No attachments for the first twelve stages
With thermoformed aligners, composite attachments are the standard tool for orthodontic leverage, and for most cases, they do exactly the job they're designed to do. But for aesthetic cases specifically, composite bumps bonded to the front teeth of a patient who came to you for aesthetics are a real-world tradeoff. It's a strange thing to ask of someone seeking an invisible treatment.
DSD Aligners don't need them, not for the first twelve stages. The aligner itself generates the force vectors, directly from its own variable geometry. After those first twelve stages, we reassess together and decide whether attachments are needed for the next phase. For many cases, they aren't.
a patient who doesn't hide their smile for six months of treatment, and roughly an hour of chair time back per case that used to go to placing, adjusting, and removing composite.