Systems, methods, and devices for improved orthodontic treatment of a patient's teeth are provided herein. In some embodiments, a method includes determining an appliance geometry for a dental appliance. The appliance geometry can include a first region representing a shell comprising a plurality of teeth receiving cavities, and a second region representing at least one integrally formed component to be integrally joined to the shell. The method can also include generating instructions including a first digital representation of the shell based on the first region, and a second digital representation of the at least one integrally formed component based on the second region. The method can further include transmitting the instructions to a fabrication system configured to additively manufacture the dental appliance by fabricating the shell based on the first digital representation, concurrently with fabricating the at least one integrally formed component based on the second digital representation.