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The Smile Project – Jordan’s Journey

Patient Information & Diagnosis

Age: 29 years old 

Gender: Female 

Patient Issue: Patient had braces when she was an adolescent and never received a retainer to wear, so her anterior teeth began to shift and crowd. Patient wants to align her maxillary anterior teeth, specifically her maxillary left central incisor.

Diagnosis: Class I R/L molars and canines, which will not be altered. Slight maxillary and mandibular crowding, which will be treated with proclination and rotations of anterior teeth. Slight deviation of maxillary midline to the right of mandibular midline, which will be treated with asymmetric IPR that is consistent with Bolton discrepancy on patient’s left side. Slight mandibular anterior recession, which will be monitored throughout treatment. 

Initial Records
Initial Panoramas

Treatment

Treatment Duration: 18 weeks

Number of aligners on upper: 8 

Number of aligners on lower: 9 

Treatment Goal: Patient wanted to straighten her anterior teeth, especially her maxillary anterior teeth. Patient did not have any concerns about her bite, so not much of that was changed, except lightening the occlusal contacts on some teeth that were hitting heavily. We did not need to make any compromises in this case with regard to patient expectations, and the final staging and setup was approved by the patient with no corrections needed. 

Treatment Plan:

  • M – midline – align to facial midline
  • A – archform – procline maxillary and mandibular incisors as needed to eliminate crowding. I did not want to bodily move these teeth as they were slightly retroclined as compared to ideal, so proclining would create space and produce a more ideal esthetic
  • C – class – maintained Class I everywhere and accepted more overjet as result of proclining incisors
  • R – resolutions – IPR (interproximal reduction) of lower anterior incisors due to tooth size discrepancy, which the software helps to calculate
  • O – occlusal plane – level Curve of Spee as needed. Leveling Curve of Spee requires space, so only some leveling will be done from the extra space from proclining mandibular incisors
  • S – special instructions – none

Retention Plan: Will be using clear Essix material retainers

Patient Feedback

“The aligners are comfortable! When I first change them, they are snug, but not too tight. Once they start to shift the teeth, they are a lot easier to get in and out, which makes me feel like my teeth are being moved efficiently and effectively. When I first got them, it took me a few days to get used to talking with them. I never felt like it affected my speech very much though. I am comfortable wearing them in social settings. The fit and clear design makes it difficult for other people to tell that I’m even wearing anything at all. I have had people say they don’t believe me when I tell them I’m wearing them!”
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