By integrating engineered occlusal blocks directly into Angel Aligner clear aligners, the A6 system provides orthodontists with a predictable, patient-friendly alternative to bulky traditional twin-block appliances.
Correcting skeletal Class II malocclusions in growing patients has traditionally required a trade-off between clinical efficiency and patient compliance. By integrating engineered occlusal blocks directly into clear aligners, the A6 Mandibular Advancement Solution from Angel Aligner allows orthodontists to bypass the preliminary leveling phase and begin advancing the jaw and aligning the teeth simultaneously from aligner one. This single-phase digital workflow eliminates bulky traditional Twin-Block appliances, significantly reducing overall treatment time while dramatically improving patient comfort and compliance. To ensure this dual-action protocol performs predictably, the technology relies on a mature, heavily vetted clinical foundation.
The A6 Mandibular Advancement Solution is backed by an 11-year global track record of more than 70,000 cases*. This extensive history of real-world use has allowed the biomechanics of the occlusal blocks to undergo continuous, iterative refinement.
“The A6 Mandibular Advancement solution is a strong example of our philosophy that clinical innovation is continuous,” says Jason Tabb, vice president and general manager of North America for Angel Aligner, in an interview with Orthodontic Products. “More than 11 years and four generations*, each iteration has been shaped by direct doctor feedback, research, and designed for predictable outcomes. Each release has expanded the range of treatable cases while improving predictability and patient comfort.”
Key Clinical Features
- Integrated true twin block design with engineered inclined planes for controlled jaw movement
- Automatic occlusal coordination across all treatment stages driven by iOrtho digital planning software
- Dynamic sizing and optimized placement of occlusal blocks adapted to specific vertical height and occlusion
- Eruption tabs for teeth in process of eruption allowing bite blocks to be planned even in the presence of edentulous spaces
- MasterControl S material construction for balanced strength and flexibility during active movement
- Post-treatment stability features, including curved turbos to hold the mandible position for a longer period of time.
- ICS — Intelligent Ceph System automates cephalometric analysis, including Skeletal Age Analysis, to help identify the optimal time to begin A6 treatment based on skeletal maturity rather than chronological age alone
Key Benefits
- Eliminates the pre-MA initial stage allowing for simultaneous tooth alignment and mandibular forward positioning
- Reduces chair time by automatically coordinating block morphology, removing the need for manual chairside adjustments
- Shortens overall treatment duration for growing patients by consolidating two distinct clinical phases into a single streamlined protocol
- Enhances patient comfort and compliance by replacing bulky traditional functional appliances with a highly aesthetic clear aligner
- Delivers predictable biomechanical control over the lower incisors and occlusal plane while advancing the mandible to an ideal position.
Clinical Application: Single-Phase Class II Correction
A primary clinical advantage of the A6 Mandibular Advancement Solution is its ability to bypass the preliminary alignment phase (often referred to as the “Pre-MA” stage) required by other clear aligner systems. Because the engineered occlusal blocks are integrated from the first stage, clinicians can begin advancing the mandible and aligning the arches simultaneously from the first aligner. This single-phase digital workflow is designed for growing children and adolescents during key developmental windows, including the rapid growth period (girls aged 9 to 10 and boys aged 11 to 12), the growth peak (girls aged 11 to 13 and boys aged 14 to 15), and the growth deceleration period (age 14 for girls and age 16 for boys). The system is indicated for mild to moderate skeletal Class II malocclusions, particularly in patients presenting with average-angle or low-angle vertical patterns and is suitable for patients who are candidates for traditional Twin-Block appliances.
Clinical Case Studies
Case Study 1: Mixed Dentition Class II Division 1 Treatment
To demonstrate these clinical principles, orthodontist Giacomo Scuzzo, DDS, utilized the A6 solution to treat a 10-year-old male patient presenting with a Class II division 1 malocclusion, mandibular retrusion, a deep bite, and reduced transversal diameters in the mixed dentition. The treatment plan utilized 25 aligners over a nine-month period, with aligner changes scheduled every 10 days. By combining upper archform enlargement (dental expansion) with the A6 mandibular advancement protocol, Scuzzo achieved a stable Class I molar and canine relationship while correcting the overjet and overbite. To support the skeletal correction, the protocol was integrated with Angel Aligner’s proprietary angelButton feature to facilitate night-time Class II elastic wear.
