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