The Challenge of Button Placement in Aligner Treatments
- Jesper Hatt DDS
- Nov 14
- 3 min read
When Digital Perfection Meets Clinical Reality
Every dentist who has treated a few aligner cases knows the feeling: the digital plan looks perfect. On the screen, movements are beautifully coordinated, attachments are ideally shaped, and occlusion is balanced to the tenth of a millimeter.Then, somewhere between the software and the patient’s mouth, things change.What seemed predictable in the plan behaves differently in reality. Forces shift, teeth respond unevenly, and the treatment begins to drift away from what we designed.
When auxiliaries like buttons and elastics come into play, this gap between digital precision and clinical reality becomes even more apparent.
The quiet complexity of button placement in aligner treatments
Most aligner systems don’t automatically add buttons or hooks. They must be requested, positioned, and later placed clinically with exact precision. Some clinicians use special pliers to cut small windows into the aligner; others design custom cutouts during planning.No matter how it’s done, the clinician must think in 3D: not only about the elastic’s pull on one tooth, but also about the counterforce it creates on the opposite arch.
A button that’s just a millimeter too gingival or too occlusal changes everything. The line of pull, the moment of force, the patient’s comfort - all of it.
Balancing theory and practice
Biomechanics is beautiful in theory, but unforgiving in practice. Elastics introduce complex force systems that can either accelerate or completely derail tooth movement.And of course, we also depend on patient compliance. A perfectly planned elastic setup means nothing if patients don’t wear them consistently.
Bridging the digital and the biological
Planning software gives us control, but not guarantees. It doesn’t account for root morphology, soft tissue interference, or variable bone density.That’s why good aligner planning - especially when auxiliaries are involved - depends on clinical judgment just as much as digital precision.
The digital plan sets the stage. The biology decides the outcome.
Want to deepen your understanding of aligner biomechanics?
If you find yourself curious about how to bring more predictability and control into your aligner treatments - especially when auxiliaries, elastics, and buttons come into play - you’ll find plenty of practical guidance in our new book, Mastering Aligner Orthodontics.
Written by clinicians for clinicians, it walks you step by step through diagnostics, treatment planning, and digital setup using today’s leading aligner systems. You’ll find detailed explanations of biomechanics, real clinical examples, and “how-to” workflows you can apply immediately in practice.
Whether you’re working with SureSmile, ClearCorrect, Invisalign, or Spark, the principles remain the same: clinical precision, biological respect, and realistic execution.
Explore the methods and mindset that help thousands of dentists worldwide turn digital plans into real, predictable outcomes.
Get your copy of Mastering Aligner Orthodontics on Amazon and take your aligner treatments to the next level - with clarity, confidence, and control.
Sharing the workload
Every clinician who has used buttons and elastics in aligner treatments knows the challenge of turning digital theory into clinical accuracy.It takes experience, structure, and an understanding of biomechanics in motion - not just on the screen.
That’s why we believe the best results come from sharing the workload.
At AlignerService, each digital setup is co-created by dentists and orthodontists who’ve worked with aligners clinically for years. We review every plan for biological integrity, functional harmony, and real-world feasibility - with special attention to auxiliaries like buttons and elastics.
You stay focused on your patients, while we handle the digital complexity - efficiently, safely, and with the precision your reputation deserves.
More than 2,000 clinics worldwide use AlignerService to save time, increase predictability, and strengthen patient satisfaction.
Your cases · Your patients · Your success - with expert support behind you.
Kind regards
Jesper Hatt DDS
P: +41 78 268 00 78
AlignerService
We are dentists helping dentists create realistic, safe and predictable treatment plans with clear aligners.
Currently more than1500 dental practices in 19 different countries use our service on a regular basis. We offer expert guidance in the following clear aligner systems: Invisalign, SureSmile, ClearCorrect, TrioClear, Angel Aligners and Spark.
AlignerService is a preferred partner of ClearCorrect and TrioClear.
Comments