Orthodontics
Fig 1
The patient’s smile before treatment showing crowded and crooked teeth
Fig 2
Occlusal view of the overcrowding and overlapped teeth
Fig 3
The patient with the clear brackets and tooth-coloured wires fitted
Fig 5 Fig 4
The braces are removed six months later
The patient’s smile after six months. The front teeth are well aligned and her smile is much improved
Fig 8 Fig 6
Fixed bonded retainers are fitted to retain the upper teeth
such as Six Month Smiles give the general practitioner a powerful new tool with which to straighten anterior teeth, and provides a real, practical alternative to invasive treatment options, such as crowns and veneers.
Case presentation Kelly is a 29-year-old woman who had always been concerned about the appearance of her teeth, particularly her crossed-over front teeth and the lateral teeth she used to call ‘fangs’ (Fig ı-2). She was also aware her bottom front teeth were fairly crowded. As a result, she was seriously lacking in confidence and really didn’t like the way things looked. Before she came to our practice,
Kelly had been for a number of consultations with specialist orthodontists, and was keen to research all of her options. Though she had previously seen a specialist, she declined the long- term treatment option as she wasn’t prepared to undergo a course of treatment that would last in excess of a year and would also involve extractions. We discussed her previous
Fig 7
Fixed bonded retainers are fitted to retain the lower teeth
consultations, as well as her treat- ment expectations. We believed the ideal situation would be for her to have comprehensive orthodontic treatment, but if she still wasn’t interested in the long-term option, there may be an alternative solution in the form of Six Month Smiles. This option was extremely appealing to Kelly, who was keen to have a faster solution to her crooked teeth. We then proceeded to carry out a full assessment of her teeth to check her suitability for the treatment and plan her course of treatment. It soon became clear that, before
we commenced orthodontic treat- ment, we would need to carry out routine stabilisation dental care. This involved hygiene care to improve the health of her gums, and root canal treatment in her upper left central incisor due to a carious cavity caused by her crossed-over incisors. We were then able to carry out
a full orthodontic assessment to assess her cosmetic needs and the issues relating to the malocclusion. We also assessed the amount of crowding in her mouth so as to confirm this was a case we
Following conclusion of the treatment, the patient is absolutely delighted with the result
“She was seriously lacking in confidence and really didn’t like the way things looked”
Dr Andy Denny
could treat with the Six Month Smiles system. Once this was complete, we carried out the normal consent process, reiterating with the patient that Six Month Smiles is not comprehensive – it’s short-term orthodontics, which means we’re not trying to correct everything about her teeth. We reminded her that this treatment option is mainly concerned with correcting the position of the front teeth, so we wouldn’t be correcting her bite at the back. Kelly was happy with this and we moved on to the impressions stage. Following standard Six Month Smiles protocol, we took records including upper and lower PVS impressions as well as bite registra- tion. We then prepared directions for the technical set-up, all of which was sent off to the Six Month Smiles lab for preparation. A few days later, we received
her individualised Patient Tray Kit (PTK) from Six Month Smiles that included her custom indirect bonding trays, which make accurate
Continued » Scottish Dental magazine 43
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