Jeffrey Briney, DDS
A 34-year-old healthy man presented to the author's practice after having multiple consultations with a general practitioner and orthodontists who all told him that aligner therapy could not resolve his dental issues. The patient's maxillary right lateral incisor was congenitally missing, contributing to his concerns about the overall appearance of his smile, and he also complained of what he believed to be temporomandibular joint (TMJ) pain. Upon examination of the patient and radiographs, the author determined that the patient's occlusal disease had resulted from the collapse of the maxillary teeth on his right side and the lingually inclined premolars and anterior teeth, leading to moderate abfractions throughout his mouth and a myofascial pain disorder that the patient had mistaken for a TMJ problem. A treatment plan was presented to both correct his cosmetic concerns and also address his "silent" occlusal disease and myofascial pain disorder. The treatment would begin with orthodontic positioning of his teeth into an ideal occlusion via ClearCorrect® aligner therapy (Straumann, clearcorrect.com) and then, after 9 months of aligner therapy, proceed to the surgical and restorative phases. The case was completed in 12 months using a digital workflow plan that involved the use of intraoral scanning, CBCT, in-office milling for a surgical guide and restorations, and orthodontic software (ClearPilot™, Straumann).
Clear aligner orthodontics has progressed to allow for advanced teeth movements in a relatively short time compared to traditional brackets and wires.
ClearPilot digital treatment design tool affords clinicians improved visualization and responsive control when reviewing and approving their ClearCorrect aligner cases.
This case involving a congenitally missing maxillary right lateral incisor centered around 9 months of clear aligner therapy and included implant placement and restoration utilizing a digital workflow.
Jeffrey Briney, DDS
Private Practice, Dana Point, California
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