European Aligner Society stages 3rd Annual Congress in Malta

Dr Graham Gardner – Past President of the European Aligner Society reviews the 3rd Annual Congress in Malta, 7-9 October 2021

It is a pleasure to report back on the European Aligner Society’s first live face to face event in over a year and a half.  The EAS hosted the 3rd International congress in Malta which had to be postponed several times from the original date of March 2020.

There was an air of excitement as delegates arrived, the companies unpacked their equipment to set up their incredible stands in the exhibition hall.  Colleagues from all over Europe and a number of other countries around the world were once again reunited.  The Malta Hilton was a fabulous backdrop to the congress which had initiated a number of workshops on the Thursday 7th October to warm things up.  Delegates could choose from a variety of sessions hosted by some of the companies supporting the event, allowing delegates to experience a hands-on experience.

The main plenary session started on Friday 8th October and continued onto Saturday 9th.  Although the numbers of delegates was understandably lower than originally hoped for, there were still 350 attendees, and there was a palpable atmosphere of excitement as the first session was opened by the President of EAS, Dr Alain Souchet and his event organising team Dr Tommaso Castroflorio, Dr Francesca Garino and the CEO Dr Les Joffe.  The program was designed to address new aspects of aligner orthodontics with the morning sessions dedicated to diagnosis and treatment planning which obviously transcends any specific aligner system – as this is probably one of the most important steps in successful orthodontic treatment.

Without doubt the message coming through is we now have the facility for 3D treatment planning incorporating CBCT scans and the incredible digital advancements using this data to generate 3D tooth movement treatment plans which allow even more realistic visualisation of tooth movement.  It is becoming apparent that this incredible digital advancement is allowing us not just to visualise crown movement, but almost more importantly, the root movements as well. The ability to get the roots in the correct place could be more significant to successful outcomes and predictability than we originally thought and CBCTs are giving us the ability to assess this. crowns.

A statement that sticks in my mind as many of us battle with the investment and use of CBCT’s, is that when the lateral ceph x-ray was first introduced most rejected its significance and it took a further 20 years before it was widely accepted in orthodontic treatment planning. People are generally resistant to change and maybe this may be the case for CBCT’s at present? However, the quality of the presentations and the evidence suggested is persuasive that 3D treatment planning is the next evolution in orthodontics.  As always, these new horizons are exciting developments in our wonderful world of orthodontics. 

The afternoon session and Saturday session moved to clinical tips to improve predictability in aligner therapy.  Presenters discussed and presented practical solutions to the common challenges we all encounter in aligner orthodontics and the use of TADs to enhance predictability was a common theme.  TAD’s not only offer improved anchorage (directly or indirectly) but can also reduce unwanted vectors of force. Of course, correct placement of the TAD’s is crucial in achieving our treatment objectives.  Sound biomechanical knowledge of how to get to the final result influences the placement of TAD’s and once again understanding 3D movement influences TAD placement. Another theme that came out of the presentations is correct staging.  The advantage of plastic biomechanics allows us to stage movements sequentially, reduce velocities when appropriate and assess our anchorage requirements precisely.  Pushing the envelope to include orthognathic surgery was impressive to see.  It was refreshing to see different aligner systems coming to market and producing some impressive results.

With aligner therapy now a mainstream approach to successful orthodontics, EAS was delighted to announce the introduction of European Board of Aligner Orthodontics Certification for excellence in aligner orthodontics. The accreditation process will require 5 cases to be submitted by candidates to the accreditation board, including presentation of the cases and an oral exam which will then result in the prestigious EAS accreditation confirming excellence in aligner therapy.  Details of the process can be found on the EAS website and is open to anyone confident in treating with aligners. 

Dr Graham Gardner, pictured centre

The welcome return to live events made me realise, more than ever, how much I had missed them. Online meetings are great for short presentations but one forgets how wonderful a live event is until you are back in an auditorium sharing the learning experience with other enthusiastic colleagues and being educated and entertained by the different personalities and presentation styles of our esteemed presenters.  Being able to ask questions face to face, interact with the presenters and share ideas with colleagues is a welcome return.

Finally, I would like to thank the Maltese people who made us feel very welcome.  Their friendliness and obvious patriotism to their wonderful country is heart-warming to see. I will not forget our tour guide, one evening, who epitomised this as she so proudly shared their heritage in the historic and walled town of Medina.  To the delegates and companies who made it across to Malta we thank you for a wonderful few days together and getting the ball rolling to live events.

