Customized aligner surfaces

Abstract

The present disclosure discusses systems and methods for altering the position of a teeth in a subject with an aligner. In an embodiment, an aligner for altering the position of teeth of a subject includes a body comprising a plurality of indentions that are complementary to the shape and position of the teeth of the subjects. The aligner also includes one or more engager voids formed in the body which protrude from the body. When applied to the subject's teeth, the engager voids create a pressure point between the engager and the aligner. The thickness of the body is increased proximate to the engager void such that the exterior surface of the body is arcuate over the engager void to reduce irritation and enhance the performance of the engager.

Description

SI 15297.00176CUSTOMIZED ALIGNER SURFACESCross-Reference to Related Application

[0001] This application claims benefit and priority to U.S. Provisional Application No. 63 / 725,010, filed November 26, 2024, entitled “Customized Aligner Surfaces.” The content of which is incorporated herein by reference in its entirety.Field of the Technology

[0002] The present technology relates to denial appliance systems for altering the position of teeth in a subject. More specifically, this technology relates to the use of aligners having engager elements that can be used for enhanced tooth movement.Background

[0003] Orthodontic aligners are appliances intended to make a series of discrete tooth position corrections aimed at aligning the teeth correctly. Aligners are equivalent to having bracket / wire braces for orthodontic treatment, but they have many advantages. For example, aligners are often transparent or semi-transparent, comfortable, and removable for cleaning allowing a subject to eat anything they want.

[0004] Some teeth are shaped or positioned in a way that can be difficult for an aligner to "grab" onto the tooth and move the tooth into the desired position. Engagers can be used to provide an additional targeted contact point to such teeth. An engager is a small shape of composite material that is commonly placed on the tooth as part of an aligner treatment to assist with certain tooth movements. The engager provides an additional small surface for the aligner to interact with teeth during treatment.

[0005] To accommodate an engager, an engager void is formed in the aligner. When the subject wears the aligner, any engagers that are bonded to the subject’s teeth are contained within engager voids formed within the aligner. The pressure between the aligner and the engagers allows additional forces to be transferred to teeth to move over time the teeth into the desired positions. The engager voids that the engagers are disposed in typically must have enough material to accommodate these forces without excessive deformation. Traditionally, these engager voids are created during the thermoforming process when the aligner material is thermoformed over an altered model of the subject’s teeth that includes protrusions that willSI 15297.00176 correspond to any engagers required for a particular treatment plan. This can cause the engager voids to appear as protrusions on the surface of the aligner. These protrusions can cause discomfort to the user as well as being aesthetically displeasing.Summary

[0006] The present technology can, in some embodiments, mitigate the problems associated with engager voids by forming an arcuate exterior surface over the engager voids, while the inner surface (i.e., the surface in contact with the engager) is conformal with the shape of the engager. An arcuate exterior surface over the engager void can be formed by increasing the thickness of the body of the aligner proximate to the engager voids.

[0007] In one embodiment, an aligner for altering the position of teeth of a subject, wherein the teeth of the subject comprise one or more engagers coupled to one or more teeth, comprises: a body comprising a plurality of indentions that are configured to receive one or more teeth of the subject; one or more engager voids, formed in the body, which are aligned with the one or more engagers when the aligner is applied to the teeth of the subject, wherein at least one of the one or more engager voids is shifted in position, in relation to the aligned engager, to create a pressure point between the engager and the aligner, and wherein a portion of the body that defines the engager voids protrudes from the exterior surface of the body. The thickness of the body is increased, proximate to the portion of the body that defines one or more of the engager voids, such that the exterior surface of the body is arcuate over the engager void.

[0008] In one embodiment, the aligner comprises at least two engager voids positioned on the aligner to engage at least two engagers positioned on the same tooth, wherein the thickness of the body is increased in a space between two of the engager voids.

[0009] In another embodiment, the aligner comprises at least two engager voids positioned on the aligner to engage at least two engagers positioned on the same tooth, wherein a first engager void is formed on a buccal side of the aligner and a second engager void is formed on a palatal or lingual side of the aligner.