Reflecting on the clinical workflow, Scuzzo wrote that he had a “positive clinical experience especially in being able to perform [two] treatment phases in the same digital planning, paying attention to the development of the upper arch form and coordinating it with the lower in the mandibular advancement.”
Case Study 2: Class II Division 2 Treatment in Growing Patients
In another clinical case, orthodontist Isabel Flores Allen, DDS, treated a 13-year-old male patient presenting with a skeletal Class II relationship, bilateral molar and canine Class II, and a Class II division 2 dental pattern with a severe deep bite. The patient was at the CS3 stage of cervical vertebral maturation, corresponding to the pubertal growth spurt—a biologically favorable window for condylar remodeling. The 10-month treatment plan utilized 35 aligners with advancement blocks followed by 10 additional aligners incorporating Class II elastics on angelButtons. Using the Frog Protocol combined with interproximal reduction (IPR), Flores Allen achieved complete leveling of the Curve of Spee and corrected the sagittal discrepancy.
Evaluating the outcome, Flores Allen wrote that “the A6 protocol allowed a progressive and well-tolerated mandibular advancement, eliminating the need for a pre-advancement phase,” adding that “digital planning ensured predictable, biologically safe tooth movements” and that “the treatment was stable, comfortable, and efficient, achieving functional, aesthetic, and skeletal objectives.”
Target Users and Clinical Integration
The A6 Mandibular Advancement Solution is designed for orthodontists who regularly treat mild to moderate skeletal Class II malocclusions in growing children and adolescents. It offers a streamlined digital alternative for practitioners looking to transition away from traditional fixed functional appliances to a fully customizable, single-phase clear aligner workflow.
Support and Continuing Education
While the A6 system represents a specific clinical solution, it is backed by Angel Aligner’s broader global footprint. For more than 23 years, the company has been at the forefront of clear aligner innovation, treating over 2 million smiles* worldwide and pioneering breakthrough solutions including angelButton, angelHook, and A6 Mandibular Advancement. According to company data, a large percentage of its cases involve complex orthodontic movements, such as molar distalization, extraction space closures, deep bites, and surgical cases. To support these treatments, the company integrates advanced software algorithms and digital treatment planning into its clinical workflow.
To assist North American practices in adopting these tools, the company operates Angel Education, an educational platform offering expert-led webinars, live events, and on-demand clinical videos. Additionally, Angel Aligner is building a 52,000-square-foot manufacturing facility in Milwaukee, Wisconsin, to streamline supply chain logistics and reduce turnaround times for domestic providers.
Availability and Contact
The A6 Mandibular Advancement Solution is available globally; for more information or to schedule a clinical demo, visit angelaligner.com.
Photo: Angelalign Technology
References
- Werner A. Angel Aligner leverages 23 years of global data as it expands its U.S. footprint. Orthodontic Products. Published May 20, 2026. Accessed July 23, 2026. https://orthodonticproductsonline.com/treatment-products/aligners/angel-aligner-expands-us-market-with-clinical-features/
- A6 Mandibular Advancement Solution. Angel Aligner. Accessed July 23, 2026. https://www.angelaligner.com/innovation-solutions-a6-mandibular-advancement/
- Scuzzo G. Correction of mandibular retrusion in growing patients with A6 mandibular advancement. Angel Aligner Case Report. Accessed July 23, 2026. https://orthodonticproductsonline.com/clinical-tips/aligner-treatment/streamlining-class-ii-correction-in-growing-patients-with-a-single-phase-mandibular-advancement-aligner/
- Flores Allen I. Correction of Class II Division 2 Malocclusion in Growing Patients using A6 Mandibular Advancement. Angel Aligner Case Report. Accessed July 23, 2026. https://www.angelaligner.com/en-us/correction-of-class-ii-division-2-malocclusion-in-growing-patients-using-a6-mandibular-advancement/
*Angel Aligner data on file.