The European Aligner Society looks forward to welcoming delegates to its Spring Meeting in Porto, Portugal on 6-7th May 2022 (dates to be confirmed), then the 4th Congress in the wonderful city of Turin on 11-13th May 2023.   For more information please visit

European Aligner Society hosts global Autumn Meeting – available to watch on-demand

The European Aligner Society (EAS) recently held its 2020 Autumn Meeting to continue to explore the perpetual advances in technologies and techniques in aligner orthodontics. The meeting, which took a virtual format to meet the needs of these challenging times, was moderated by EAS President Alain Souchet and Scientific Director Tommaso Castroflorio. It comprised three plenary sessions with speakers presenting the latest findings and experiences of aligner therapy. These can be watched on-demand here:

As befitting a European organisation, the lectures were delivered by an International line-up of expert speakers, and attracted 207 delegates from Europe, North and South America, the Near and Far East and the Mediterranean countries. In the space of a day, delegates were taken on a world tour, taking in the latest orthodontic expertise without the need for a passport.

The global excursion started in Greece with Dr Gina Theodoridis who was one of the first Invisalign certified doctors and has been treating with aligners for almost twenty years. She is currently a Diamond provider and an Invisalign speaker. Dr Theodoridis’ lecture examined the factors and biomechanical concepts which affect the effectiveness of distalising the posterior teeth with aligners, and explored the realistic outcomes which can be achieved in such circumstances. In the two cases she presented, she concluded that the 50% sequential distalisation protocol was the most predictable and that posterior distalisation in the mandibular arch is a predictable option with aligners.

Traveling (digitally) from Europe to Japan where Dr John Kaku addressed he meeting. Dr Kaku obtained his Orthodontic Certificate and MSD degree from Boston University and is an Instructor at the Japanese Academy of Non-Extraction Orthodontics. For the EAS meeting, Dr Kaku took delegates on a tour of his practice to show them ‘How to have successful Invisalign First cases and management amongst team’. The presentation demonstrated the whole patient journey at his private practice, SuperSmile International Orthodontic Office, highlighting how involving a well-trained team and the right digital tools contributed to the success of the practice.

Back to Europe where the Vice-President of the Portuguese Aligner Society (SPAD) Dr Pedro Monteiro expanded on the changing orthodontic landscape and the behavioural shift amongst consumers. Dr Monteiro highlighted the importance of reinventing the patient journey using artificial intelligence and tele-dentistry in the virtual era and the need for building a virtual practice for what is not just the post Covid era, but the new reality. As he commented: “Virtual dentistry is a way of wowing your patients with outstanding service they cannot get elsewhere, it offers convenience, it also gives the patient an estimated treatment time and cost before any firm commitment is needed from them.”

Dr Rafi Romano has a private exclusively orthodontic practice in Tel Aviv, Israel, from where he delivered his lecture. Dr Romano’s emphasis on adult and aesthetic orthodontics, using state-of-the-art technologies was the focus of his session entitled ‘Optimise your aligner treatment utilising outcome simulation and progress assessment tools’. Dr Romano’s lecture focused on chairside tools which help orthodontists visualise, discuss and predict treatment options before beginning treatment and, later on, to assess the progress and fine-tune the treatment to maximise efficiency, shorten back-and-forth and the need for additional aligners. He explained how he uses the iTero Outcome Simulator and progress assessment tool features and artificial intelligence in order to make his work easier and more predictable. Dr Romano concluded that the tools you have today are not what you will have tomorrow as artificial intelligence algorithms are perpetually improving, and will give even better guidance about making the best tooth movements using clear aligners.

From Israel to Lithuania where Dr Dalia Latkauskiene is a Diamond II Invisalign provider. She practises in multidisciplinary orthodontic clinics and gives module courses on aligners based on basic principles of orthodontic biomechanics. At the EAS meeting Dr Latkauskiene presented on the topic of asymmetries in aligner treatment. If not properly diagnosed, slight asymmetries tend to be revealed throughout orthodontic treatment, thereby extending treatment time and hindering final outcomes. For correcting or reducing asymmetries, clinicians may choose asymmetrical dentoalveolar or skeletal mechanics, asymmetrical extractions or surgical interventions. Multidisciplinary treatments prove very useful to help solve dentoalveolar asymmetries. Aesthetic improvements of a dental nature and gingival outlines are required in deviated smiles, or frontal tipping of the occlusal plane. Working on pink and white aesthetic patterns may reduce dentoalveolar asymmetries and increase patient’s satisfaction. Dr Latkauskiene presented different plans of aligner treatment for dentoalveolar and skeletal asymmetries and advised her peers to be cautious with asymmetries of skeletal growth when treating children.

