The use of engagers or buttons with Zendura aligners to achieve difficult tooth movements is becoming more prevalent. To make it easier for you to integrate the use of engagers into your orthodontic treatment modality, we engineered Zendura AT (item # 9206) specially for fabricating clear aligner therapy (CAT) attachment templates. It allows you to form attachment templates that capture the attachment details designed in software more exactly than possible using other plastic sheet materials. It also allows you to more precisely place attachments, as well more easily remove the template once the attachments are placed.
So, when would you consider using engagers? In some cases a tooth is shaped or positioned in a way that makes it hard for an aligner to apply the necessary force to complete the desired rotation or other motion. Small composite-resin bumps (engagers) can be placed on the surface of such teeth. These engagement points greatly help the aligner move the tooth in the desired direction. See the details below.
Why do you recommend intruding teeth by placing engagers on the adjacent teeth, instead of on the intruding tooth?
If you only place an engager on the tooth you're trying to intrude, there won't be anything holding the aligner securely in place. The aligner is likely to lift off the other teeth, instead of pushing the targeted tooth down. When you place engagers on the adjacent teeth, they hold the aligner in place, and the targeted tooth is pressed into the gums.
Instructions on Placing Engagers
After fabricating your attachment template using Zendura AT (item #9206), insert the template on the patient's teeth to test it for proper fit.
Identify the location of all engagers.
For each tooth to receive an engager, etch the tooth only in the area where the engager will be bonded to the tooth. Do not etch the whole facial.
Rinse off acid.
Lightly coat engager voids with petroleum jelly to prevent the engagers from sticking to the template.
Fill engager voids about 2/3 full with paste-type composite.
Fill remaining 1/3 of engager voids with flowable composite.
Place bonding agent on etched tooth.
Light cure bonding agent.
Light cure composite.
Remove template and clear off extra flashing material with scaler.