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Dental Tribune Middle East & Africa No. 2, 2017

14 GENERAL DENTISTRY Dental Tribune Middle East & Africa Edition | 2/2017 Importance of Support and Mentorship for Reliable Results Calum Imray from Stafford Street Dental Care in Edinburgh, Scotland, details his fi rst anterior alignment case using the IAS Inman Aligner appliance By Calum Imray, Scotland I have always felt the most impres- sive restorative and aesthetic dental treatments are those, which lead to “invisible” results, providing the most natural appearance possible whilst preserving as much of the ex- isting tooth structure as possible. As part of this philosophy, I was keen to be able to offer my patients a simple orthodontic system that required no extractions and minimal tooth preparation. After researching sev- eral systems, I was introduced to the IAS Inman Aligner by colleagues who were already certifi ed users and I de- cided to take the hands-on certifi ca- tion course. Patient history, examination and treatment planning My fi rst case involved a young fe- male patient who wanted to correct a mild alignment issue before her wedding. She had no medical com- plications, a minimally restored dentition and good oral hygiene. Her main complaint was the slightly protruding upper left central incisor. The mild crowding of the lower an- terior teeth did not concern her. The occlusion was stable with a Class 1 molar relationship and canine guid- ance and there was no history of par- afunction or cusp fractures. Following a normal examination, we assessed the space which would be required to align the patient’s up- per anterior teeth by taking clinical Initial close front photographs and then measuring the mesio-distal widths of the teeth and drawing a trace of our desired arch curve using Spacewize+™ arch evaluation software (available free to all IAS practitioners). This estimated that around 1.6mm of space would Initial front Initial RHS Initial LHS Initial close RHS Initial close LHS Initial upper arch need to be created by interproxi- mal reduction (IPR) using diamond strips. Considering the beauty of the unrestored anterior teeth and the Initial positions arch Projected result arch minimal amount of tooth prepara- tion required in this case, the patient and I agreed that orthodontic align- ment and some tooth whitening would be preferable to more exten- sive restorative approaches such as direct or indirect veneers. After posting the initial photographs on the online forum and receiving advice from two IAS Academy men- tors, PVS impressions were sent to the lab along with instructions for the desired movements. A full treat- ment plan, 3D printed models of the potential end result and the IAS Inman Aligner itself were returned ready to start the case. The 3D model- ling determined that in total, 2.2mm of space creation would be needed. Treatment At the fi t appointment, a small amount of IPR was performed and the patient was instructed to wear the aligner for around 20 hours per day, removing it to eat and brush her teeth. After just 11 days she returned with a noticeable improvement and a subsequent set of photographs and IPR were posted on the forum after each review until the case was ÿPage 16 Spacewize Initial positions model Projected result model Initial positions front Projected result front Initial positions left Projected result left

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