July 2021

Pearl: 

  • 30

  • Chief Complaint : "I want to fix my smile, I'm embarrassed and I want to be able to smile confidently."

Examination: 

  • Full mouth x-ray

  • Comprehensive exam, including head, neck and periodontal

Evaluation:

  • Hyperplastic Gingival tissue

  • Generalized supra and sub gingival calculus

  • Active periodontal disease

  • # 1 & # 16 impacted, retained roots # 4 & # 31

  • Gross decay # 17 & # 20 non-restorable

  • Class I Malocclusion Severe Maxillary and Mandibular crowding >6 mm

  • Narrow Arches: Maxilla & Mandible

  • Compromised Hygiene

Treatment:

  • Extractions: #1, #4, #16, #17, #20, #31

  • Periodontal Therapy: 4 quads of S/RP

  • Comprehensive Invisalign treatment once periodontal condition stabilized

  • 1 week wear

  • EPS Munchie protocol pink 1st half of treatment and blue 2nd half of treatment

  • Use munchie at every insertion of aligners and an additional 5-10 a day

  • Total Treatment time: 11 months / 44 trays

  • Whitening treatment in aligners during treatment

  • Black triangle closure between # 8 and # 9 with BioClear BT closure matrices and technique

  • Vivera retention: 6 weeks full time wear, nighttime wear after 6 weeks

Shon Dempsey