CDE0111

I 33 MICD _ Inman Aligner I cosmeticdentistry 1_2011 The patient was thrilled with the result we achieved using an Inman Aligner and some simple bonding. She described that when she had once considered having veneers, she had hoped for a similar result. There are still minor imperfections, but, in my opinion, these contribute to her natural beauty. There is a stark contrast between the treatment selected and the potential treatment approaches in this case. Where once a patient, who refused ortho- dontics, would have consented and received highly aggressivetoothpreparationstoachievecorrectalign- ment with veneers, now a removable aligner and some simple bonding were able to achieve a similar and arguably better result in less than three months with not a micrometer of tooth reduction needed. _Case II (Figs. 9–17) This young lady had been attending my practice for some time and was aware of porcelain veneers, havingseenourpreviouslyadvertisedcases.Wehad spokenabouttheaestheticbenefitsofveneersyears before. However, on reviewing her case, it was clear that we could improve her alignment dramatically with an Aligner in a short period. We took an occlusal image of her anterior teeth andoutlinedtheamountoftoothstructurethatwould havetoberemovedtoproduceveneersthatwouldlook aesthetic. It was immediately apparent to the patient thatalignmentofherteethwouldofferapossiblybet- ter treatment outcome. Her case was suitable for an InmanAlignerandasonly2.5mmcrowdingwaspres- ent,thismeantitcouldbetreatedquicklyandsimply. Her Inman Aligner was fitted and IPR performed progressively over three visits. At week eight, upper and lower bleaching trays were constructed even though her alignment was not yet complete. Home whitening was begun with clear and concise in- structions. We used rubber trays with a deep seal cut into the model to create a tight dam effect. Over two weeks, her teeth whitened nicely and at week ten, she returned for a review. Interestingly,thepatient’sperceptionofhersmile had changed dramatically. Owing to the improved line angles, whiter teeth and balanced gum heights, her eyes were now only drawn to the irregular out- line caused by chipping and differential wear. Thepatientthenenquiredaboutfixingtheedges. Weofferedtobondtheincisaledgewithvirtuallyno preparation. A hybrid composite (Tetric Flow, Ivoclar Vivadent) was placed palatally and incisally with amicro-fillonthefacialsurface.ThiswasdoneinB0 and B1 shades to match the bleaching. The patient wasdelightedwiththeresultandawireretainerwas bonded immediately. Despite some clear deviations from her ideal simulated smile, the patient explained that she felt her smile after alignment was better than she had Fig. 17 Fig. 15Fig. 14 Fig. 16