Mark Lowe, DDS
A 14-year-old male patient presented with amelogenesis imperfecta and a severe anterior open bite. Due to the absence of adequate enamel to bond fixed appliances, clear aligners were used to achieve the orthodontic goals of the case before restorative rehabilitation. ClearCorrect (A Straumann Group Brand, clearcorrect.com) aligners were selected because of the lack of enamel and inability to utilize attachments/engagers. ClearCorrect aligners would provide the necessary thermal plastic rigidity and a gingival trimline for increased retention and efficacy of the aligner movement. The patient's skeletal open bite, mandibular midline deviation with associated buccal crossbite, and small teeth (reduced surface area) presented orthodontic challenges. However, using the fundamentals of aligner tooth movement, including predictable posterior intrusion, these challenges were overcome through the use of the ClearCorrect aligners, and a dramatic prerestorative occlusal modification was achieved in just 12 months. The anterior restorations enabled a vastly improved esthetic smile change and boosted the patient's self-esteem. The posterior restorative rehabilitation will occur in the near future. Nighttime retention will be needed to maintain the result.
ClearCorrect orthodontic aligners are an ideal choice when there is a lack of enamel to bond appliances, and their rigidity and style of trimline decrease the need for attachments/engagers.
The trimline used by ClearCorrect aligners helps overcome a small generalized tooth size (ie, decreased surface area). The relatively high trimline on the gingiva increases retention to overcome the reduced surface area.
In treating amelogenesis imperfecta, restorative dentistry after orthodontic therapy enabled an ideal result to be achieved, including a vast improvement in the patient's smile.
Mark Lowe, DDS
Attending Orthodontist, General Practice Residency at Community Regional Medical Center, University of California San Francisco - Fresno; Private Practice in Orthodontics, Fresno, California
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