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Fig 16: Maxillary arch with pre and post overlap showing the changes with Fig 17: Mandibular arch with pre and post overlap showing the
the blue depicting her dentition before treatment and beige showing the changes with the blue depicting her dentition before treatment and
changes post treatment completion. beige showing the changes after treatment completion.

by an ABC— another 3 sets of aligners for completion of aligner therapy, here the
A- Alignment using aligners, focus is simply on minor corrections with a focus on future aesthetic
B- Bleaching or teeth whitening and work (Figure 13).
C- Composite buildup and finishing. On finishing the aligners, we treated the patient with composite
thineers (Figures 14 and 15) to complete the treatment. Since the
After a quick pretreatment intraoral scan, we followed up with a patient showed compliance and did not want fixed retainers, we
thorough scaling of the patient. A set of alginate impressions were provided her with Essex retainers with her final smile intact to be
also taken, so as to create a mockup of the final shape of the incisors worn for 6-8 hours daily.
and treatment simulation before any intraoral cutting. The patient was
recalled after 1 week to deliberate and proceed with the plan. CONCLUSION
The patient was positively motivated for the treatment after seeing This case displays an interdisciplinary approach driven by patient
the digital renderings (Figures 4 and 5), and wanted to proceed centric treatment plans, attention to detail and development of a
straightaway. We began with the teeth whitening, since space closure confident smile which could be achieved without depending on fixed
cases barely require any attachments, if any. Thus, we only placed appliance (Figures 16 and 17), which would probably be rejected by
attachments in the treatment plan as a prophylaxis, they would only be the patient due to its highly compromising visibility as well as duration.
placed if deemed as a need due to improper adaptation of the aligners Aligner therapy coupled with a holistic approach helps create results
subsequently. which are greater than the sum of their parts, leading to patient as well
After the bleaching, using two cycles of the Philips Zoom teeth as operator satisfaction . n
(10)
(8)
whitening system (Figures 6 and 7), we did a final assessment of the
dentition and finished extensive interproximal reduction and did a REFERENCES
final scan to take onto the planning software. 1) Tommaso Castroflorio, Simone Parrini, Gabriele Rossini, Aligner
The control provided to us by employing our in-house aligner biomechanics: Where we are now and where we are heading for,
fabrication system created a smooth virtual mockup, just as Journal of the World Federation of Orthodontists, Volume 13, Issue
(9)
previously discussed and planned, and we proceeded with the model 2, 2024, Pages 57-64, ISSN 2212-4438,
making for aligner manufacturing. 2) Lombardo L, Martines E, Mazzanti V, et al. Stress relaxation
The patient on her part, was supremely compliant and we had visible properties of four orthodontic aligner materials: a 24 - hour in vitro
results from the first aligner onwards (Figures 8, 9, 10 and 11). A total study. The Angle Orthodontist 2017;87(1):11-8.
of six aligner sets were completed in six weeks, changes of sets every 3) Kravitz ND, Kusnoto B, BeGole E, et al. How well does Invisalign
week and progress scans were taken every two sets to ensure tracking work? A prospective clinical study evaluating the efficacy of tooth
and adequate adaptation. The end result was distinctly positive and movement with Invisalign. American Journal of Orthodontics and
the patient expressed that her confidence levels had increased, smiling Dentofacial Orthopedics 2009;135(1):27-35.
wider and feeling less conscious due to her teeth while speaking 4) Kohda N, Iijima M, Muguruma T, et al. Effects of mechanical
(Figure 12). properties of thermoplastic materials on the initial force of
An added advantage of deploying an in-house system means thermoplastic appliances. The Angle Orthodontist 2013;83(3):476-
refinement is fast, so after their initial treatment the patient uses 83.

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