SmartForce Features Protocols

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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.

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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.

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SmartForce Features and Attachments

Buccal Power Ridge Feature Threshold

Maximum
Visual Feature Available on Movement for Velocity
placement

Buccal Power Upper and lower Lingual Root 1 degree /

3 degrees of LRT
Ridge feature incisors Torque stage

Buccal + Lingual Lingual Root 3 degrees of LRT 1 degree &

Power Ridge Upper incisors Torque + incisor + anterior 0.25mm /
feature retraction retraction stage

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SmartForce Features and Attachments

Threshold for Maximum

Visual Feature Available on Movement
placement Velocity

Optimized Upper and lower

Rotation canines & Rotation 5 degrees of rotation 2 degrees / stage
Attachment bicuspids

Upper and lower

Optimized
incisors, canines, Individual
Extrusion 0.5mm of extrusion 0.25 mm / stage
bicuspids and extrusion
Attachment
molars

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SmartForce Features and Attachments

Threshold
Maximum
Visual Feature Available on Movement for Velocity
placement

Multi-tooth
All four upper 0.5mm of
Extrusion Incisor extrusion 0.25 mm / stage
incisors extrusion
Attachment

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SmartForce Features and Attachments
Threshold
Maximum
Visual Feature Available on Movement for Velocity
placement

Upper incisors, 0.75 mm of M/D

Optimized Root Mesio-Distal root
upper and lower translation of
Control tip 0.25 mm / stage
canines & center of
Attachment
bicuspids resistance

Absolute extrusion
Extrusion ±
0.1 mm + crown
crown tipping ±
tipping + > 5 deg
rotation
rotation
Optimized
Upper lateral 0.25 mm / stage or
Multi-Plane OR 2 degrees / stage
incisors Rotation > 5 deg
Attachment
+ intrusion
Rotation with
intrusion or
Rotation > 5 deg +
extrusion
extrusion

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SmartForce Features and Attachments
Threshold
Maximum
Visual
Pressure Areas Feature Available on Movement for Velocity
placement

Upper and lower

Pressure areas incisors and lower Absolute intrusion 0.5 mm intrusion 0.25 mm / stage
canines

Movement

Upper and lower

Anchorage/
premolars.
Available on retention during When anterior
Optimized anterior intrusion. intrusion and/or 0,5
For retention, can
Deep Bite mm premolar 0.25 mm / stage
also be placed on
Attachment Activated for extrusion is
canine or molar if
Threshold premolar planned
can't be placed on
extrusion
premolar

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SmartForce Features and Attachments

Threshold
Maximum
Visual Feature Available on Movement for Velocity
placement

Intrusion > 1mm

Optimized
Upper lateral on either adjacent
Support NA 0.25 mm / stage
incisors canine or central
Attachment
incisor

Precision Bite
Ramps*
(* are not SmartForce
features per se, but Disocclude the
Upper incisors NA NA
can be prescribed by the
Provider, and
posterior teeth
are placed depending on
compatibility
with other features)

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SmartForce Features and Attachments
Multi-Tooth Unit Threshold for Maximum
Visual Feature Available on Movement Velocity
placement
Optimized First premolar
Upper and lower Canine
Retraction extraction planned for
Attachment canines retraction
maximum or moderate
anchorage or up to 2
Multi-tooth Optimized
unit Upper and lower Posterior mm of mesial crown 0.25 mm / stage
Maximum or posterior movement
second moderate or
Moderate
premolars and maximum for maximum
Anchorage
Attachment molars anchorage anchorage or 5mm for
moderate

Upper molars and

second premolars.
Optimized Anchorage Anterior
SmartStage 1 mm 0.25 mm / stage
Attachment retraction
activations in both
arches.

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SmartForce Features and Attachments

Threshold
Maximum
Visual Feature Available on Movement for Velocity
placement

Rotation 5 degrees
Optimized Rotation +/-
Upper and lower in either direction 0.25 mm / stage or
Multi-plane intrusion or 2 degrees / stage
molars with or without
Attachment extrusion
extrusion/intrusion

© 2017 Align Technology, Inc. All rights reserved.

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

0.5 mm
3 mm,
3 mm 4 mm,
5 mm 2 mm
3, 4, 5 mm

2 mm 1 mm 2 mm 1 mm 1.25 mm

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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.

