Minimal biologic loss

A 30-year-old female patient presented to the practice unhappy with the appearance of her upper anterior teeth. She didn’t like how they stuck out in photos and that her two front teeth were different shapes. She hadn’t undergone orthodontic treatment previously, but was keen to avoid fixed braces and any lengthy treatment.

A full orthodontic assessment was performed (table 1) with the compromised treatment plan explained in detail to the patient for informed consent (table 2).

Treatment planning

The Spacewize+ arch evaluation tool suggested an estimated total of 2.5mm of space would need to be created – well within the 3mm recommended limit of the ClearSmile Inman Aligner. Progressive interproximal reduction (IPR) and predictive proximal reduction (PPR) was planned throughout treatment, with PPR expected to focus on the mesial surfaces of the central incisors. Following alignment, we planned to replace the defective mesial composite restorations on UR1 and UL1 and perform composite incisal edge bonding on UL1. Retention would be provided via a bonded flexible spiral wire retainer, over which would be fitted a vacuum-formed retainer.