SmartForce Features Protocols...1The Invisalign default protocols are used to create the initial ClinCheck Treatment Plan, based on the Invisalign Provider’s prescription. However,

SmartForce Features Protocols

1© 2017 Align Technology, Inc. All rights reserved. Confidential – For Internal Use Only


SmartForce Features

Introduction

• SmartForce features are designed to allow the Invisalign clear aligners

to apply the optimal simple and complex orthodontic force systems to

the teeth, either individually or in segments, where the direction,

magnitude and point of application of these forces are optimized in

order to achieve the desired treatment outcome.

• SmartForce features can be built into the intrinsic shape of the

aligners (Power Ridge features & Pressure Areas/Points) or require

composite material to be bonded to the teeth in pre-defined shapes

that interact with features built into the aligners (Attachments).

• They are automatically placed by the software based on patient’s initial

clinical situation and Doctor’s Clinical Preferences, treatment goals

and strategies.

• Cannot be prescribed and position cannot be adjusted, only removed.


SmartForce Features and Attachments

Optimized Attachments and aligner features:

• Provide the optimal force system to achieve predictable

tooth movements.

• Are tailor-made for each tooth width, long axis and

contour.

• Are positioned precisely to deliver the forces while

eliminating interferences. Crown size and tooth anatomy will

determine the ideal placement.

• Are used individually or in predefined combinations.


4© 2017 Align Technology, Inc. All rights reserved.

Buccal Power Ridge FeatureVisual Feature Available on Movement

Threshold

for

placement

Maximum

Velocity

Buccal Power

Ridge feature

Upper and lower

incisors

Lingual Root

Torque3 degrees of LRT

1 degree /

stage

Buccal + Lingual

Power Ridge

feature

Upper incisors

Lingual Root

Torque + incisor

retraction

3 degrees of LRT

+ anterior

retraction

1 degree &

0.25mm /

stage



Visual Feature Available on MovementThreshold for

placement

Maximum

Velocity

Optimized

Rotation

Attachment

Upper and lower

canines &

bicuspids

Rotation 5 degrees of rotation 2 degrees / stage

Optimized

Extrusion

Attachment

Upper and lower

incisors, canines,

bicuspids and

molars

Individual

extrusion0.5mm of extrusion 0.25 mm / stage



Visual Feature Available on Movement

Threshold

for

placement

Maximum

Velocity

Multi-tooth

Extrusion

Attachment

All four upper

incisorsIncisor extrusion

0.5mm of

extrusion0.25 mm / stage




Threshold

for

placement

Maximum

Velocity

Optimized Root

Control

Attachment

Upper incisors,

upper and lower

canines &

bicuspids

Mesio-Distal root

tip

0.75 mm of M/D

translation of

center of

resistance

0.25 mm / stage

Optimized

Multi-Plane Attachment

Upper lateral

incisors

Extrusion ±

crown tipping ±

rotation

OR

Rotation with

intrusion or

extrusion

Absolute extrusion

0.1 mm + crown

tipping + > 5 deg

rotation

Rotation > 5 deg

+ intrusion

Rotation > 5 deg +

extrusion

0.25 mm / stage or

2 degrees / stage



Available on

Threshold

Movement

Pressure AreasVisual Feature Available on Movement

Threshold

for

placement

Maximum

Velocity

Pressure areasUpper and lower

incisors and lower

canines

Absolute intrusion 0.5 mm intrusion 0.25 mm / stage

Optimized

Deep Bite Attachment

Upper and lower

premolars.

For retention, can

also be placed on

canine or molar if

can't be placed on

premolar

Anchorage/

retention during

anterior intrusion.

Activated for

premolar

extrusion

When anterior

intrusion and/or 0,5

mm premolar

extrusion is

planned

0.25 mm / stage




Threshold

for

placement

Maximum

Velocity

Optimized

Support Attachment

Upper lateral

incisorsNA

Intrusion > 1mm

on either adjacent

canine or central

incisor

0.25 mm / stage

Precision Bite

Ramps*(* are not SmartForce

features per se, but

can be prescribed by the

Provider, and

are placed depending on

compatibility

with other features)

Upper incisorsDisocclude the

posterior teethNA NA



Multi-Tooth UnitVisual Feature Available on Movement

Threshold for

placementMaximum

Velocity

Multi-tooth unit

OptimizedRetraction

Attachment

Upper and lower

canines

Canine

retraction

First premolar

extraction planned for

maximum or moderate

anchorage or up to 2

mm of mesial crown

posterior movement

for maximum

anchorage or 5mm for

moderate

0.25 mm / stageOptimized Maximum or

Moderate Anchorage

Attachment

Upper and lower

second

premolars and

molars

Posterior

moderate or

maximum

anchorage

Optimized Anchorage Attachment

Upper molars and

second premolars.

