Minor Anterior Crowding – Lower Arch

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Minor lower anterior crowding as shown here is one of the most common types of cases we see for clear aligner treatment. This case was treated with 4 aligners and IPR. Note the slight expansion of the cuspids to improve the arch form. 

[tabby title=”Simple anterior crowding”]

Simple lower anterior crowding treated with 3 aligners and IPR. Only the centrals and laterals were reset in the laboratory.

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Lower anterior crowding treated with 4 aligners. The overjet dictated the corrections be done with IPR as the anteriors could not be moved to the labial.

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Minor Anterior Crowding – Upper Arch

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Upper anterior crowding treated with 3 aligners. There was a slight shift of the centrals with space made possible by .25mm IPR on the distals.

[tabby title=”Very simple anterior crowding”]

Very simple upper anterior crowding case treated with 2 aligners. There was a slight rotation of the right central with the left central tipped out to the labial.

[tabby title=”Treated with 4 aligners”]

This upper anterior crowding case was treated with 4 aligners. Just the centrals and laterals were reset for the aligner fabrication. As the distal of the left central rotated out, space was created for the right central to tip forward to help reduce the amount of IPR required.

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Moderate Anterior Crowding – Lower Arch

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Lower anterior crowding treated with 4 aligners. All 4 anterior teeth had 0.2mm IPR on the mesial and distals. Patient is also receiving 1 additional “refinement” aligner to improve the final position of the left central.

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Moderate Anterior Crowding – Upper Arch

[tabby title=”Anterior crowding”]

Upper anterior crowding treated with 4 aligners. The cuspids were reset and expanded slightly to help reduce the amount of IPR needed for the anterior corrections.

[tabby title=”Anterior crowding”]

Upper anterior crowding treated with 5 aligners. The cuspids were reset with the mesials rotated to the buccal to help improve the arch form and reduce the IPR. Note the right central did not change position in the overall arch form.

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Space Closing – Lower Arch

[tabby title=”Arch space closure”]

Lower arch space closure with 5 aligners to this point. The centrals, laterals and left cuspid were reset in the laboratory.

[tabby title=”Arch treatment”]

Lower arch treatment where the space between the right lateral and cuspid was used to help align the anterior teeth and reduce the amount of IPR.

[tabby title=”Progress of arch”]

Progress photos of lower arch treatment space closure with a missing central. The cuspids were also reset to improve the arch form as the space is closed.

[tabby title=”Moderate arch space closure”]

Moderate lower arch space closure with 4 aligners. All four anterior teeth were retracted to close spaces.

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Space Closing – Upper Arch

[tabby title=”Arch treated with 3 aligners”]

Upper arch treated with 3 aligners to close anterior space. Overjet will not allow additional space closure.

[tabby title=”Unique arch space closure”]

Unique upper arch space closure with 5 aligners. The lateral was moved distal with 5 aligners so the dentist could fabricate a restoration with mesial and distal balance.

[tabby title=”Significant arch space closure”]

Significant upper arch space closure with 5 aligners. The lower arch had concurrent space closure to allow retraction of the upper teeth.

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Mid-Range Lower Arch Treatment

[tabby title=”Treated with 4 aligners”]

Lower anterior crowding case treated to this point with 4 aligners. The cuspids were reset but not expanded which dictated .5mm IPR on the mesials and distals of the centrals and laterals. Two additional refinement aligners were requested.

[tabby title=”Treated with 7 aligners”]

This lower anterior crowding case was treated with 7 aligners, an initial Series 4 followed by 3 refinement appliances. The centrals and laterals were flared to the labial slightly with IPR on all 4 teeth.

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This lower anterior crowding case was treated with 5 aligners and IPR. There was enough overjet to move the teeth labially with the rotational corrections.

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Mid-Range Upper Arch Treatment

[tabby title=”Treated with 5 Aligners”]

Five aligners were used to correct this “Mid-Range” anterior crowding case. Just the centrals and laterals were reset with .25mm of IPR mesial and distal to all 4 teeth.

[tabby title=”Treated with 5 Aligners”]

Before and after progress photos of an upper anterior case treated with 5 aligners to this point. There is slight expansion of the cuspids in addition to .25mm IPR on all anterior contacts. Three continuation aligners were requested to complete the corrections.

[tabby title=”Treated with 7 Aligners”]

Upper anterior crowding case treated with 5 initial aligners followed by 2 refinement aligners. The cuspids were not reset so there was moderate IPR on the centrals and laterals.

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