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.

Continuing to check the contacts lets us avoid doing too much IPR, with hand stripping being used to do the final IPR as the contacts become tight. The exciting thing is that the overjet has been reduced significantly. The lingual of the upper incisors are less than 1 mm from contacting the lower incisors. The pontic spaces have been reduced by approximately two thirds of the original space. Of course, the effect on the roots of the central incisors is what everyone wants to see. ShiAnn was sent to have a periapical x-ray taken for evaluation (see figure 2). Clinically the upper left central incisor has Class I mobility, and the upper right central has somewhat less. The PA reveals that there has been some root resorption, but it is questionable whether the root resorption has progressed since orthodontic treatment was resumed with aligners. Another x-ray will be taken in six months at the completion of the initial set of aligners.