A 15-year-old female presented for orthodontic
treatment with the complaint that “her
fang was out of place.” Initially, traditional
fixed appliances were offered however, this option was quickly rejected since the young lady
was already self-conscious about her smile and didn’t want the added distraction of braces. An
alternative treatment plan using ClearCorrect clear aligners was selected.
The patient had no medical problems and no dental problems other than a minimal
amount of attached gingiva on the mandibular central incisors. Oral hygiene was excellent.
Skeletally, she was Class I with a Class I molar relationship. The maxillary right canine was in
crossbite, and maxillary and mandibular incisors were recumbent. Crowding was moderate in
the maxillary arch and mild in the mandibular arch. Figures 1 through 5 show the pretreatment
After obtaining pretreatment orthodontic records and a signed informed consent form,
treatment began with the Phase 0 aligners. Phase 0 is an important step since it allows the
patient to become used to wearing aligners without having to deal with tooth soreness that is
associated with tooth movement that begins with aligner 1A. Phase 0 aligners also allow the
practitioner to verify the fit of the aligners prior to the fabrication of treatment aligners.
Should there be a problem with the fit of Phase 0 aligners, new impressions or
scans of the teeth can be submitted. This bypasses the cost of fabricating new treatment
aligners based on an initial inaccurate model. Managing costs is what allows
ClearCorrect to deliver an exceptional product at a lower cost than their competitors.
Starting with aligner 1A, aligners were dispensed two at a time with each aligner being
worn for three weeks. Each phase of treatment consists of four sets of aligners. During Phase 2,
engagers were placed on the maxillary left canine and right second premolar and the mandibular
right canine and left second premolar. Engagers can assist in specific tooth movements as
well as improve the overall retention of the aligners in the mouth. It is helpful to bond the
engagers by quadrants, and this can be done by cutting each engager template in half. Once
the template is lightly coated with Vaseline, composite may be placed in the engager template
with a PFI instrument. Applying a liquid bonding agent initially to the PFI keeps the composite
from sticking to the PFI once the composite has been placed in the template. Each
engager was cured with a light for 15 to 20 seconds, and any extra flash was removed with a
composite finishing bur.
Treatment involved six phases for a total of 24 aligners and 16 months of treatment. No
interproximal reduction was required. This patient was exceptionally motivated and maintained
excellent oral hygiene throughout treatment. Retention involved aligners identical to
the final treatment 6D aligner (with the engagers removed). Aesthetics were improved on the
maxillary anterior teeth with a minor amount of enamel recontouring.
Treatment results were very good as seen in figures 6 to 10, with only a minor midline discrepancy
present. A small amount of gingival recession occurred during treatment on the
mandibular right central incisor. The patient was referred for a periodontal evaluation and
possible gingival graft.
ClearCorrect clear aligners are a valuable tool in today’s orthodontic practice. The
ClearCorrect doctor’s portal (dr.clearcorrect.com) is easy to navigate and allows a practitioner
to view the status of every case submitted. The ability to upload all patient records is an added
bonus. ClearComm also offers patient education tools and practice advertisement and promotion
that can be downloaded as needed.