SmartStage

activations in both

arches.

Anterior

retraction1 mm 0.25 mm / stage


© 2017 Align Technology, Inc. All rights reserved.


Threshold

for

placement

Maximum

Velocity

Optimized

Multi-planeAttachment

Upper and lower

molars

Rotation +/-

intrusion or

extrusion

Rotation 5 degrees

in either direction

with or without

extrusion/intrusion

0.25 mm / stage or

2 degrees / stage


Conventional Attachments

Conventional attachments can be prescribed in addition or in lieu to any other attachment or SmartForce

feature placed by default (depending on compatibility).

Ellipsoid Rectangular Rectangular Beveled

3 mm,

4 mm,

5 mm

2 mm

3 mm

1 mm

0.5 mm

2 mm

1.25 mm

3, 4, 5 mm

2 mm 1 mm


Conventional Attachments

Conventional attachments can be placed directly

on the 3D model and their placement can be

adjusted with ClinCheck Pro 3D-Controls.

Conventional rectangular attachments can also

be adjusted for prominence and degree

of beveling.


Clinical Preferences

You can set up your Clinical Preferences for conventional attachments

for rotation, retention, and extrusion through the attachments interface


Clinical Preferences

Attachments interface

• Default attachment setting includes Optimized

Attachments whenever they are needed according to

protocol.

• If clinical preferences display conventional attachments

on any tooth in which an Optimized Attachment would

apply, software will respect Doctors’ preference.

• The preference can be ‘reset’ to include the Optimized

Attachments.


SmartForce ProtocolsInvisalign SmartForce Features per Tooth & Movement Programmed default placement rules

Rotation Extrusion Intrusion M/D Root Tip RetentionLingual Root

Torque

Upper

Central

Incisors

n/a

Optimized

Extrusion (single

and multi-tooth)

Lingual Pressure

Area

Optimized Root

Controln/a

Single Buccal Power

Ridge feature or

Dual Buccal + Lingual

Power Ridge feature for

LRT + Retraction

Upper

Lateral

Incisors

Optimized

Multiplane

Optimized

Extrusion (single

and multi-tooth)

Lingual Pressure

Area

Optimized Root

Control

Optimized Support(Individual Central or Canine

Intrusion)

Single Buccal Power

Ridge feature or

Dual Buccal + Lingual

Power Ridge feature for

LRT + Retraction

Lower

Incisorsn/a

Optimized

Extrusion

Lingual Pressure

Arean/a n/a

Buccal Power Ridge

feature

U/L

CaninesOptimized Rotation

Optimized

Extrusion

Lingual Pressure

Area (lower only)

Optimized Root

Control (double or

single + SmartStage)

n/a n/a

U/L

BicuspidsOptimized Rotation

Optimized

Extrusionn/a

Optimized Root

Control (double or

single + SmartStage)

Optimized Deep Bite (Anterior Intrusion Anchorage ±

Bicuspid Extrusion)

n/a

U/L MolarsOptimized

Multiplane

Optimized

Extrusionn/a n/a n/a n/a


SmartForce Protocols

Optimized SmartForce Default Placement Hierarchy

• High Level Hierarchy:

• P1: 1st Bicuspid Extraction & Multi-tooth Extrusion movements

• P2: Root Movements (Mesial-Distal)

• P3: Single tooth vertical & rotation

• P4: Anchorage for intrusion

• P5: Power Ridge feature for LRT

Note: Power Ridge feature for Lingual Root Torque cannot be placed concurrently with attachments on the same tooth; as such, when

Lingual Root Torque is present with other movements that require attachments, the movements need to be separated (increasing

number of stages) or the Power Ridge feature will not be placed and only the required attachment will be used. Align is now defaulting

to not placing the Power Ridge feature in low stage treatments with these conditions to avoid increasing the number of aligners and

treatment time.

Pressure areas are placed lingually and are compatible with buccal attachments and buccal Power Ridge features.


SmartForce Placement Protocols – Placement Hierarchy per Tooth

Upper Central Incisors Upper Lateral Incisors

• P1: Multi-tooth Optimized Extrusion – when all four

incisors are extruding

• P2: Optimized Root Control

• P3: Optimized Extrusion (individual)

• P4: Power Ridge feature for Lingual Root Torque

• P1: Multi-tooth Optimized Extrusion – when all four

incisors are extruding


• P3: Optimized Multiplane (rotation & rotation with

intrusion or extrusion)


• P5: Optimized Support (retention)


Note: Pressure areas are placed lingually and are compatible with buccal attachments and buccal Power Ridge features.