[0010] The aligner can be composed of a clear material, such as a clear polymeric material.

[0011] The aligner can cover one or more of the subject’ s teeth. In one embodiment an aligner covers one or more of the maxillary teeth or one or more of the mandibular teeth.SI 15297.00176

[0012] In an embodiment, a method of altering the position of teeth of a subject comprises: obtaining an aligner, the aligner comprising: a body comprising a plurality of indentions that are configured to receive one or more teeth of the subject; one or more engager voids, formed in the body, which are aligned with the one or more engagers when the aligner is applied to the teeth of the subject, wherein at least one of the one or more engager voids is shifted in position, in relation to the aligned engager, to create a pressure point between the engager and the aligner, and wherein a portion of the body that defines the engager voids protrudes from the body; wherein a thickness of the body is increased, proximate to the portion of the body that defines the engager voids, such that the exterior surface of the body is arcuate over the engager void. The aligner is positioned on the teeth of the subject such that one or more engagers attached to the subject’s teeth are disposed in the engager voids on the aligner.

[0013] In another embodiment, a method of making an engager as described herein comprises: generating digital representations of a series of aligners that can incrementally reposition the teeth of a subject, wherein one or more of the aligners in the series of aligners comprises one or more engager voids; modifying the digital representation of the one or more aligners comprising one or more engager voids by increasing the thickness of a body of the aligner proximate to the engager voids such that an arcuate exterior surface is defined over the engager voids; and creating the series of aligners, wherein the aligners comprising one or more engager voids are created using the modified digital representations. In one embodiment, the aligners are formed using 3D printing technology.Brief Description of the Drawings

[0014] The technology will be more fully understood from the following detailed description taken in conjunction with the accompanying drawings, in which:

[0015] FIG. 1A depicts a projection view of an aligner having an engager void.

[0016] FIG. IB depicts a front view of a tooth having an engager coupled to the tooth;

[0017] FIG. 2 depicts a top view of an aligner for use with a plurality of engagers.

[0018] FIG. 3 depicts a cross-sectional view of a conventional aligner having an engager void with a raised exterior profile.

[0019] FIG. 4 depicts a cross-sectional view of an aligner of the present technology having an engager void with an arcuate exterior profile.SI 15297.00176

[0020] FIG. 5 depicts a cross-sectional view of an aligner having two or more engager voids positioned to align with two or more engagers formed on the same surface of a tooth.

[0021] FIG. 6 depicts a cross-sectional view of an aligner having two or more engager voids on opposing sides of the aligner.Detailed Description

[0022] The present technology provides one or more aligners that include a body and one or more engager voids formed in the body. The engager voids are aligned with engagers on the subject’s teeth, when in use at least one of the one or more engager voids is shifted in position, in relation to the aligned engager, to create a pressure point between the engager and the aligner. The body of the aligner, where the engager voids are located, can protrude from the exterior surface of the body. To reduce the discomfort caused by the engager voids, and to increase the structural strength of the aligner where it contacts the engagers, the thickness of the body can be increased proximate to the portion of the body that defines the engager voids. On the outer or labial surface of the aligner, this can create a more arcuate surface over the engager void. The arcuate surface is substantially arch-shaped and provides a more consistently curved labial surface that effectively “smooths” the edges created by the protruding engager void, making the aligner more comfortable for the user.

[0023] Aligners, generally, can be used to alter the position of one or more teeth within a subject’s mouth. Aligners include a plurality of indentions and are configured to fit tightly on the subject’s teeth. Aligners are maintained on the teeth through an interference fit between the aligner and the teeth. Aligners also include some indentations that do not perfectly match the current shape or position of the patient’s teeth. The mismatch between the aligner and the teeth is predetermined so that the aligner applies pressure to specific teeth. In areas where the shape and position of the aligner does not match the current shape or position of the teeth, pressure points between the aligner and the teeth are created. The forces applied at the pressure points will trigger bone remodeling in the maxilla or mandibula, and, over time, teeth will shift position towards the shape and position dictated by the aligner. The specific force needed trigger bone remodeling results from a combination of specific pressure points between that tooth and the aligner. The forces at the pressure points are substantially greater than the pressure applied to the teeth through the interference fit.SI 15297.00176

[0024] The aligner covers the teeth and, optionally, a portion of the gums when inserted into the mouth. The aligners used in the present technology, are designed to provide forces to the teeth, at pressure points created by contact of the aligner with the teeth, to direct the teeth to a more desirable configuration. After the subject’s teeth adjust to the new positions dictated by the aligner, the aligner may be replaced with a new aligner having a slightly different configuration which creates pressure points that exert additional forces on the teeth to continue movement of the teeth until the configuration dictated by the new aligner is achieved.

[0025] The aligners described herein cover either the maxillary teeth (top teeth) or the mandibular teeth (bottom teeth). Aligners can be made of any material suitable for dental applications. Preferably, aligners are composed of a clear material, particularly a polymeric clear material. The aligner material can be a unitary material or can be composed of multiple layers of one or more materials (made, e.g., by a 3D printing process). Aligners can cover one or more of the teeth.

[0026] In some instances, an orthodontist or treatment planner may recommend using engagers that are bonded to a subject’s teeth in order to provide specific contact points between the aligner and a particular tooth. Engagers are often formed from a composite material that is bonded to a subject’s tooth in a particular location. Engagers can have different sizes, shapes, and orientations in order to achieve desired forces on a particular tooth. Different types of engagers can be helpful to achieve more difficult tooth movements. For example, some engager geometries can be used to better translate, rotate or tip particular teeth, while other geometries can be used for extrusion or intrusion of teeth, or to assist in anchoring the aligner more firmly onto the subject’s teeth. Engagers provide targeted contact points on the teeth which interact with the aligner to create enhanced pressure points on the teeth to improve movement.

[0027] Problem to solve: aesthetics and functionality. Existing engagers or attachments result in prominent protrusions extending out of the labial surface of the aligners. This is due to the traditional thermoforming technique used to manufacture aligners. According to this technique, a model of the subject’s teeth is 3D printed for each stage of an orthodontic treatment plan, and protrusions are manufactured on this model to match the shape, orientation, and location of any engagers that will be used for a particular treatment plan stage. When the aligner material is thermoformed over this 3D printed model, the resulting aligner will have a cavity or indentation on the interior surface of the aligner (referred to herein as an engager void) that can mate with an engager that is bonded to the subject’s tooth by a dental practitioner. Because the alignerSI 15297.00176 material is typically a polymeric sheet with a substantially uniform thickness, when it is thermoformed over the model that includes a virtual engager it creates an undesirable protrusion on the labial surface of the aligner.

[0028] In addition to being aesthetically displeasing and potentially uncomfortable, when a thermoplastic material is thermoformed over a model with a virtual engager, some thinning occurs around portions of the engager. This thinning of the material occurs in precisely the location where the aligner material contacts the engager and should be providing a consistent force on the engager. Orthodontists and treatment planners often recommend wearing aligners for between 20-22 hours every day, and each aligner is often worn for 1-2 weeks before moving on to the next step of a treatment plan. Over the course of this wear schedule, a thinning of the aligner material around the engagers can decrease the mechanical strength of the aligner in precisely the locations where more force is needed. Thinning of the aligner material may also result in decreased stability of the aligner during use, or increased plastic deformation of the aligner when the subject inserts or removes the aligner.

[0029] In one example embodiment, several of these challenges can be addressed using the techniques described herein. For example, the use of 3D printing or other additive manufacturing techniques to directly manufacture an aligner can avoid the thinning of the aligner material caused by the thermoforming process. Furthermore, direct 3D printing of aligners can allow an aligner manufacturer to create an aligner that has increased thickness in the areas contacting engagers and actually increase the force applied to those engagers. Direct 3D printing of aligners can also allow an aligner manufacturer to create an aligner with a smoother outer or labial surface that does not have noticeable bumps or protrusions where an engager is being used.

