The aligner was delivered to the compliant patient. The patient was engaged in active monthly treatment for an additional three months to correct the rotations and achieve the desired refinement. Fig. 3C shows the completed MTM ® readiness for esthetics. Case Completion with Esthetic Bonding Fig. 3D panorex The case was submitted to Invisalign ® . Align-panorex. Align ers were fabricated, delivered to the patient, and in regular two week intervals, exchanged anew. Treatment length was 12 months. After undergoing Invisalign treatment, this case clearly illustrated the importance of both the horizon-tal and vertical components of tooth alignment. With respect to the root angulations, the vertical compo-nent was approached first to ensure an improved emergence profile as well as greatly improved occlu-sion reducing abfractions. To complete this case, the patient opted for compos-ite bonding to restore his smile. A nano-hybrid composite, Venus Diamond ® (Heraeus Kulzer) was used to restore teeth Nos. 7 through 10 and 26. Using a total-etch and bond system to maximize enamel adhe-sion, care was taken to respect the new tooth angula-tions yielding to improved emergency profile with respect to interproximal contours. The patient was very pleased with his improved esthetics and function shown in Fig.3D. Conclusion Offering minor tooth movement is extremely benefi-cial for patient care as well as providing professional satisfaction. Patients now have the treatment option that correctly aligns 1-4 teeth by focusing forces placed in plastic. Earlier schools of thought would have mandated traditional wires and brackets to correctly align the malposed teeth. However, with current restorative technology and improved plastic materials, the ability to offer MTM ® to patients opens avenues of blending fundamental principles with esthetics to create a win-win for oral hygiene and tooth longevity. Minor Tooth Movement for Refinement At the end of the treatment year, rotation of specifi-cally teeth Nos. 8 and 10 required refinement shown in Figure 3B. Minor tooth movement was the choice to finalize the arch. An ACE ® (ACE plastic, Dentsply Rain-tree Essix) plastic was fabricated from an alginate impression turned into stone working model. Specific blockout areas were fashioned opposite all expected force points before thermoforming. 26 March/April 2012 JAOS
Journal of the American Orthodontic Society March-April 2012: Page 26