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Clinical Preferences

You can set up your Clinical Preferences for conventional attachments

for rotation, retention, and extrusion through the attachments interface

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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.

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 SmartForce Protocols
Invisalign SmartForce Features per Tooth & Movement Programmed default placement rules
Lingual Root
Rotation Extrusion Intrusion M/D Root Tip Retention
Torque
Single Buccal Power
Upper Optimized Ridge feature or
Lingual Pressure Optimized Root
Central n/a Extrusion (single
Area Control
n/a Dual Buccal + Lingual
Incisors and multi-tooth) Power Ridge feature for
LRT + Retraction
Single Buccal Power
Upper Optimized Optimized Support Ridge feature or
Optimized Lingual Pressure Optimized Root
Lateral Multiplane
Extrusion (single
Area Control
(Individual Central or Canine Dual Buccal + Lingual
and multi-tooth) Intrusion) Power Ridge feature for
Incisors
LRT + Retraction

Lower Optimized Lingual Pressure Buccal Power Ridge

n/a n/a n/a
Incisors Extrusion Area feature

U/L Optimized Optimized Lingual Pressure Optimized Root

Control (double or n/a n/a
Canines Rotation Extrusion Area (lower only)
single + SmartStage)

U/L Optimized Optimized Optimized Root Optimized Deep Bite

n/a Control (double or (Anterior Intrusion Anchorage ± n/a
Bicuspids Rotation Extrusion Bicuspid Extrusion)
single + SmartStage)

Optimized Optimized
U/L Molars Multiplane Extrusion
n/a n/a n/a n/a

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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.

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SmartForce Placement Protocols – Placement Hierarchy per Tooth

Upper Central Incisors Upper Lateral Incisors

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

• P2: Optimized Root Control • P2: Optimized Root Control

• P3: Optimized Extrusion (individual) • P3: Optimized Multiplane (rotation & rotation with
intrusion or extrusion)
• P4: Power Ridge feature for Lingual Root Torque
• P3: Optimized Extrusion (individual)

• P5: Optimized Support (retention)

• P6: Power Ridge feature for Lingual Root Torque

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

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SmartForce Placement Protocols – Placement Hierarchy per Tooth

Lower Incisors Upper & Lower Canines

• P1: Optimized Extrusion (individual) • P1: Optimized Retraction (for bicuspid space closure)

• P2: Power Ridge feature for Lingual Root Torque • P2: Optimized Root Control

• P3: Optimized Rotation

• P4: Optimized Extrusion (individual)

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.

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SmartForce Placement Protocols – Placement Hierarchy per Tooth

Upper & Lower Bicuspids Upper & Lower Molars

• P1: Optimized Maximum/Moderate Anchorage • P1: Optimized Maximum/Moderate Anchorage

Attachment (for first bicuspid space closure) Attachment (for first bicuspid space closure)

• P2: Optimized Root Control • P2: Optimized Multiplane Attachment

• P3: Optimized Rotation • P3: Optimized Extrusion Attachment

• P4: Optimized Extrusion

• P5: Optimized Deep Bite (intrusion retention)

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Placement per Clinical Solution
First Bicuspid Extractions –
Maximum or Moderate
Anchorage

First & Second Molar +

Second Bicuspid:
• Optimized Maximum or
Moderate Anchorage
Attachment
Canines:
• Optimized Retraction
Attachment
Multi-tooth unit
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Placement per Clinical Solution Deep Bite Correction
(without premolar extrusion)

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.
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Placement per Clinical Solution Deep Bite Correction with
premolar extrusion

• Deep Bite attachments

on both bicuspids with
activation for extrusion

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Placement per Clinical Solution Open Bite Correction

Upper Central and Lateral

Incisors
• Optimized Multi-tooth
Extrusion

Lower Incisors:
• Optimized Extrusion
(individual)

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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.

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Placement per Clinical Solution Second Premolar
Extractions or First
Premolar extractions not
planned for maximum or
moderate anchorage

Molars:
• Conventional Vertical
Rectangular attachment
Bicuspid:
• Optimized Root Control
Attachment
Canines:
• Optimized Root Control
Attachment
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Placement per Clinical Solution Lower Incisor Extraction

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

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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).

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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

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INVISALIGN, CLINCHECK, and ITERO among others, are trademarks and/or service
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may be registered in the U.S. and/or other countries.
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