Adhesiveless Bonding of Metal Buttons to Clear Aligners: A Technical Report

Auxiliary buttons are often required in clear aligner therapy for elastic traction. We introduce an adhesiveless flame-fusion technique for affixing auxiliary metal buttons to clear aligners, aiming to eliminate the extra chair time, occasional debonding, and translucent haze associated with resin adhesives. Round‑base stainless‑steel buttons are grasped with locking forceps, heated in an alcohol flame (~600-650 °C for 10-15 s), and immediately pressed with moderate manual pressure (~5 N) for 5-10 s onto 0.75 mm polyethylene terephthalate glycol (PETG) aligners that are fully seated on working models to prevent distortion. Clinical use has shown the buttons remain firmly embedded under routine intra‑ and inter‑arch elastic forces without compromising aligner fit or transparency, while bonding can be completed in well under a minute. This simple, cost-effective protocol is readily adaptable to most commercial aligner systems and avoids the drawbacks of adhesive bonding, including extra chair time, occasional debonding, and the translucent haze associated with resin adhesives.