cosmetic dentistry - beauty & science

32 I I case report _ Inman Aligner Fig. 1_Upper jaw model with Iman Aligner in situ (not the presented patient). Fig. 2_Coloured Inman Aligner on the model. Fig. 3_Inman Aligner on the model. Fig. 4_Lower teeth initial situation. Fig. 5_Lower teeth view post-op. cosmeticdentistry 2_2012 _There has probably never been a better time to practise dentistry. However, dentists and patients arebeingbombardedwithimagesofbeautifulsmiles and, for many years, practitioners have been pres- sured into believing that porcelain veneers are the answer. There are many situations for which veneers are the ideal treatment, and when well placed and properly bonded to enamel, they will last for many years.LaytonandWalton,forexample,showed73% survival at 16 years for veneers bonded to enamel. Unfortunately, in my practice, these ideal cases rarely come through the door. Most of the patients coming in for cosmetic dentistry do so for more severe problems. Crowding of the upper and lower teeth is a common condition that adult patients would like improved. Porcelain veneers and ‘instant orthodontics’designedtotreatthiswilloftenleadto excessive enamel removal, risking pulp vitality and compromising bond strengths, or over-contoured restorations, which can compromise plaque control. Poor root position will also compromise the emer- genceprofile.Thepatient,whobynowhasalsoentered the restorative cycle, will require the periodic replace- mentoftheseveneerswithmoreinvasiverestorations. BurkeandLucarottishowedthesurvivalrateofveneers in England and Wales to be approximately 10.5 years. The Inman Aligner has proved to be a valuable appli- ancetohelppatientswithmisalignedanteriorteeth. Fig. 4 Fig. 5 Ethicalsmiledesignwith the InmanAligner— Acase study Author_Dr Andrew Wallace, UK Fig. 1 Fig. 2 Fig. 3