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ShiAnn

Chief Complaint:

Teeth becoming more crowded

Kelly

Chief Complaint:

Cannot bite front teeth together

Daniel

Chief Complaint:

Crowding of front teeth
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About This Blog
Join Dr. Clark Colville, a Texas-based orthodontist and Invisalign Premier Provider, in this unique online format as he treats three current patients with Invisalign. The Clear Chronicles provides the opportunity for Dr. Colville to open up his practice and for you to 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. Colville’s recommendations or proposed solutions are suggestions, however the final decision for treatment is the responsibility of the treating doctor. The following information represents Dr. Colville’s 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. Clark

Dr. Clark D. Colville is an assistant clinical professor in the Orthodontic department at the University of Texas Health Science Center Houston Dental Branch. Dr. Colville graduated from UTHSC San Antonio Dental School in 1989 and received a certificate from St. Francis Hospital and Medical Center the following year after completing a hospital-based general practice residency. In 1993 he completed his graduate orthodontic training at UTHSC Houston Dental Branch and received both a certificate and a Master's degree.


» Dr. Clark Colville’s Bio
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Shiann: Post treatment, Retention

September 21, 2009 - 12:34pm

ShiAnn

Chief Complaint:

Teeth becoming more crowded



As reported in the last treatment blog, ShiAnn was in a Hawley retainer with a bite plane and we were expecting the posterior occlusion to settle. ShiAnn returned in 6 weeks and the posterior teeth had settled adequately into functional occlusion. The gingival tissue responded well to the laser recontouring and I decided to add bonding to the mesial-incisal corner of both upper lateral incisors to make them look more natural (Figures 1, 2, 3, 4).

Kelly: End of Refinement

September 21, 2009 - 12:33pm

Kelly

Chief Complaint:

Cannot bite front teeth together



Kelly has completed all 15 of her refinement aligners and is currently awaiting delivery of her Vivera retainers. The following will outline her final treatment visits.

The aligners were delivered in series of 5, and were worn for 1 week each. At the delivery of the final 5 refinement aligners (11 – 15), the upper right lateral and cuspid were not completely tracking. Tight contacts were noted and reduced using a hand-held flexible strip. The remaining teeth in the arch were tracking well, including the lower arch (Figures 1, 2, 3).

Daniel: Retention

September 21, 2009 - 12:33pm

Daniel

Chief Complaint:

Crowding of front teeth



Daniel has been wearing his Vivera retainer full time since April 2009. Initially, the retainer was used to recapture the exact position of the teeth at the end of case refinement. After he had lost a Hawley retainer, the initial fit of the Vivera revealed there had been some shifting of the upper teeth because the retainer did not fully seat. After wearing the Vivera for 2 weeks, the teeth were fully seating in the retainer. I added dimples using the dimple plier to add retention in the posterior areas.

ShiAnn: Aligners Completed: 35 upper and lower

May 1, 2009 - 8:19am

ShiAnn

Chief Complaint:

Teeth becoming more crowded



ShiAnn’s treatment was completed after all 35 upper and lower aligners were worn for the prescribed period. Case refinement was expected as the final phase of treatment. However, close evaluation at the completion of aligner 35 revealed that case refinement was not necessary.

Kelly: Refinement Aligner Delivery: 1 through 6

May 1, 2009 - 8:17am

Kelly

Chief Complaint:

Cannot bite front teeth together


Treatment date: 4-10-09

Kelly started case refinement aligners in late March. CR aligners numbered 1 thru 6 were delivered after attachments were bonded. Scheduled IPR was performed on the lower arch (Figures 1, 2, 3). That is the short and simple explanation of what has happened since January when impressions were sent to initiate case refinement.

Daniel: Case Refinement 8, plus 3 overcorrection

May 1, 2009 - 8:16am

Daniel

Chief Complaint:

Crowding of front teeth



Daniel completed all 8 refinement aligners and then moved on to the overcorrection aligners in both arches (Figures 4, 9). Tooth 8 and tooth 27 needed additional rotation correction. Both teeth had 4 degrees of overcorrection planned. The contacts were checked closely to make sure space was available. As an added measure, I added dimples to enhance the rotational moments of force on these two teeth.

ShiAnn: Aligner Delivery: 32 through 35

February 10, 2009 - 2:21pm

ShiAnn

Chief Complaint:

Teeth becoming more crowded


ShiAnn and I hit a milestone at this last visit – it was her 50th visit to the office since we started seeing her in 2002! I think that has to be a record of some sort, although it's nothing to brag about.

Kelly: Start of Case Refinement

February 10, 2009 - 2:20pm

Kelly

Chief Complaint:

Cannot bite front teeth together


Treatment date: 1-07-09

Kelly completed the initial set of 35 aligners in both arches. All attachments were removed. The teeth were polished and incisal edges were reshaped where needed. Progress records were made, and new PVS impressions have been sent for case refinement. The analysis of treatment progress to this point shows good improvement, with some treatment decisions needed to meet the final treatment objectives.

Daniel: Refinement Aligners 5 through 8

February 10, 2009 - 2:18pm

Daniel

Chief Complaint:

Crowding of front teeth



Daniel is wearing his case refinement aligners. I last reported Daniel’s progress when we sent new PVS impressions for case refinement.

The specific goals for case refinement are as follows:

ShiAnn: Aligner Delivery: 29 through 31

November 18, 2008 - 2:29pm

ShiAnn

Chief Complaint:

Teeth becoming more crowded


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.
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