cosmetic dentistry - beauty & science

I 35 case report _ Inman Aligner I cosmeticdentistry 2_2012 ing increasingly more crowded. In four months, her upper and lower teeth were aligned for less than the cost of four porcelain veneers. Thephotographsshowthedetailofthemorphol- ogy and shade characteristics of the teeth—repro- duction of this would have proved a challenge for even the most gifted dental technician. Just a few years ago, the options open to the patient or her dental practitioner would have been limited to full orthodontic treatment or re- storative treatment. The restorative options would have involved either excessive removal of enamel and dentine for porcelain veneers or excessively bulky and over-contoured restorations with poor interproximal contacts. Now, clinicians have the option of an altogether more satisfactory ap- proach. Alignment treatment such as that offered by the InmanAlignercanofferrapidcosmeticimprovement of moderately crowded front teeth or orthodontic relapse.Becauseoneappliancedoesalmostallofthe toothmovement,thereducedlaboratorycostallows for a more affordable option for patients, increasing patient uptake. Case selection is key and a full discussion with patients about their complaints and what they wish tohavecorrectedisvital.Onlycorrectionofthefront teeth is possible. Incisors can be rotated and tipped relatively easily, with limited movement of the ca- nines possible. Thecasestudypresentedabovewasanidealcase. With others, it may be essential to talk the patient through what he or she can expect to be corrected and what will not be possible. Often, this form of treatment will be a precursor to restorative treat- ment. Pre-alignment can allow us to offer the ideal cosmetic result with a much-reduced biological cost in enamel and dentine removal, and an ideal emer- gence profile. Often only minor enameloplasty or enamel bonding is required after alignment to cor- rect the differential wear we often see with crowded teeth. IPR has been shown to be a safe way of creating space for tooth movement. Zachrisson followed up patients ten years after IPR and found no increased caries risk, bleeding on probing, gingival recession or periodontal bone loss in these patients. The four-month treatment time required for this young lady is not unusual. The interdental space required is often created by rounding out the arch and moving teeth that are lingually placed, forward and placing them on a wider arc. In conclusion, the Inman Aligner is not a re- placement for conventional orthodontics but now clinicians can offer quick and affordable tooth alignment in general dental practice. My provision of cosmetic dentistry treatments has grown signif- icantly since the introduction of the Inman Aligner to my practice. _Acknowledgements I would like to thank Dr Tif Qureshi and Dr James Russell for their help in planning my early cases. _ Fig. 12_Retracted close up pre-op. Fig. 13_Retracted view post-op. Dr Andrew Wallace gained his BDS from Queen’s University Belfast in 1998. As well as practising full time in private practice in Bachelors Walk Dental Surgery,Lisburn, he is studying at King’s College London for a Master of Clinical Dentistry in Fixed and Removable Prosthodontics. He is a full member of the BritishAcademy of Cosmetic Dentistry.He gained certification in InmanAligner treatment through StraightTalk Seminars in January 2009. _about the author cosmeticdentistry Fig. 12 Fig. 13