The Clear Chronicles - An Invisalign Treatment Blog
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Stephanie

Chief Complaint:

Teeth becoming more crowded

Sheena

Chief Complaint:

Spaces between front teeth

Justin

Chief Complaint:

Crowding of front teeth
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About This Blog
Join Dr. Perry Jones in this unique online format as he treats three current patients with Invisalign. The Clear Chronicles provides the opportunity for Dr. Jones to open up his practice to other general dentists so that you may follow in real-time as he shares the progress and challenges with these unique patients over the course of the next year...

Welcome to the Clear Chronicles where the doctor is real, the patients are real and the results are real.

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Disclaimer:
The tips and techniques and clinical information set forth in this presentation are general recommendations and proposed solutions. The doctor is solely liable for the treatment of patients with the Invisalign System.  Dr. Jones' recommendations or proposed solutions are suggestions, however the final decision for treatment is the responsibility of the treating doctor. The following information represents Dr. Jones' opinion and does not represent Align policies and Align will not be liable for these recommendations or proposed solutions.
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About Dr. Perry

Dr. Perry Jones is a 1974 graduate of Virginia Commonwealth University Dental School, where he is currently an adjunct faculty associate professor in both the Oral Maxillofacial Surgery department and the Oral Pathology department. A general dentist, he is a Fellow of the Academy of General Dentistry and maintains an active private practice in Richmond, Virginia.


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Justin: Refinement Completed

August 10, 2009 - 8:59am

Justin

Chief Complaint:

Crowding of front teeth


The photos show Justin’s completed tooth movement. You will notice in the intraoral pictures with the aligners in place, on the right side, you can see through the aligner to the healing abutment of the implant in the #29 area. The aligners fit the teeth, and the space distribution for the implant restoration is equal to the M-D width of the first bicuspid #28.



Sheena: End of Treatment: Upper Aligner 14, Lower Aligner 13

August 10, 2009 - 8:59am

Sheena

Chief Complaint:

Spaces between front teeth



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.


Stephanie: Aligner Delivery 16-18 & 19-20

August 10, 2009 - 8:57am

Stephanie

Chief Complaint:

Teeth becoming more crowded



Aligner Delivery 16-18

Stephanie reports that she is doing well and is most compliant. As can be seen in the photos with the aligner in place, the aligners fit well with little on no space between the occlusal portion of the teeth and the internal occlusal portion of the aligner plastic. The contacts were checked, as is the case at each monitoring visit, and there were no tight contacts. In this case, no additional IPR was indicated.


Stephanie: Aligner Delivery 13 through 15

May 27, 2009 - 8:12am

Stephanie

Chief Complaint:

Teeth becoming more crowded



It looks like Stephanie is progressing well. After checking the contacts with floss we discovered several areas with tight contacts. Using the “sequential/incremental” method to execute interproximal reduction (IPR), we elected to perform IPR at these tight contacts. The tight contacts were at contacts 22-23, 23-24, 24-25, 25-26, 26-27. The IPR prescription approximation called for a total of 0.3mm IPR at each of these contacts.


Sheena: Aligner Delivery 13 through 14

May 27, 2009 - 8:11am

Sheena

Chief Complaint:

Spaces between front teeth



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.


Justin: Final Aligner Delivery & Attachment Removal

May 27, 2009 - 8:09am

Justin

Chief Complaint:

Crowding of front teeth


Justin has completed aligner wear and presents having finished wearing upper aligner #11 and lower aligner #10. As you can see in the photos, the arch shape looks good but there are several anterior rotations and some arch form symmetry to complete. At this point the results are good but need some additional movements for a “stellar” finish. The solution is to use a refinement that is included with the Invisalign Full product. The refinement provides for a new ClinCheck that we may modify to create a new series of aligners to achieve the desired results.


Sheena: Aligner Delivery: 9 through 10

March 18, 2009 - 9:38am

Sheena

Chief Complaint:

Spaces between front teeth



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.


Justin: Aligner Delivery: 10 through 11

February 4, 2009 - 12:53pm

Justin

Chief Complaint:

Crowding of front teeth



Justin presented for his third monitoring visit. Evaluation of the aligner fit and observation of the attachment fit appeared to be satisfactory. There did appear to be some slight movement lag in the extrusion of the upper incisors as well as slight rotation lag of the lower incisors. After some discussion with Justin he agreed that he had been less than consistent in his overall wear time.


Stephanie: Aligner Delivery: 10 through 12

February 4, 2009 - 12:52pm

Stephanie

Chief Complaint:

Teeth becoming more crowded




It looks like things are going very well with Stephanie's progress. First we checked progress with aligners in place looking for any "space" between the internal occlusal portion of the aligner and the incisal edge/occlusal cusp tips of the teeth. This is a first clue to evaluate for movement lag. Next using magnification loops, I look very carefully at each attachment to evaluate the fit.


Justin: Aligner Delivery: 7 through 8

December 9, 2008 - 12:52pm

Justin

Chief Complaint:

Crowding of front teeth


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.


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