Butons and Elastics for Clear Aligners​

Buttons and elastics are used in orthodontics for anchorage control in certain types of movements. To place a button or an elastic, a cut must be made in the aligner which could come prefabricated by the aligner manufacturer or be made manually chairside by the treating doctor.

There are two types of cuts:

• Button cutout that allows for a button to the bonded directly on the tooth.
• Elastic hook or “slit” which allows for direct engagement of the elastic to the aligner.

For manual aligner cutouts, multiple cutout pliers are available in the market. These manual cutouts may be needed for in-office aligners or mid-treatment troubleshooting when a tooth is not moving as expected due to anchorage limitations.

Buttons are bonded directly on a tooth for Class II or Class III molar anchorage or when the force needs to be used for “pulling” the tooth. Some examples are:

• Canine distalization.
• Premolar extraction closure.
• Canine extrusion.
• Crossbite correction.
• Rotation on posterior round teeth.
• Single tooth extrusion.

Elastic hooks are used on Class II or Class III canine anchorage or when the force is not required to pull on a single tooth however, the combination between button cutouts and hooks can be planned at the discretion of the treating doctor.

Buttons are available in different materials and shapes and the choice is at the treating doctor’s discretion. Below are some examples of different buttons available on the market.