[0030] An aligner 100 for use with engagers 150 is depicted in FIG. 1A. The aligner 100 includes a body 110 having a plurality of indentions 120 that are configured to receive one or more teeth of the subject. The body 110 further includes one or more engager voids 130 formed in the body. FIG. IB depicts a tooth 140 of the subject which has an engager 150 coupled to the tooth. During use the aligner is placed over the teeth of the subject such that the one or more engager voids are aligned with the engagers. When in place, the engagers are positioned within the engager voids. At least one of the one or more engager voids is shifted in position, in relation to the aligned engager, to create a pressure point between the engager and the aligner. FIGS. 1A-1B illustrate an example embodiment with a substantially rectangular engager 150.SI 15297.00176However, various different engager geometries can be used, and these engagers can be positioned in different locations and different orientations on the surface of any tooth.

[0031] FIG. 2 depicts a top view of an aligner 200 for use with a plurality of engagers 250. Aligner 200 includes a body 220 having a plurality of engager voids 230 formed in the body. As shown in FIG. 2, during use, the aligner is placed over the teeth of the subject such that the one or more engager voids 230 are aligned with the engagers 250. When in place, the engagers 250 are positioned within the engager voids 230.

[0032] FIG. 3 shows a cross-sectional view of a conventional aligner 300 that includes a body 310 having an engager void 330 covering an engager 350. The aligner further includes a plurality of indentions 320 that are configured to receive one or more teeth of the subject (only one tooth indentation is depicted). The engager void 330 has a shape that is conformal with the shape of the engager 350 but is shifted in position to create a pressure point between the engager and the aligner. This creates indentations 355 on either side of the engager void 330, which further creates a protrusion along the aligner outer surface at the point of the engager void. In the example shown in FIG. 3, the aligner 300 was manufactured using a traditional thermoforming technique from a polymeric sheet having a substantially uniform thickness. This thermoforming process results in a stretching and thinning of the aligner material at the indentations 355, which is precisely where the aligner contacts the engager 350 and should be exerting a desired force on the engager 350. As discussed above, the thinning of the aligner material at indentations 355 may decrease the mechanical strength of the aligner in precisely the locations where more force is needed, decrease stability of the aligner during use, or increase plastic deformation of the aligner when the subject inserts or removes the aligner 300. The protrusion created during the thermoforming process can also cause discomfort to the user of the aligner and, in some instances, irritation of the inner mouth.

[0033] FIG. 4 shows a cross-sectional view of an aligner 400 of the present technology that includes a body 410 having an engager void 430 covering an engager 450. The engager void 430 is positioned to align with the engager 450 but is also shifted in position, in relation to the engager 450, to create a pressure point between the engager and the aligner. The aligner further includes a plurality of indentions 420 that are complementary to the shape and position of the teeth of the subject (only one tooth indentation is depicted). The aligner further includes an engager void 430 that has an interior shape that is conformal with the shape of the engager 450. In contrast to the aligner of FIG. 3, the thickness of the body 410 of the aligner 400 is increasedSI 15297.00176 in regions 445, proximate to the portion of the body that defines the engager voids. The thickness of the body is increased in regions 445 such that the exterior surface 415 of the body 410 is arcuate over the engager void. Creating an arcuate surface over the engager void mitigates some of the discomfort caused by a protruding engager void.

[0034] The point of contact between the engager and the engager void is under more stress than other portions of the aligner. Engagers provide targeted contact points on the teeth which interact with the aligner to create enhanced pressure points on the teeth to improve movement. The aligner provides the force needed to move / rotate the tooth by having an inherent resistance to deformation. By adding more material to the body proximate to the engager void, the aligner is now locally stiffer, and can provide more consistent forces to the engager, with less of the force being reduced by deformation of the aligner at the point of contact with the engager.