As she commented “We need to understand dentoalveolar asymmetries and adaptations, and how they reflect on facial soft tissues. We also have to be careful of TMJs and how they are approached, especially with aligners, both in children and adults, especially as aligners disengage the bite so that the teeth don’t bite together.”

Next to the USA to meet John Morton who has had a forty-year career in orthodontic biomechanics and is Senior Technology Fellow for Align Technology. He discussed the Invisalign SmartForce features, SmartTrack material and SmartStage technology which together provide the optimised progression of tooth movements, reduce unwanted interference and increase the predictability of Invisalign treatment. The importance of using the principles of biomechanics when planning treatments with aligners was highlighted by John who advised his peers that they need to investigate the anchorage capabilities of aligners, control the active and the reactive units and trust that the combination of SmartForce, SmartTrack and SmartStage are powerful enough to treat very complex cases with the Invisalign system.

Dr Sandra Tai from Canada has been an Invisalign certified orthodontist since 2000 and is currently an Invisalign Diamond Plus Provider. She is also the author of the most recent textbook on clear aligners called “Clear Aligner Technique”. Dr Tai’s presentation looked at the results of a research study completed at the University of British Columbia comparing skeletal, dental and soft tissue effects of Class II malocclusions treated with Invisalign with Mandibular Advancement compared with Twin Block functional appliances.

According to Dr Tai, both the twin block appliance and the Invisalign MA feature may be considered appropriate treatment alternatives when considering treatment options for class II, growing, retrognathic patients. The Invisalign system with MA showed a significant difference over twin block patients in increase in SNB and also offered better control on lower incisor inclination, and better vertical control of lower incisor position.

Dr Tai stated: “I was the twin block queen. When clear aligners first came out in year 2000, many of us thought of clear aligners as an appliance for class I minor crowding with a lot of IPR. In 20 years, clear aligner technology has evolved significantly. Never in my wildest dreams did I think I would be able to do growth modification for class II patients with a clear aligner appliance. I now believe that the Invisalign treatment with MA represents a ground breaking evolutionary leap forward for the field of clear aligner technology and for orthodontics. The future is digital and the future is clear”.

From North America to South where Dr Tomas Salazar from Chile presented ‘In office aligner workflow’ underlining that clear aligners have their place in an orthodontic clinical practice. He showcased the importance of the digital workflow in the treatment of malocclusions as it gives the exact information of how much and when each tooth will move. He concluded that aligners are the most individualised prescription ever created and looked at the option of fabricating them in clinic as a cost-effective and predictable process.

Dr Antonino Secchi from the USA received the 2005 David C. Hamilton Orthodontic Research Award from the Pennsylvania Association of Orthodontists (PAO), and the 2010 and 2013 Outstanding Teacher Awards from the Department of Orthodontics of the University of Pennsylvania. Dr. Secchi is the founder of the “Complete Clinical Orthodontics System” (CCO System™) and the Secchi Institute™, which provides continuing education for orthodontists in the USA and throughout the world. Dr Secchi presented Dentsply Sirona: The SureSmile Advantage. He advised that SureSmile assures the clinician has total control and predictability in their orthodontic treatment options. During this presentation Dr Secchi presented the principal advantages of SureSmile Aligner Therapy and illustrated its benefits with completed cases. He suggested that “SureSmile is a powerful cloud base software solution that provides accuracy, tremendous versatility, as well as superb control for clear aligner cases”.

The delegate feedback was unequivocally favourable, with testimonies including: “Congratulations on putting on a marvellous program. The past six months I have logged into a number of webinars from different organisations including two dental schools and a major Wall Street investment bank. In my opinion, you exceeded or were on par with all of them.” – Dr Barry Winnick (USA)

“I wish to thank you again for affording me the opportunity to present on this distinguished platform yesterday. There is no doubt that you are doing remarkable work for us doctors and you have created the most objective and informative Society.” – Dr Rafi Romano (Israel)

“I was so excited to watch the virtual meeting. I missed a few of the events because of the time. Glad the presentations are available later to watch” – Prof. Rooz Khosravi (USA)

For those, like Professor Khosravi, who would like to watch the lectures in their own time it is possible to do so by visiting, scrolling down to “Detailed Program” and underneath each presentation title there is an icon with “Recorded Video: Watch video”. Click to watch as many times as you wish.

At the conclusion of the EAS Virtual Meeting, The Executive Secretary of the European Aligner Society Dr Leslie Joffe updated delegates about the EAS’ 3rd Congress in Malta which is scheduled for 25th – 27th March 2021, but of course is subject to the prevailing health and travel guidelines. He advised that it would be a good idea to visit for more information and updates. It is also possible to renew Society membership and benefit from reduced Congress booking rates on the site.