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Cosmetic Tribune United Kingdom Edition | 10/2016 18 COSMETIC TRENDS Abstract This article discusses the advan- tages of short-term anterior tooth alignment using the Inman Aligner system, particularly for general den- tists. The article will give a brief de- scription of the Inman Aligner appli- ance and its use in short-term ortho- dontics,anditwillanswerthreemajor questions the general dentist should askhimselforherselfduringthetreat- mentplanning process.Insupportof this treatment modality, three case scenarios general dentists see daily willbegivenasexamples. Introduction Generaldentistsfacethedailychal- lenge of performing instant veneers for patients with misaligned anterior teeth who refuse orthodontic treat- ment, many of whom regard fixed orthodontic treatment as too long a commitment for achieving their desired aesthetic results. In today’s fast-paced life, some patients are not prepared to wait or to go through longtreatments.1,2 Oneofthegreatest benefits of short-term anterior align- mentisthatmanypeoplewhowould refuse comprehensive orthodontic treatment may accept short-term re- movable alignment techniques such astheInmanAlignersystem. The Inman Aligner is a simple re- movable appliance, a modification of the removable spring retainer. It usessuper-elasticcoilspringstoapply highly efficient light and consistent forces on both the labial and lingual surfacesoftheanteriorteeth(Figs.1&2). The appliance is fabricated on a cast on which, based on a surgical model, theanteriorteethneedingcorrection have been removed and reset in the ideal position in wax on the working cast.3 When the patient wears the ap- pliance, the built-in forces generated by the spring coils will correct the misalignedanteriorteeth(Fig.3). What distinguishes the Inman Aligner appliance from other short- term orthodontic systems such as Invisalign (Align Technology) and Six Month Smiles is its low cost, low risk and short learning curve for gen- eralpractitioners.Onlyoneappliance is used from the start to the end of the treatment. Sometimes, several clearalignersmaybeusedtode-rotate resistant canines. The system is well received by patients because it is fast andrelativelycheap.Italsoaccommo- dates today’s active lifestyle. Usually, most cases take from six to 16 weeks. Patients can take the appliance out duringmealsorworkmeetings. As with any other treatment tech- niques, the Inman Aligner has its limitations. Hence, case selection is imperative, as the Inman Aligner is notsuitableforposteriororthodontic treatment or Class II or III treatment. Only certain types of movements are possible and some patients will still needconventionalorthodontictreat- mentorindirectrestorations.Certain criteria should be met before treat- mentproceeds.Atconsultation,other orthodonticalternativesshouldbeof- fered. The dentist must quote for the long-term retention maintenance and should look for any skeletal dis- crepancies. Compromises mustbesignedoff. Treatment concept and case presentation Dentists need to consider three questionsabouttreatmentduringthe treatmentplanningprocess.Thefirst question: can the patient’s teeth be 17 18 19 14 15 16 11 12 13 8 9 10 5 6 7 2 3 4 Fig. 1: Inman Aligner appliance.—Fig. 2: Illustration of the Inman Aligner showing the appliance components.—Fig. 3: Inman Aligner appliance in the mouth. Case 1—Fig. 4: Frontal view with the teeth in occlusion before treatment.—Fig.5: Frontal view with slightly open bite showing the status of the teeth before treatment.—Fig.6: Frontal view withtheteethinocclusionafteralignmentandbleaching.—Fig.7:CloseupfrontalviewofthemaxillaryteethafterABB.—Fig.8:RightsideviewofthemaxillaryteethbeforeABB. —Fig.9:RightsideviewofthemaxillaryteethafterABB.—Fig.10:LeftsideviewofthemaxillaryteethbeforeABB.—Fig.11:Leftsideviewofthemaxillaryteethafteralignment and bleaching.—Fig. 12: Full face before treatment.—Fig. 13: Full face after treatment.—Fig. 14: Frontal view showing the patient’s natural smile before treatment.—Fig. 15: Frontalviewshowingthepatient’snaturalsmileaftertreatment.—Fig.16:Fullfaceshowingthepatient’snaturalsmilebeforetreatment.—Fig.17:Fullfaceshowingthepatient’s naturalsmileaftertreatment.—Fig.18:Occlusalviewshowingthemaxillaryarchbefore treatment.—Fig.19:Occlusalviewshowingthemaxillaryarchaftertreatment. Conservativesmiledesign forthegeneraldentist By Dr Rami Chayah,Lebanon 1 171819 141516 111213 8910 567 234