[0035] The ability to customize the thickness of the aligner material at critical contact points with the engager, as well as create a more uniform and smoother labial surface, can be achieved, in some embodiments, by directly 3D printing the aligner and thus avoiding the thermoforming process. While some portions of the aligner material can be thicker, as illustrated in regions 445, the thickness of other portions of the aligner can be decreased or otherwise customized in order to achieve the desired forces. For example, if a treatment plan calls for the intrusion of a particular tooth, a portion of the aligner located on the occlusal side of an engager can have an increased thickness to increase the force pushing the tooth into the bone, while a portion of the aligner located on the gingival side of an engager may have a decreased thickness to decrease any forces resisting the desired intrusive force. Various other arrangements of aligner thicknesses can be implemented with different engager geometries depending on the desired tooth movements. In some embodiments, an aligner can be customized to include increased thickness on one side of an engager void in order to provide a desired force in a desired direction, and decreased thickness on an opposite side of the same engager void in order to decrease resistance to the desired force.

[0036] FIG. 5 depicts a cross-sectional view of an alternate embodiment of an aligner 500 that includes a body 510 having engager voids 530a, 530b covering engagers 550a, 550b. The engager voids are positioned to align with the engagers formed on the same surface of a tooth but are also shifted in position, in relation to the engagers 550a, 550b, to create a pressure point between the engager and the aligner. The aligner further includes a plurality of indentions 520 that are configured to receive one or more teeth of the subject (only one tooth indentation isSI 15297.00176 depicted). The thickness of the body 510 of the aligner is increased in regions 545, proximate to the portion of the body that defines the engager voids. The thickness is further increased in the space 547 between the engager voids. The combination of increased thickness proximate to the sides of the engager void and in the space between the engager voids creates a smooth arcuate surface that extends over both engager voids 530a, 530b. As discussed above, this increased thickness can also increase desired pressure on the engagers, increase stability and retention of the aligner, and help resist deformation of the aligner in these critical areas.

[0037] FIG. 6 depicts a cross-sectional view of an alternate embodiment of an aligner 600 that includes a body 610 having engager voids 630a, 630b covering engagers 650a, 650b. The engager voids are positioned to align with the engagers formed on the same surface of a tooth but are also shifted in position, in relation to the engagers 650a, 650b, to create a pressure point between the engager and the aligner. The aligner further includes a plurality of indentions 620 that are configured to receive one or more teeth of the subject (only one tooth indentation is depicted). The thickness of the body 610 of the aligner is increased in regions 645a, proximate to the portion of the body that defines the first engager void 630a. The thickness of the body 610 of the aligner is also increased in regions 645b, proximate to the portion of the body that defines the second engager void 630b. The combination of increased thickness proximate to the sides of the engager voids creates an arcuate surface that extends over both engager voids 630a, 630b. The thickness of the body is increased in regions 645a and 645b such that the exterior labial surfaces of the body 610 are smooth and arcuate over the engager voids. Similar to the embodiments discussed above, the increased thickness of the body can also increase desired pressure transferred on the engagers, increase stability and retention of the aligner, and help resist deformation of the aligner in these critical areas.

[0038] In an illustrative embodiment, the aligners described herein can be formed from biocompatible aligner materials. Examples of aligner materials include polyurethanes (e.g., Isoplast), epoxies, and metals. In an example, the aligner material can be clear or colored to allow for aligners with designs in them instead of being uniformly clear. The formation and use of aligners is generally described in U.S. Pat. Pub. US20120270173A1 by Pumphrey et. al., titled "Aligners for incrementally moving teeth, and methods and apparatus of making and using such aligners”, which is incorporated herein by reference.

[0039] The aligners described herein can be made using 3D printing technology. In an exemplary embodiment, a 3D printing system can be used to make one or more aligners havingSI 15297.00176 engager voids with arcuate outer surfaces. A series of aligners can be made which allow incremental movement of the subject’s teeth to the desired positions.

[0040] To create an aligner using a 3D printer, a digital representation of the aligner is obtained. A digital representation of an aligner can be produced by initially scanning the user’ s teeth to create a 3D image of the teeth. Alternatively, a model of the users’ teeth can be made by preparing a polymeric resin impression of the teeth. A 3D digital model can be generated from the polymeric impression directly or by creating a model of the subject’s teeth and scanning the model.