Lower Incisors Upper & Lower Canines



• P1: Optimized Retraction (for bicuspid space closure)


• P3: Optimized Rotation


Special situations:

• Optimized Retention attachment placed when incisors

intrude and posterior teeth are covered by Mandibular

Advancement Precision Wing.

• Optimized Retention attachment placed on contralateral

canine on unilateral first bicuspid extraction solution (G6)

to support anterior SmartStage activation

Note: Pressure areas are placed lingually and are compatible with buccal attachments and buccal Power Ridge features.



Upper & Lower Bicuspids Upper & Lower Molars

• P1: Optimized Maximum/Moderate Anchorage

Attachment (for first bicuspid space closure)


• P3: Optimized Rotation

• P4: Optimized Extrusion

• P5: Optimized Deep Bite (intrusion retention)

• P1: Optimized Maximum/Moderate Anchorage

Attachment (for first bicuspid space closure)

• P2: Optimized Multiplane Attachment

• P3: Optimized Extrusion Attachment


First & Second Molar +

Second Bicuspid:

• Optimized Maximum or

Moderate Anchorage

Attachment

Canines:

• Optimized Retraction

Attachment

Multi-tooth unit

• SmartStage

First Bicuspid Extractions –

Maximum or Moderate

Anchorage

Placement per Clinical Solution


Deep Bite (anchorage) on

first bicuspids

• If first bicuspid already

has an attachment for a

different movement,

then Deep Bite

attachment on second

bicuspids

• If attachments for

different movements are

already present on both

bicuspids, they remain.

Deep Bite Correction

(without premolar extrusion)



• Deep Bite attachments

on both bicuspids with

activation for extrusion

Deep Bite Correction with

premolar extrusion



Upper Central and Lateral

Incisors

• Optimized Multi-tooth

Extrusion

Lower Incisors:

• Optimized Extrusion

(individual)

Open Bite CorrectionPlacement per Clinical Solution


Default Protocols

• For certain Invisalign treatments, conventional attachments will be placed by default1 (unless otherwise specified in

Clinical Preferences or in the Prescription Form), sometimes in combination with Optimized Attachments in

another teeth.

• Providers may request attachments when aligner retentiveness is a concern. Attachments for aligner retention are

NOT offered by default.

1The Invisalign default protocols are used to create the initial ClinCheck Treatment Plan, based on the Invisalign Provider’s prescription.

However, the final treatment plan remains the responsibility of the Invisalign Provider and should be reviewed carefully and modified as

necessary before the ClinCheck Treatment Plan is approved.


Molars:

• Conventional Vertical

Rectangular attachment

Bicuspid:

• Optimized Root Control

Attachment

Canines:

• Optimized Root Control

Attachment

Second Premolar

Extractions or First

Premolar extractions not

planned for maximum or

moderate anchorage




Lower Incisors mesial &

distal to extraction space

• Conventional Vertical

Rectangular attachment

• If any Optimized

Attachment is placed on

the canine, it will be

maintained in place

Lower Incisor Extraction


SmartForce Placement Protocols

Common reasons why attachments may not be placed

• There isn’t a default attachment defined for a given tooth movement programmed.

• A preference has not been set to place an attachment on a given tooth movement.

• Movement is below attachment placement threshold.

• Movement threshold triggers attachment placement, but another attachment has a higher priority.

• Due to Doctor preferences conflict.

• Due to feature conflict (i.e. Precision Cut and attachment don’t fit together).

• Due to lack of space (short clinical crown).


SmartForce Placement Protocols

Common reasons why attachments may not be placed

• Movement threshold triggers attachment placement, but there is another feature that isn't compatible.

• Due to higher placement hierarchy rules – clinical protocol.

• Due to doctor Prescription Form instruction.

• Movement threshold triggers attachment placement, but there isn't enough space/clinical

crown/collision/pinching/gingiva.

• Backup attachments alternatives can be used, based on internal protocol or Doctor preferences

INVISALIGN, CLINCHECK, and ITERO among others, are trademarks and/or service

marks of Align Technology, Inc. or one of its subsidiaries or affiliated companies and

may be registered in the U.S. and/or other countries.


SmartForce Features Protocols...1The Invisalign default protocols are used to create the initial ClinCheck Treatment Plan, based on the Invisalign Provider’s prescription. However,

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