The patient is a 56-year-old female that presented to the practice to discuss possible treatment options for improving the appearance of her anterior teeth. While her medical history revealed that she had anaemia as well as possible sleep apnoea, her dental history was clear.
Biomechanical, Periodontal, Functional and Aesthetic Assessment
During the clinical assessment, the patient’s biomechanical risk was found to be moderate with several restored teeth. However, there were no signs of active decay or root canal therapy.
Periodontally, there was sound support for the teeth with no bone loss, inflammation or bleeding on probing. When asked about functionality, the patient reported normal function when chewing and did not complain of feeling more than one bite. Furthermore, there were no signs of temporomandibular joint disorders (TMD).
Aesthetically, she presented as high risk due to a high smile line. When smiling, the patient revealed all tooth structure and up to 6mm of the gingival complex. The patient had no prior history of orthodontic treatment. The tooth position before treatment involved rotation, facial inclination of the anterior teeth and crowding.
The treatment goal was to align the anterior teeth without changing the bite. After discussing various treatment pathways, the patient opted for the ClearSmile Inman Aligner for both the upper and lower arches. Thereafter, IAS Academy’s Spacewize+™ digital crowding calculator software was used to establish suitability of treatment, before using Archwize™ 3D planning software to predict the interproximal reduction (IPR) that would be needed to achieve the intended result. The results showed that a total of 0.30mm IPR was required.
Throughout the treatment process, the patient was reviewed every two to three weeks to ensure that the correct progress was being made. After alignment of the teeth, tooth whitening was carried out to achieve the patient’s desired colour, and finally the front teeth were bonded to repair unevenly worn edges on the anteriors.