Justin arrived for his second monitoring visit and did not report any problems. After inspection with his aligners in place the tooth movements appeared to be following the virtual representations. There appeared to be minimal movement lag with some slight incisal edge lag apparent in the case of the maxillary extrusion. Justin easily removed the aligners. Even though there was no IPR in this case, we used floss to check for tight contacts.

Sheena was seen for her second monitoring visit. She seems very compliant and reports that it “is a breeze” to wear the aligners. First I like to use magnifying loops to closely inspect each attachment for an intimate fit with the reservoir it should fit. Sheena’s attachment fit perfectly. Next, I like to evaluate that the patient is comfortable with aligner removal, so we will ask the patient to remove the aligners so that we may observe the movements and evaluate the contacts.

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.

Treatment date: 10-23-2008

We are getting near the end of the initial set of aligners and things are progressing nicely for ShiAnn. She learned to get the upper aligners in and out easily and noted that the aligners were much more retentive without the pontic teeth present.

Treatment date: 10-1-2008

As we progress into the final 7 aligners, critical evaluation is necessary to make changes and alterations in the aligners and in the treatment plan to start developing the final occlusion. The main idea on difficult cases is to get as close to the final occlusion as possible so that major changes do not need to occur in the case refinement aligners.

Treatment date: 10-20-2008

Daniel returned today and was excited to have completed the initial series of aligners. At this point all the attachments were removed, the teeth were shaped to optimize the esthetic appearance, and the occlusion was checked closely to determine what needs to be accomplished in case refinement.

Treatment date: 9-11-2008

ShiAnn called the office and sounded a little uneasy because she could not get her next scheduled aligner to fit. We asked her to come in for an emergency (eeks!) visit to determine the cause of her problem. My initial concern was that one of the central incisors had not fully fit in the aligner and was being pushed way off track.

Treatment date: 9-8-2008

These are the final 3 aligners of the first set of aligners. Aligner 31 in the upper arch is a surgical shift aligner and will not be worn. This occurs because the surgical shift of the upper arch is read by the Treat software as a change in position of the upper arch; thus another aligner is manufactured.

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.

Sheena returned for her first monitoring visit all smiles and reported that she had not experienced any problems. She found the aligners easy to seat and easy to remove. No discomfort was reported during aligner wear, and in fact, she reported that it was as if there was “nothing in my mouth”. She loves the esthetics of Invisalign!