[0041] Once a 3D digital model of the subject’ s teeth is obtained, a treatment plan is developed. A treatment plan is a series of steps that are predetermined by the provider to reposition the teeth of the subject into a desired configuration. Each step of the treatment plan corresponds to a specific movement of one or more teeth of the subject by a series of aligners. The series of aligners can be created from the initial 3D digital model of the subject’s teeth. Each aligner in the system is created to have one or more mismatches between the current or projected configurations of the teeth, so that pressure points are created between the aligner and the teeth to induce movement of the teeth toward the final tooth position as defined by the aligner.

[0042] In an exemplary embodiment, the desired movement of the teeth is broken down into a series of incremental steps designed to gradually move the subject’s teeth from the original position of the teeth, as defined by the 3D digital model of the subject’s teeth, to a final desired position of the teeth. The 3D digital model of the subject’s teeth can be used to generate a series of aligners that can incrementally reposition the teeth of the subject from the original position to the final position. The series of digital models of aligners is determined using a machine / software that runs a program that includes rules that provide the machine / software with a manner of evaluation and decision making. Some rules will define which teeth are best to be moved first, in a certain manner, and if multiple teeth can be moved at the same time with any given aligner in a sequence of aligners. The machine / software will perform assessments of the original teeth positions versus final teeth positions and perform calculations of what movement(s) are logically next in the sequence of aligners based on governing rules and parameters that serve as guidance for achieving optimally arranged teeth. In some implementations, identifying an arrangement of the second teeth alignment based on the first teeth alignment can be provided as an input performed manually by a provider. In this case, the number of iterative forces or movements required to cause the arrangement of the second teethSI 15297.00176 alignment can be determined based on the manually determined arrangement of the second teeth alignment.

[0043] Digital models of aligners can be created by using design software to create offsets (mismatches) between the teeth and the aligner for each of aligners in the series. The digital models can be designed, trimmed, smoothed, and modified using the design software.

[0044] In a 3D printing method, printing instructions for printing each aligner are determined from the digital models of the aligner created using the design software. In an exemplary embodiment, the printing instructions can include an ordering or sequence and timing of each additive manufacturing layer using a particular material within the alignment structure. In an exemplary embodiment, the printing instructions can be configured for a respective printer's capabilities to print with multiple materials, to resolve 3D objects into discrete volumetric pixels (“voxels”). Additionally, the printing instructions can provide for the method of additively manufacturing different materials (resins) at the correct location in such a way that the intended shape can be constructed with the designed features that are calculated for the aligner to accomplish predetermined movements of one or more teeth. In an example, the printing instructions can be configured to print on an additive manufacturing printer such as a Polyjet printer from Stratasys, Ltd. (Billerica, MA) Polymeric 3D printers that can be used to form aligners include, but are not limited to, fused deposition modeling (FDM) printers, stereolithography (SLA) printers, and selective laser sintering (SLS) printers.

[0045] The aligner digital models are typically generated without consideration of the formation of protrusions caused by engager voids. In an embodiment, the aligner digital models are modified prior to 3D printing. The aligner digital models are modified such that the thickness of the body of the aligner, proximate to the engager voids, is increased. The thickness is increased to create an arcuate exterior surface over the engager voids. The use of 3D printing technology allows the modification of the aligner digital models to be done prior to printing the aligner. This allows the aligner body to be formed as a single unitary structure.

[0046] After the series of aligner digital models has been defined, the series of aligners is created using 3D printing technology. The aligners comprising one or more engager voids are created using one or more of the modified digital representations.

[0047] Further details for using 3D printing technology to form aligners can be found in U.S. Patent Application Publication No. 2020 / 0383754, which is incorporated herein by reference.SI 15297.00176

[0048] Specific embodiments and methods of aligners having an arcuate eternal structure formed over engager voids have been disclosed. It should be apparent, however, to those skilled in the art that many more modifications besides those already described are possible without departing from the inventive concepts herein. The inventive subject matter, therefore, is not to be restricted except in the spirit of the disclosure. Moreover, in interpreting the disclosure, all terms should be interpreted in the broadest possible manner consistent with the context. In particular, the terms “comprises” and “comprising” should be interpreted as referring to elements, components, or steps in a non-exclusive manner, indicating that the referenced elements, components, or steps may be present, or utilized, or combined with other elements, components, or steps that are not expressly referenced.

