DTUK1210

May 3-9, 2010United Kingdom Edition Midi Premium • piezo scaler and curing light included • 2 handpiece outlets with fibre optics • pneumatic unit based on standard DCI parts • comfortable chair with seamless, artificial leather upholstery • 4 basic movements and 4 programmable settings • porcelain spittoon bowl • only 7% VAT 27 Woodcock Close Birmingham, B31 5EH mobile voicemail fax e-mail office@profi-dental.co.uk RRP £2,210 HIGH SPEED HIGH SPEED TURBINES non-optic £649 RRP £1,170 3x TKD THALIA® push button, single spray, non-return valve, direct connection to Midwest 4-hole HIGH SPEED TURBINES WITH LED ILLUMINATION Cominox autoclaves TKD Handpieces WWW.PROFI-DENTAL.CO.UK RRP £4,550 6l autoclave with fast 10-min B-type cycle, perfect for implantology, printer SterilClave 6 B £3,820 RRP £3,150 great value 18l autoclave for everyday sterilisation, integrated printer SterilClave 18 S £2,640 RRP £5,600 large 24l, B-type autoclave for busy practices, integrated printer SterilClave 24 B £4,690 £1,199 3x TKD THERA®L 40SE illumination 25,000 lux, titanium finish, ceramic bearings, triple spray, non-return valve, compatible with Kavo® Multiflex®, 2 year guarantee 1x TKD GYROFLEX® LED RRP £2,210 Simple and reliable unit with generous specification. £7,990 SPECIAL OFFER - SPRING 2010 DENTAL CHAIRS AUTOCLAVES SUCTION PUMPS X-RAY UNITS HANDPIECES WASHER DISINFECTORS COMPRESSORS SURGERYPLANNING 07981075157 08450044388 08719442257 to perform any necessary IPR. At the completion of treatment, retainers are fabricated and giv- en to the patient to stabilise and maintain this new position. One of the nice things about Invisalign is that hardly any new armamentarium is required to begin treating patients with this system. Every general dentist has impression material already in their office. Every dentist should have a digital camera to assist with treatment planning. The only new equipment needed is a few IPR disks and strips, which can be acquired for a trifle amount. Case 1 This 35-year-old male patient pre- sented to our office seeking to cor- rect his minor crowding (Fig. 3). His chief complaint was that his teeth were overlapped, causing food to become impacted. In ad- dition, he was concerned with the esthetic appearance of his smile. This patient was familiar with the Invisalign brand name, and specifically asked if he wo- uld be a candidate for this treat- ment modality. A complete dental and medi- cal work up was performed. No carious lesions were noted, and his periodontal health was in order. Alternative treatment op- tions were given, along with the risks and benefits of each choice. After a thorough discussion, the patient decided to proceed with Invisalign. Detailed PVS impressions were taken (Genie Heavy and light Body, Sultan Healthcare) along with a bite registration (Ge- nie Bite, Sultan Healthcare) and all necessary p h o t o g r a p h s using a digital camera (Canon Rebel XT). The Clin- Check was de- veloped and can be seen in Fig. 4. The maxillary arch exhibits 4mm of overlap- ping, with the left lateral incisor being positioned slightly palatally. The left central incisor partially covers the lateral incisor, with the left canine protrud- ing bucally. The mandibular arch has approximately 3mm of crowd- ing present; the right lateral incisor is being pushed lingually and slight crowding is present in the rest of the anterior region. Treatment objectives were to ro- tate the canines and anterior teeth, creating more space for the lateral in- cisors to properly come into the arch. Once aligned, the anterior teeth would return back into position, allowing for a uniform, symmetrical arch form. The patient’s treatment lasted ap- proximately nine months, and re- quired minor IPR on both the max- illary and mandibular arches. At the end of treatment all teeth were aligned properly, with no overlapping present between them (Fig. 5). Notice how the ClinCheck matches exactly with the actual end of case photos (Fig. 6). Re- tainers were fabricated and instruc- tions were given to the patient how to properly maintain his new smile. This patient was glad to finally have this minor issue resolved after so many years. He never wanted to have traditional fixed orthodontics, and was happy to have his teeth aligned properly in less than one year’s time with clear, removable appliances. Case 2 This 28-year-old female patient wished to close the spaces present between her front teeth. Intra-oral examination revealed that diastemas were present between most anterior teeth, in both dental arches (Fig. 7). A full workup was performed and no contraindications were noted. Al- ternative treatment options discussed, and the patient elected to continue with Invisalign treatment. PVS impressions, a bite registra- tion, and photos were taken. The Clin- Check setup was constructed, and can be viewed in Figure 8. The maxillary arch exhibits 2mm of spacing present, most noticeably between the two cen- tral incisors. The mandibular arch has 3mm of spacing, and slight mis- alignment of the central incisors. The goal of treatment was to retr- ude the anterior teeth slightly, while rotating the canines to help close all diastemas. In addition, the teeth would be aligned properly with even contact points present between them. Since this case required only mi- nor movements to achieve its desired goal, it qualified as an Invisalign Ex- press case. An Express case is one where approximately 2mm of spacing or crowding is present, and less than twenty degrees of rotation is neces- sary (Fig. 9). Only ten aligners are fab- ricated for an Express case, and treat- ment time is six months or less. The advantage of this over a full Invisalign case is that the cost to the practitioner is significantly reduced. The treatment time for this patient was six months. At the completion of treatment,alldiastemaswereresolved, and the teeth were in proper align- ment (Fig. 10). Again, take note how the ClinCheck and end of treatment photographs are identical (Fig. 11). Using just Invisalign, we were able to correct this patient’s con- cerns, allowing her to enjoy her new smile. Once treatment was finished, she was thrilled with her new smile and has become a spokesperson for our practice, and for Invisalign. Invisalign is a resourceful treat- ment tool, that will help boost patient satisfaction and lead for a bright fu- ture for your practice. DT About the author Dr Schwartz graduated from Touro College with a Bachelor of Arts degree in Biology. He received his Doctor of Dental Surgery degree from New York University College of Dentistry. Dr Schwartz practices general and cosmetic dentistry in Midtown Manhattan. He is a member of the American Dental Association, the Academy of General Dentistry and the New York State Dental Society. He currently resides on Long Island with his wife and family. He is an avid magician and enjoys bike riding. page 13DTß Take a good look at the teeth shown in Fig1a, b, c: Clinical appearances that can be treated using the Invisalign system. Fig2a & b: ClinCheck representation. Fig1a: Fig1b: Fig2a: Fig2b: Fig1c: Fig7a & b: Patient with diastemas in anterior segments. Fig8a & b: ClinCheck model showing spaces present in the anterior. Fig9 table: Invisalign Express criteria. Fig10a & b: Intra-oral photographs show di- astemas are resolved. Fig11a & b: ClinCheck showing all spaces closed. Fig7a: Fig10a: Fig11a: Fig8a: Fig9: Fig8b:Fig7b: Fig10b: Fig11b: Case 2 Fig3a & b: Patient with minor crowding present in both arches. Fig4a & b: ClinCheck representation showing crowding. Fig5a & b: Invisalign treatment lasting only 9 months. Fig6a & b: ClinCheck model showning projected treat- ment outcome. Fig3a: Fig4a: Fig6a: Fig6b: Fig4b: Fig5a: Fig5b: Fig3b: Case 2