Clear Idea #3

12 www.acasociety.com | info@acasociety.com Plastic, elastics for a class II teen fix • The nasolabial line angles wider on right side with narrow buccal corridor on the RHS. • Low lip line Dental • Tooth 11 proclined • Upper central line angles deviate to RHS • Upper and lower central incisors have uneven wear/chipping • Uneven gingival heights anteriorly • Tooth 13 blocked out of archform Facial Aesthetics Extra oral • Horizontal thirds appear to be equal • Vertical fifths are uneven with the right maxilla region being wider • Nose deviates slightly towards the right hand side • Smile line in line with the interpupillary line • Prominent chin Peri-oral • Maxillary central incisors midlines are symmetrical with the patient’s facial midline. W hen clear aligners were first introduced to mainstreamdentistry, there were a lot of detractors. There were some clinicians who wrote it off as a passing fad, or a gimmick. At most, they were seen as an adjunct to fixed orthodontics, something that can be incorpo- rated towards the end of active treatment. We now know this to not be the case. And although it must be noted that there have been significant advances since the “early days”, we must take a moment to be grateful to the clinicians who continued to persevere with it and continued to light a path for the profession. This perseverance has allowed us to add an incredible appliance to our armamentarium. Below, please see a case of a mature teenage who presented to our clinic wanting to improve his smile. He had been conscious of his smile, but was more conscious of the fact that he wanted to avoid being called “train tracks”. We usedAORTA’s smile design and clear aligner principles to achieve a wonderful stable outcome that exceeded his and his parent’s expectations. PRESENTING COMPLAINT: A male teenager presents for a consultation to improve his smile. He explains how he feels his front tooth is sticking very far forward and his canine tooth looks very sharp. He has seen friends go through braces, and wanted to avoid this, however he has become self-conscious of his teeth more and more. He does not have any pain. DIAGNOSTICS: Clinical examination shows patient presents with relatively healthy dentition and periodontium. His oral hygiene is good and has been a regular attender of the practice with his family for many years. He has mild lower crowding, moderate-severe upper crowding with an overall class II division I occlusion. He has narrow buccal corridors. By Dr John Hagiliassis and Dr George Abdelmalek “Simple can be harder than complex: You have to work hard to get your thinking clean to make it simple. But it’s worth it in the end because once you get there, you can move mountains.” – Steve Jobs Before treatment George Abdelmalek John Hagiliassis