Having recently taken a training course to provide a new cosmetic orthodontic treatment, it was my 29-year-old dental nurse who first approached me wishing to enhance the appearance of her anterior teeth.
She had previously undergone fixed orthodontic treatment as a teenager to correct a class I division II malocclusion, but otherwise had required very little dental work. She was medically fit and well, had maintained excellent oral health and had zero caries experience, but her upper central incisors were beginning to relapse. The upper left central incisor was retroclined and the UL2 was noticeably proclined.
Treatment options
We discussed the following treatment options:
- Do nothing, wait and see
- Fixed orthodontics
- Removable orthodontic appliance
- Inman Aligner
As the patient was concerned that the appearance of her anterior teeth would worsen with time, she was not prepared to leave them and see what happened. She also declined fixed orthodontic treatment due to the appearance of the brackets. With regards to the two removable appliances, as only the upper lateral incisors needed aligning the first choice seemed unsuitable. In the end, it was the speed of the Inman Aligner treatment and the discretion of the appliance that most attracted the patient.
Treatment
Interproximal reduction (IPR) was carried out during the patient’s initial visit mesially on the U3-3 using the blue strips and red elsewhere, and she reported no sensitivity. During her next two visits the red IPR strips were used on U3-3 to create enough space for the teeth to move effectively. The patient wore her appliance for at least 20 hours per day, with the exception of the Christmas holiday period. Initially, her speech was difficult, with increased saliva.
The treatment progress was rapid and very positive, with the upper left central and lateral incisors moving in just one month. The rate of movement slowed down at this point, so we decided to do any final tweaks with a clear aligner, and no further IRP was required. The final fixed wire retainer was fitted palatally on the U3-3 four months after initial visit.
Outcome
The patient (my dental nurse) was delighted with the treatment outcome and is pleased to have her old smile back once more. For my first case using the Inman Aligner, I found the treatment simple to deliver and attribute the fast results both to its ease of use and the patient’s high compliance.