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.

Treatment date: 7-28-2008

A lot of treatment decisions were made today. The current aligner (23) fit well in most areas. Looking critically with the aligners in place, in the upper arch the upper right lateral was lagging slightly, less than 0.5 mm.

Treatment date: 8-6-2008

Kelly checked in today wearing aligner 24 of 35 total aligners. The current aligner is fitting very nearly identical to what we have seen the last few visits. The fit of the lower aligners is good except for the lower left lateral incisor.

Treatment date: 7-23-2008

ShiAnn had been wearing aligner 23 for three weeks when she came in for her appointment. The fit of the aligners was essentially the same as it has been for the past 2-3 visits, with nothing remarkable other than the slight uneven incisal edges of the upper anterior teeth.
The contacts were checked and found to be tight around both cuspids. This is not unexpected since we had done scheduled IPR in February and we routinely do somewhat less than the total amount of IPR that is requested.

Treatment date: 6-4-2008

Kelly showed up in her usual cheerful mood and reported that all was well. We delivered the next four aligners, 21 through 24, out of a total of 35 aligners. In the lower arch, the contacts were all light and did not require any IPR. In the upper arch, additional hand reduction of 0.1 mm was performed between teeth 6 and 7. As we initially reported, tooth 23 is the rate determining tooth and will be the most difficult tooth to correct.

Treatment date: 6-2-2008

Daniel came into the office one week ahead of schedule and had worn aligner 19 for one week. We gave Daniel the next four aligners in the series, 20 through 23, and asked him to continue wearing aligner 19 until he had completed the second full week of wear. We are still performing IPR with a hand strip due to tight contacts. The areas in the upper arch that required reduction were the contacts between teeth 6-7, 7-8, 10-11, and 11-12.