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Dental Tribune United Kingdom Edition

Case I The 25-year-old female patient complained about the appear- ance of her lower anterior teeth. She gave a history of orthodontic treatment in her teenage years, having a fixed appliance fitted for a period of two years. She had been given a retainer at the time but was told to wear it at night for three months only. She had noticed her lower four inci- sors starting to become crowded again. Treatment options dis- cussed were invisible braces, conventional fixed brackets or an Inman Aligner. The amount of space re- quired for reduction was calcu- lated as 3.5mm. Interproximal reduction was performed us- ing diamond strips (Brasseler). A reduction of 0.13mm at each contact point was achieved at the fitting appointment. This was verified with a thick- ness gauge. The patient was seen three weeks later and a further 0.13mm reduced at each contact point. The teeth were aligned in just over nine weeks. The Aligner was left in for one month to stabilise the tooth positions. Tooth whitening was undertaken for two weeks during the last two weeks of treatment. Simultaneous bleach- ing is a significant advantage in removable systems and helps patient motivation. Finally, an orthodontic retention wire was bonded in place on the lin- gual surfaces, ensuring the pa- tient could still use super floss for hygiene. Case II A female patient presented com- plaining mainly about her ro- tated upper right central tooth. She was considering veneers to redistribute the space over the four front teeth. This would have meant that she would undergo three aggressive preparations and one invasive preparation with endodontic treatment of the upper right central tooth. Space calculation with model analysis indicated that treatment would be possible with an Inman Aligner. Be- cause of the relatively low cost, the patient selected this option, understanding that we would not be able to achieve Golden Proportion, owing to the width and length of her lateral teeth. A midline screw was in- corporated to allow for a small amount of operator-controlled expansion to provide a lit- tle more space. (Incorporated expanders can be used to re- lease extra space in cases with very constrained space.) Up to 2 mm of space can be created by expansion, which has the effect of pushing the cuspid away from the lateral. After alignment, this expansion will just relapse. It is a temporary technique to create sufficient space to align the an- terior teeth. After alignment, the expander can even be unwound if required. Treatment took 13 weeks with three sessions of IPR. A to- tal of three mm was stripped and one mm was gained with the ex- pander. The teeth were retained using orthodontic gold chain bonded from canine to canine. An upper Essix Retainer was also worn nightly as back-up for retention. Case III The patient in this case originally presented for porce- lain veneers on her upper ante- rior teeth. The preparations would have required root-canal treatment of two of her incisors in order page 17DTß Fig. 7 Smile view before treatment Fig. 5 Occlusal view before treatment Fig. 6 Occlusal view after 13 weeks with an Inman Aligner ‘Simultaneous bleaching is a significant advantage in removable systems and helps patient motivation’ February 7-13, 2011United Kingdom Edition Implantology starts at the time of extraction ” ” Luxator is a registered trademark owned by Directa AB. 3382-1101©DirectaAB Easier for the dentist and dramatically less traumatic for patients and their dentition Highly acclaimed, renowned and proven functions in traditional shapes and sizes The Luxator® Periotome with 10 mm shorter shaft Elevator with traditional ergonomic Luxator handle providing extra strength and maintained tactility Innovative dual purpose tip for probing and luxating