Sheena

Chief Complaint:

Spaces between front teeth

• Sheena's Bio &
  Initial Treatment
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Sheena returned for her monitoring visit having completed wear of upper aligner 14 and lower aligner 13. These were the last stages of the original case. The photos show the intraoral standard views with and without the aligners. The space has closed but there remains some “openbite” in the bicuspid areas. This is likely the result of the “relative” intrusion effect of the retraction of the teeth to close the spaces. A refinement will be done to give some additional aligners to help improve the posterior occlusion.

Sheena

Chief Complaint:

Spaces between front teeth

• Sheena's Bio &
  Initial Treatment
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Sheena was unable to return to the office for a scheduled monitoring visit at aligner 10 but did continue consistent aligner wear and presented having completed wear of aligner #12. Sheena continues to track well, and is only a few aligners away from the original predicted finish. She did not report any problems and is anxious to finish her treatment.

Sheena

Chief Complaint:

Spaces between front teeth

• Sheena's Bio &
  Initial Treatment
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I had not seen Sheena for some time and as a result, I had some concern that the case may not be progressing properly. As successful treatment depends heavily on patient compliance, it is of great concern when a patient fails to follow the planned monitoring schedule. I was relieved to learn that when Sheena presented for her third monitoring visit, she was wearing aligner #8 and the fit was perfect which is testament to the effectiveness of the Invisalign product. She reported that although she was not able to visit the office, she had continued to faithfully wear the aligners. Clinically we observed that the lower aligner was beginning to show some fatigue.

Sheena

Chief Complaint:

Spaces between front teeth

• Sheena's Bio &
  Initial Treatment
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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.

Sheena

Chief Complaint:

Spaces between front teeth

• Sheena's Bio &
  Initial Treatment
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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!

Sheena

Chief Complaint:

Spaces between front teeth

• Sheena's Bio &
  Initial Treatment
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Let’s take a look at the attachment rationale for Sheena.

The following attachments were placed automatically according to Align’s standard protocols:

Generally, vertical attachments serve two purposes. First they provide retention for the aligner and second they aid in movement control for rotation. Close monitoring at each patient appointment is necessary for attachments, especially the rectangular option as unintended forces will be applied to the tooth, if the attachment “slips” out of the plastic reservoir of the aligner (Figure 1).

Sheena

Chief Complaint:

Spaces between front teeth

• Sheena's Bio &
  Initial Treatment
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Let’s outline the basic steps to deliver Sheena’s Invisalign case, with a focus on the attachments!

1. As there were several attachments, first try in the aligner “template” to ensure an intimate fit to the teeth (see figure 1- We check the fit closely to be sure that the teeth fit intimately in the template. Check the occlusal of the attachment template to evaluate that there is no space between the teeth and the occlusal of the template).

Sheena

Chief Complaint:

Spaces between front teeth

• Sheena's Bio &
  Initial Treatment
• All Blog Entries

Let’s review our initial treatment plan for Sheena: