’s jaws appears instantly on the computer screen.
- Treatment Planning. After obtaining the digital impressions, the orthodontist collaborates with Invisalign technical specialists to develop a detailed tooth movement plan. Essentially, this is a virtual simulation of the treatment process. The patient can see how their smile will change at every stage of treatment. The estimated treatment duration and the required number of aligners are also determined. Depending on the complexity of the case, anywhere from 12 to 48 aligners may be required. Minor crowding may require only 12 aligners over approximately 6–7 months, whereas more significant bite problems may require 30–40 aligners over approximately 18 months. The treatment plan is approved only after the patient has reviewed and accepted it.
- Fabrication and Delivery of the Aligners. Once approved, the treatment plan is sent to Align Technology for manufacturing, where a customized series of clear aligners is produced. Several weeks later, the completed Invisalign set is delivered to the clinic. During the appointment, the orthodontist fits the first aligners, ensures that they fit accurately, and places attachments. If necessary, IPR (interproximal reduction) may be performed to create minimal space between teeth in cases of severe crowding. The doctor also provides detailed instructions on how to insert and remove the aligners, how to care for them, and how many hours per day they should be worn (typically 20–22 hours). At Yarema Dental, patients may also receive a trial set of aligners—several low-force aligners designed to help them become accustomed to wearing aligners before beginning the main course of treatment. This unique practice helps patients adapt without stress.
- Active Treatment Phase. Typically, each set of aligners is worn for approximately 1–2 weeks, although the exact schedule is determined by the orthodontist. Routine follow-up visits are scheduled every 4–6 weeks. During these visits, the orthodontist evaluates progress, may rescan the teeth to verify that treatment is proceeding according to plan, provides the next sets of aligners, and makes adjustments if necessary. If the aligners are causing pressure or discomfort, the orthodontist can address these issues. It is important to follow the orthodontist’s recommendations and maintain proper oral hygiene. Aligners should be cleaned at least once a day using a soft toothbrush with soap or special cleaning tablets. Teeth should ideally be brushed after every meal before reinserting the aligners.
- Results and Retention. Once the active phase of treatment has been completed, treatment itself is finished, but an equally important stage follows—retention. The orthodontist will provide retention aligners or other retainers that must be worn according to a prescribed schedule, typically only at night, for a minimum of six months. This is necessary to prevent the teeth from returning to their previous positions while the surrounding bone tissue fully stabilizes. At the final appointment, photographs of your new smile will be taken, and you will be able to compare them with your pre-treatment photographs to appreciate the remarkable transformation that has taken place.
Clinical Case: Correcting Malocclusion with Invisalign Aligners at Yarema Dental
Olha, a 26-year-old patient, was dissatisfied with her smile due to a cosmetic dental defect and complained of frequently biting her cheek while chewing.
During the examination, crowding of the upper front teeth and a unilateral crossbite were identified: several upper teeth were positioned behind the lower teeth. Olha was very reluctant to wear braces and was looking for a more aesthetic solution. She works as a manager and communicates with clients on a daily basis.
After a comprehensive diagnostic assessment, the orthodontist recommended treatment with the Invisalign system. Considering the patient’s wishes and clinical situation, this was the optimal treatment option.
A series of 32 custom-made Invisalign aligners was fabricated for both the upper and lower arches. The estimated treatment duration was 14 months. Small composite attachments were bonded to several teeth to enable the aligners to more effectively expand the constricted dental arch and correct the crossbite. At the beginning of treatment, the orthodontist also performed minor IPR (interproximal reduction) — slight enamel polishing between the lower incisors — to create the space necessary for their proper alignment.
During the first few weeks, the patient adapted to wearing the aligners. She reported that they were virtually invisible during conversations and did not interfere with her work. Discomfort was minimal. Olha experienced only slight pressure on her teeth when inserting a new aligner. There was no pain or irritation of the oral tissues.
The patient followed all recommendations carefully. She wore the aligners for 22 hours per day and removed them only during meals. The aligners were changed every two weeks.
After three months of treatment, the orthodontist had already observed noticeable progress. The dental arches had begun to align.
Following 14 months of treatment, Olha’s smile was completely transformed. The upper teeth became properly aligned and no longer overlapped each other. The crossbite was corrected, and the teeth now occlude properly, which not only improved aesthetics but also eliminated the cheek-biting problem. Olha achieved a well-aligned smile and proper dental occlusion.
The patient stated that she was extremely satisfied with her choice of Invisalign. According to her, the greatest advantages were comfort, aesthetics, and predictability of the results. She knew in advance how her teeth would change, which served as a strong source of motivation throughout treatment.
After completing treatment and removing the final aligner, Olha received clear retention aligners, which she now wears at night. She continues to attend follow-up appointments with her orthodontist at Yarema Dental to monitor the long-term stability of the treatment results.
At Yarema Dental, Invisalign treatment is provided by orthodontists with extensive experience in aligner therapy who utilize advanced digital treatment-planning technologies. Our orthodontists combine expert knowledge, international experience, and genuine care for every patient. We use state-of-the-art equipment, including 3D scanners and digital treatment-planning systems, and work directly with Align Technology to ensure the authenticity of every aligner.
Every case at our clinic is treated as an individual project. Our goal is to achieve an ideal bite and a harmonious smile while taking into account each patient’s unique needs and expectations.
This article does not replace a medical consultation. For complete and personalized information, please consult your dentist.