Claims

SI 15297.00176CLAIMSWhat is claimed is:

1. An aligner for altering the position of teeth of a subject, wherein the teeth of the subject comprise one or more engagers coupled to one or more teeth, the aligner comprising: a body comprising a plurality of indentions that are configured to receive one or more teeth of the subject ; one or more engager voids, formed in the body, which are aligned with the one or more engagers when the aligner is applied to the teeth of the subject, wherein at least one of the one or more engager voids is shifted in position, in relation to the aligned engager, to create a pressure point between the engager and the aligner, and wherein a portion of the body that defines the engager voids protrudes from the exterior surface of the body; wherein a thickness of the body is increased, proximate to the portion of the body that defines one or more of the engager voids, such that the exterior surface of the body is arcuate over the engager void.

2. The aligner of claim 1, wherein the aligner comprises at least two engager voids positioned on the aligner to engage at least two engagers positioned on the same tooth, wherein the thickness of the body is increased in a space between two of the engager voids.

3. The aligner of claim 1, wherein the aligner comprises at least two engager voids positioned on the aligner to engage at least two engagers positioned on the same tooth, wherein a first engager void is formed on a buccal side of the aligner and a second engager void is formed on a palatal or lingual side of the aligner.

4. The aligner of claim 1, wherein the aligner is composed of a clear material.

5. The aligner of claim 4, wherein the clear material is a polymeric material.

6. The aligner of any one of claims 1-5, wherein the aligner covers one or more of the maxillary teeth.

7. The aligner of any one of claims 1-5, wherein the aligner covers one or more of the mandibular teeth.

8. A method of altering the position of teeth of a subject, comprising:SI 15297.00176 obtaining an aligner, the aligner comprising: a body comprising a plurality of indentions that are configured to receive one or more teeth of the subject ; one or more engager voids, formed in the body, which are aligned with the one or more engagers when the aligner is applied to the teeth of the subject, wherein at least one of the one or more engager voids is shifted in position, in relation to the aligned engager, to create a pressure point between the engager and the aligner, and wherein a portion of the body that defines the engager voids protrudes from the body; wherein a thickness of the body is increased, proximate to the portion of the body that defines the engager voids, such that the exterior surface of the body is arcuate over the engager void; positioning the aligner on the teeth of the subject such that one or more engagers attached to the subject’s teeth are aligned with the engager voids on the aligner.

9. The method of claim 8, wherein the aligner comprises at least two engager voids positioned on the aligner to engage at least two engagers positioned on the same tooth, wherein the thickness of the body is increased in a space between two of the engager voids.

10. The method of claim 8, wherein the aligner comprises at least two engager voids positioned on the aligner to engage at least two engagers positioned on the same tooth, wherein a first engager void is formed on a buccal side of the aligner and a second engager void is formed on a palatal or lingual side of the aligner.

11. The method of claim 8, wherein the aligner is composed of a clear material.

12. The method of claim 11, wherein the clear material is a polymeric material.

13. The method of any one of claims 8-12, wherein the aligner covers one or more of the maxillary teeth.

14. The method of any one of claims 8-12, wherein the aligner covers one or more of the mandibular teeth.

15. A method of making an engager as described in any one of claims 1-9, the method comprising:SI 15297.00176 generating digital representations of a series of aligners that can incrementally reposition the teeth of a subject, wherein one or more of the aligners in the series of aligners comprises one or more engager voids; modifying the digital representation of the one or more aligners comprising one or more engager voids by increasing the thickness of a body of the aligner proximate to the engager voids such that an arcuate exterior surface is defined over the engager voids; and creating the series of aligners, wherein the aligners comprising one or more engager voids are created using the modified digital representations.

16. The method of claim 15, wherein the aligners are formed using 3D printing technology.

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