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CAD/CAM - international magazine of digital dentistry

I 33 case report _ CAD/CAM aligners I CAD/CAM 2_2012 Treatment plan All upper incisors were covered with crowns. The patient was satisfied with these crowns with regard to their shade, size and shape. In such cases, three treatment options are available: 1. new crowns for the upper anterior teeth; 2. conventional braces, which would lead to two problems:riskoffrequentbracketbondingfailure and scratching of the labial crown surfaces; and 3. aligners. Byusingaligners,neitherdidthecrownsneed to be changed nor did we face problems gener- ally associated with brackets. Using CAD/CAM technology, Figure 9 shows the initial situation and the expected outcome. Treatment progress AsshowninTableIII,thefirstphaseoftreatment focused on levelling and aligning the teeth in both upper and lower arches. Thereafter, intrusive and extrusive forces were applied to level the lower incisors followed by the retraction of the teeth by lingual tipping. The entire treatment time lasted less than five months using only nine aligners. Results AsshowninFigures10a–e,allthespaceswere closed in the upper arch, the lower arch crowd- ing was relieved, and both upper and lower in- cisors were retracted. _Discussion Although space management in adults can be done using prosthetic appliances alone, cooper- ationwithanorthodontistinsuchsituationscan lead to better aesthetic results, especially when teeth are moved using aligners, an almost invis- ible treatment option. Patient cooperation is the critical factor in achieving a successful aligner treatment. Aligners should be worn for at least 20 hours per day, seven days a week.4 The overall hygiene maintenance and the level of clinical finish achieved are of satisfac- tory quality. The acceptance of this treatment modality is far higher compared with conven- tional orthodontics.5 _Conclusion Space management in the dental arch in adult patients,whichcanbecausedbydifferentfactors suchasextractedteeth,congenitallymissingteeth or generalised spacing, should be approached with a team including an orthodontist. Aligners have the advantage of being an invisible appli- ance, offering better oral hygiene and patient ac- ceptance as compared with fixed orthodontics._ Editorialnote:Acompletelistofreferencesisavailable from the publisher. Table III_Teeth movement records for case 3. Dr Khaled Abouseada BDS, MS,Orthod,Cert. Asnani Dental Clinic P.O.Box 122721 Jeddah 21332 SaudiArabia khaledseada@yahoo.com CAD/CAM_contact Table III Fig. 10c Fig. 10d Fig. 10e Fig. 10a Fig. 10b