Case of the month by Dr Salman Siddiqi

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Treatment carried out by Dr Salman Siddiqi

 

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

Tel:01642 750124
www.thornabydentalcentre.com

Introduction/Presenting Complaint

Emma came to see me in May 2016 for a consultation regarding improving the appearance of her teeth. She reported a history of previous orthodontic treatment in her teens which had relapsed and led to minor crowding of the upper and lower arches. He main concern was the ‘crowded and crooked’ appearance of her upper front teeth.

Assessment

A comprehensive clinical and orthodontic examination revealed the following key points:
• Class I incisor relationship on a class I skeletal base
• Average FMPA and Lower face height
• Soft tissues – lips competent at rest, normal tongue position and size, no posturing of
mandible at rest and no habits reported
• Centreline deviated to RHS by 2mm
• Class I Molar and Canine relationships bilaterally
• Mild upper labial segment crowding with well aligned upper buccal segment
• Slightly retroclined UR1 with distally rotated and overlapping UL1
• Some gingival recession seen at UL2 but otherwise periodontally good health

A full series of photographs were recorded as per the IAS protocol and measurements made of the widths of the upper teeth using digital calipers. This information was used to digitally plan the case using the SpaceWize software.

All options for orthodontic treatment were discussed including fixed appliance treatment by a specialist orthodontist. Emma was not keen on undergoing fixed appliance therapy and preferred the flexibility of wearing a removable Inman Aligner appliance as it was better suited to her busy working lifestyle.

Treatment

Valid written consent was obtained after discussed all risks, benefits, advantages and alternatives. The IAS Consent forms for Inman Aligner are a fantastic resource and allowed me to have comprehensive discussion with Emma about the specific risks of having treatment. Accurate PVS impressions in rimlock trays and a CR bite registration was recorded and a prescription requesting a ‘Standard Inman Aligner’ with a plan of the proposed tooth movements sent to Nimro Dental in London.

The Appliance was fitted after 2 weeks as requested in June 2016. The first composite anchors were placed on the most ‘in standing’ teeth UR1 and UR2. Space was created between the teeth at each 2 week appointment using graduated IPR strips and PPR was carried out where needed with sofflex discs. PPR was important to progress this case as it allowed more efficient alignment of any crowded contacts. Topical fluoride was applied to the surfaces all teeth where IPR was carried out and oral hygiene reinforced at each appointment.
The total treatment time was 14 weeks. At the end of treatment a bonded palatal retainer was provided with a clear essix for night time wear. 2 weeks of external vital bleaching was also carried out using 10% Carbamide Peroxide in close fitting trays. The final cosmetic improvement was done by providing composite bonding to the UR2 and UL1 to improve the proportions of previously worn and chipped edges.

Mentor Support

I have been a certified provider of the Inman Aligner since 2015. I found the hands on course very accessible with excellent teaching and demos on the IPR and PPR techniques. As a complete beginner to anterior alignment orthodontics I found it reassuring that the IAS ethos placed heavy emphasis on comprehensive orthodontic examination and appropriate case selection.

The IAS Inman Aligner forum is a fantastic resource for all GDPs providing this treatment. The one to one support provided online by the team of mentors is always excellent and very prompt. The forum is regularly checked to ensure all members are well supported and no posts go missed.

I am a great supporter of the IAS Inman Aligner and truly feel it has given me a new outlook to approaching anterior cases. The ability to predictably improve the position of any crowded or retruded anterior teeth allows me to provide minimally invasive solutions in ortho-restorative cases which would have otherwise required heavy preparations for crowns/veneers.
I would recommend the IAS Inman Aligner Accreditation course to colleagues who are considering starting their anterior alignment journey as the support and teaching is in a league of its own !

Patient Testimonial - Emma

‘’After having braces as a teenager, I was really unhappy when my upper teeth started gradually moving, giving them a very crooked appearance.

When I saw the advertisement for the Inman Aligner, and having talked it through with Salman, I couldn't believe how easy and quick it all sounded and I decided to proceed with the treatment.

Sure enough my teeth looked noticeably straighter within a few weeks and the treatment was virtually painless. I am over the moon with the results and would recommend the Inman Aligner to anyone ‘’

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