Let's review our initial treatment plan for Stephanie:
- Resolve upper and lower crowding
- Improve right side posterior crossbite
- Resolve canine and bicuspid rotations
- Maxillary expansion and procline with no IPR
- Mandibular expansion and IPR with no procline
- Improve the vertical appearance of deepbite with anterior extrusion
- Maintain posterior CL I A-P relationship
Read more
We followed the same simple attachment placement steps outlined in Sheena’s update.
After first trying the attachment template for fit, we used a basic bonding technique to etch, wash, dry and bond the bonding material to the specific teeth scripted for attachments. TPH composite material was placed in the attachment reservoirs and light cured. Excess material was removed and the aligners were delivered.
Read more
Let’s take a look at the attachment rationale for Stephanie.
The following attachments were placed automatically according to Align’s standard protocols:
- Mandibular right first bicuspid: Vertical rectangular
- Mandibular second bicuspids: Vertical rectangular
- Mandibular cuspids: Vertical rectangular
- Mandibular left lateral incisor: Ellipsoid (horizontal)
- Maxillary right second bicuspid: Vertical rectangular
- Maxillary right central incisor: Ellipsoid (horizontal)
Generally, vertical attachments serve two purposes. First they provide retention for the aligner and second they aid in movement control for rotation.
Read more
Stephanie returned for her first monitoring visit. Her current set of aligners, stage 3, fit perfectly. I should first report that there was a problem to solve during the scheduled first 3 aligners. Stephanie called us while on her vacation to report that she had “lost” aligners #2. Since the aligner #2, two week activation wear time was almost completed, we instructed Stephanie to move to aligners #3. In most cases, this will work just fine especially when the aligner wear is almost complete for the “lost” stage.
Read more
Stephanie presented for her second monitoring visit anxious to let us know just how much she enjoyed her Invisalign experience. She did not report any problems or complaints. As usual, we first took care to use magnification to examine the aligner fit, especially the attachments. Everything looked very good. Next Stephanie was asked to remove her aligners and we evaluated the contacts with floss. In this visit, the contacts did not present as “tight”, therefore no IPR was indicated.
Read more