Clear Aligners Alone Used to Correct Multiple Problems in Teenaged Patient

Ly T. Mar, DMD, MSc, FRCDC

A 13-year-old male patient presented with severe crowding on the lower arch, a constricted maxillary arch, and enamel decalcification on multiple teeth. He also exhibited a deep anterior bite that caused constant irritation to the papilla and prevented a diastema from closing. Due to weak enamel and hygiene concerns, clear aligners were used to treat this case without any metal or bonded brackets on the teeth. ClearCorrect^™ (A Straumann Group clear aligner product line, clearcorrect.com) clear aligners were selected, which require only a minimal number of attachments/engagers to achieve a quick and successful outcome. ClearCorrect aligners provide optimal fit, rigidity, and traction for the necessary movements to correct crowding and achieve arch expansion. Their higher gingival trimline and revolutionary plastic material (ClearQuartz^™) facilitate the necessary contact to all teeth surfaces, improving traction and increasing the efficiency of the dental movement. By applying the fundamentals of orthodontic biomechanics and clear aligner tooth movement and using ClearCorrect aligners, the orthodontic challenges presented by the patient-constricted maxillary arch, class II deep bite, weakened enamel, and severe crowding-were overcome. The treatment was achieved in just 10 months. The patient was provided with upper and lower ClearCorrect clear retainers to maintain the result.

Key Takeaways

ClearCorrect aligners are ideal for treating teeth with existing enamel deficiency. The tray fit, shape memory, and aligner rigidity increase efficiency in correcting narrow arches and crowded teeth.

The high trimline of the ClearCorrect trays combined with the state-of-the-art ClearQuartz material is well-suited for treating short clinical crowns often found in teenaged patients. Greater tooth surface contacts minimize the need for multiple attachments/engagers.

Digital setup allows clinicians to visualize treatment step by step from start to finish; the stain-resistant, esthetic, and transparent ClearCorrect aligners allow easy hygiene monitoring and are well-accepted by teens.

About the Author

Ly T. Mar, DMD, MSc, FRCDC
Part-time Clinical Professor in Orthodontics, University of Alberta; Clinical Advisor for Straumann/ClearCorrect North America; Private Practice in Orthodontics,
St. Albert, Alberta, Canada

Figures and Images

Fig 1

Fig 2

Fig 3

Fig 4

Fig 5

Fig 6

Fig 7

Fig 8

Fig 9

Fig 10

Fig 11

Fig 1

Fig 1. Patient’s frontal smile. The 13-year-old patient presented with severe crowding on the lower arch, a constricted maxillary arch, and enamel decalcification on multiple teeth. A large diastema between teeth Nos. 8 and 9 was also noted.

Fig 2

Fig 2. Patient’s intraoral condition. Besides the problems mentioned in Fig 1, also noted were a low frenum attachment, midline deviation, and recession on the lower right central incisor.

Fig 3

Fig 3. Initial panoramic X-ray showing full permanent dentition, crowding, and midline deviation.

Fig 4

Fig 4. Initial lateral cephalometric x-ray showing class II malocclusion, large overjet, deep bite, and deep curve of Spee. Chin retrusion was also noted.

Fig 5

Fig 5. Initial ClearCorrect trays insertion appointment. Only five engagers were used, all on the lower arch. The trays fit well, and the gingival trimline did not impinge any tissues. A lower lingual holding arch had been removed prior to the initial insert.

Fig 6

Fig 6. Six-month revision trays insertion appointment. Only one engager, on tooth No. 21, was used at this time. The trays fit well, and much improvement was noted in arches expansion and crowding. The midline was now corrected.

Fig 7

Fig 7. Initial ClearCorrect treatment setup showing engagers (in green) on the lower teeth. The deep bite, crowding, and arch constriction were clearly evident.

Fig 8

Fig 8. The revised ClearCorrect treatment setup at 6 months. Considerable improvement was noted in the crowding, midline, and bite correction.

Fig 9

Fig 9. Patient’s frontal smile at the completion of treatment after 10 months.

Fig 10

Fig 10. Patient’s intraoral condition showing final correction, which included all crowding, the midline, improved gingival recession, and closed diastema. The bite was now ideal, and the archforms improved. The treatment was succesfully completed after 10 months using only ClearCorrect aligners.

Fig 11

Fig 11. The trimline on ClearCorrect aligners (top) is higher than on other aligners that use a scalloped trimline near the cementoenamel junction (bottom). This characteristic helps make the ClearCorrect aligners highly retentive and enable a more efficient treament outcome.