Treatment carried out
by Galer Farrer
I normally shy away from treating friends and family, so when a friend contacted me to discuss the Inman aligner, I was filled with a sense of foreboding. Her wedding was in 5 ½ months, time was not on our side and I don’t like working to a deadline!
She had previously discussed her dental alignment with an orthodontist and had been quoted £6000 for Invisalign; out of her budget! She was disappointed when they told her it would not be finished for her wedding and so wanted to review her other options.
Her main complaint was her ‘goofy’ front teeth and she insisted that she wasn’t fussy and would be happy with any improvement for the big day. She really did not want a brace on her mandibular teeth.
I uploaded her pictures to the forum and the consensus was that her teeth could be improved with the Inman Aligner but her result would not be perfect. This did not sit well as I consider myself a perfectionist, especially when treating a friend. He suggested a digital set up and preview before continuing and the lab suggested:
- Opening the bite with composites on the lower 7s to allow the Dahl principle to over erupt the posterior teeth
- Midline expansion screw
- Progressive PPR and IPR
The Inman was fitted in mid January and she was a very compliant patient. She wore the appliance for over 20 hours a day and attended the surgery every two weeks. Interestingly she is a primary school teacher and teaches phonetics twice a week. She had to remove the appliance for this lesson! She never complained of pain – in fact she welcomed pain as a sign that it was working!
I placed palatal anchors on the upper lateral incisors to drive them out and once these moved to the desired position I placed anchors buccally on her central incisors. I left the palatal anchors in situ to prevent the palatal bow from slipping.
The team advised me to keep posting pictures every two weeks so they could observe the progress and guide accordingly. It really does help knowing that you have support and can ask any questions, however trivial they may be, at any time of day! I was using a cheap digital camera and was reminded to use my DSLR camera as it is not worth the compromise in quality.
I am a very conservative dentist and probably could have done more PPR and IPR at each visit. I was guided to check the final widths on the 3D model and sure enough I needed to perform more IPR and PPR.
As we neared the end of her treatment her teeth were whitened. Her overbite reduced from 9mm to 4mm; she certainly could not be considered ‘goofy’ any longer. 19 weeks treatment time from start to finish.
The palatal fixed bonded retainer was placed under rubber dam and composite was directly bonded at this visit to the mesial of her UL2 and UR2. This all happened on the Thursday before her wedding on the Saturday.
I couldn’t have had a happier patient, nor timed it better! She looks absolutely sensational!
With may thanks to the team for all their help and guidance on this case.
Tif, Andy, Santosh and Tim
For most of my adult life I have felt embarrassed by my ‘goofy’ teeth and have always been interested in getting them straightened. With my wedding approaching I decided to look into finally doing something about them.
After an initial consultation I was pleased to learn that this would be possible in time for my wedding.
The results have far surpassed my expectations and I am over the moon with the end result. I feel so much more confident in my smile and only wish this is something I had done sooner. I cannot thank or recommend Dr Farrer enough