Case of the Month by Dr Salman Siddiqi

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Treatment carried out by Dr Salman Siddiqi BDS MFDS RCS Ed

 

Thornaby Dental Centre
31 Allensway
Thornaby
Stockton on Tees
TS17 9HA

Tel:01642 750124
www.thornabydentalcentre.co.uk/

Patient testimonial

"I was never fully happy with the placement of my front teeth after having braces when I was a teenager. I made a appointment with Salman to see if I was eligible for the Inman Aligner. Once I agreed to the treatment, it was predicted that my teeth would be aligned within 6 to 8 weeks. For the first couple of days my teeth were sensitive but not painful. My results speak for themselves as they are amazing and people can not compliment me on my teeth enough."

Dentist Testimonial

Megan, a 21 year old patient attended for a consultation with me in November 2015. Her main concern was the ‘crowded’ appearance of her front teeth, in particular an ‘overlapping’ front tooth (identified as UR1).

Further questioning revealed she had previously had fixed upper and lower appliance orthodontics when she was 18. However, following poor retention of results due to low compliance with wearing her Essix retainer, she experienced relapse around the upper incisors.

ASSESSMENT

A comprehensive intraoral orthodontic exam was performed. The salient features were a Class II division I malocclusion on a class II skeletal base with mild labial segment crowding, retroclined UL1 and palatally positioned UL2. Buccal segment examination revealed a bilateral Class I molar relationship with a right side Class I and left side 0.5 unit Class II canine relationship. Hard tissue examination revealed a minimally restored dentition with good oral hygiene of both smooth and interproximal surfaces.

The extra-oral examination showed competent lips at rest position and facial profile analysis revealed a low Frankfort-Mandibular Plane Angle (FMPA) and average lower face height.

A full series of intra-oral and extra-oral clinical photographs were also taken at the consultation stage. Digital callipers were used to accurately measure the widths of upper anterior teeth and to calculate the degree of crowding involved.

TREATMENT

After valid written consent was obtained an accurate upper putty and wash impression was recorded alongside a lower opposing alginate impression and bite registration. After filling out the lab prescription with details of proposed movements, a request was made for a ‘standard’ inman aligner. All impressions were then posted to Nimro Dental, the selected orthodontic lab for IAS.

The appliance was delivered after 14 days as requested and fitted at the first appointment in December 2015. The lab also provided a 3D printed model of the final outcome treatment which was very useful in achieving patient compliance throughout the treatment.

When the IAS Inman Aligner was fitted, the patient was shown how to place and remove the appliance and was instructed to wear it for at 20 hours a day. Instructions were also given on cleaning and storage of the appliance.

At the fit appointment a composite anchor was placed palatally on the upper left lateral as marked on the guide model. This allowed the palatal bow to rest in the incisal third and provide the required force to labially advance lateral.

Once the lateral was in the desired position, the palatal composite anchor was removed and labial anchors were placed on the centrals to achieve mild rotations.

The space required to achieve these movement was created using interproximal strips. The strips were passed through the required contact points as advised by the interproximal reduction (IPR) guide. Topical fluoride was applied to the surfaces all teeth where IPR was carried out.

The patient was reviewed for appliance adjustment and space creation over 5 appointment at 2 weekly intervals. The total treatment time was 12 weeks.

At the end of the treatment, a palatal wire retainer was bonded using flowable composite (picture to follow). Due to her dental history of orthodontic relapse the patient was also provided a clear essix retainer for night time wear in case the wire retainer debonded.

SUPPORT RECEIVED

I have been a certified provider of the Inman Aligner since 2015. I attended the hands-on certification day in Manchester in June 2015 and found the style of the course delivery very engaging with the right mix of theory and practical techniques covered. Particular emphasis was placed on patient assessment and diagnosis which gave me greater confidence in treatment planning anterior alignment cases.

The IAS trainers are very approachable and provide invaluable guidance and support through the online forum

I would highly recommend the attending the Inman Aligner hands on course as it has truly changed the way I approach anterior aesthetics and treatment planning for restorative cases. The multitude of simple anterior crowding cases that can be treated predictably with the Inman Aligner make it a great addition to the skill set of the modern general dentist.

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