Treating orthodontic relapse

Patrick Puckett presents a recent case study using clear aligners to treat upper and lower orthodontic relapse.

A patient presented at the practice with concerns about the appearance of her smile. She had undergone orthodontic treatment twice previously, but the upper anterior teeth had since drifted forward and the lowers had become crowded again. She expressed an interest in removable appliances due to the convenience of this type of treatment.

As part of the comprehensive orthodontic assessment, clinical photographs, a bitewing registration and an OPG were taken. No obvious pathology was detected. Impressions were also taken and sent to the IAS Laboratory for Spacewize+ digital calculations. These demonstrated that 1.8mm of space would need to be created in the upper arch, confirming suitable case selection for treatment with the Inman Aligner. In the lower arch, 2.4mm of IPR (interproximal reduction) would be required, which was also within the limitations of the appliance.

The entire treatment process was explained to the patient in detail – including benefits, risks and limitations – and she was given the chance to ask any questions. The importance of lifelong retention was also emphasised, which was particularly relevant given the relapse the patient had experienced twice already from previous treatments. This was supplemented with oral hygiene advice and recommendations for before, during and after the orthodontic procedure. Informed consent was obtained to proceed.