5 - Mild Crowding

Photographs and X-rays

Orthodontic Summary

ClinCheck Files

Earn CE Hours

Case Differences

• Accepted ClinCheck: Doctor requested alternate type and orientation of attachments.

• Accepted ClinCheck: Doctor requested customized sequential staging vs. simultaneous movements across all teeth per the latest protocol

Mild Crowding

Case provided courtesy of
Dr. Jonathan Nicozisis

Diagnosis

Patient's Chief Concern
The patient wanted correction of the crowding of her upper front teeth.

Diagnostic Summary

Maxillary right cuspid is blocked out of arch and needs to be extruded
Maxillary right lateral is in crossbite
Needed to establish cuspid guidance in extrusion

Treatment

Treatment Summary

Extruded maxillary right cuspid without auxillaries
Corrected crossbite of upper right lateral
Aligned Midlines
Able to finish treatment without IPR and no refinement

Post Invisalign Treatment

Following the orthodontic treatment, a lingual bonded retainer was placed on maxillary and mandibular incisors along with an Essix® retainer.

Treatment Tip

In this case, the extrusion was accomplished without the use of buttons and elastics and relied solely on the use of the attachment with careful monitoring throughout treatment to ensure engagement.

Align automatically places a horizontal ellipsoid attachment for extrusions of anterior teeth. The setup protocols are based on the experience gained from over 600,000 cases in treatment with Invisalign. The default setup protocols are used to create the initial ClinCheck® setup, based on your prescription. However, the final treatment plan remains the responsibility of the treating dental professional and should be reviewed carefully and modified as necessary before the ClinCheck® is accepted.

For extrusions, many doctors have also seen success by using a horizontal beveled attachment. This variation is by doctor request only and must be requested on the Prescription Form or through your Doctor Preferences page in the "Special Instructions" section.

In this case, the treating doctor chose to override the standard protocols by requesting a horizontal beveled attachment for the extrusion. By default, beveling is towards the incisal, but additionally, the doctor requested the beveling to be towards the gingival because his experience has shown this configuration to be most successful with cases he has treated.

With experience, you may find there are variations to the standard protocols you prefer. Click here to learn more about Align's standard protocols for attachments.