December 13, 2018 at 12:45 am #387
Hi Dr John,
I hope you are doing well. I would like your advice regarding a 48 yr old female patient who is interested in having clear aligners. She is mainly concerned about her overlapping upper centrals and a bit concerned about her lower anterior crowding as well. She had removable orthodontic treatment when she was 13 yrs old and had her 1st premolars extracted except 44 which is still present. She has a heavily restored dentition and 26 has been RCTreated over 12 yrs ago with an amalgam core restoration which is not very satisfactiory as it has a small chip on the distobuccal margin. I have stressed the importance of getting it crowned prior to having orthodontic aligners but she is not keen on the crown. Could you please advice if it is ok to proceed without or advice on how to convince her further? I have attached some images for you to view.December 13, 2018 at 1:43 am #391
Im unable to upload the other images as the file size is bigger…. is there any other way to send it to you?December 13, 2018 at 1:57 am #393
OPGDecember 27, 2018 at 9:53 pm #398
Hi Neha again my apologies not responding
To answer your question regarding the 26
Generally I would crown after alignment as it is easier to place attachments on enamel then porcelain.
Secondly the tooth although weak would be protected with 22 hour of aligner use.
I think given the history if the tooth warm it is vulnerable either way and also advise that you will not move tooth in software
Can you upload X-ray?December 28, 2018 at 4:43 am #399
Hi Dr John,
I have emailed you the x-rays separately to info@aorta…… as im unable to upload it here as the file size is too big.December 28, 2018 at 10:55 am #400
Ok so I have checked opg nothing significant
Regarding whether you reinforce and treat 26 before treatment is a clinical judgement by you
Setting up software first as a diagnostic tool allows you to assess further whether to crown of fill a weaker tooth before aligners or wait until after.
As a clinician you need to assess pros and cons of this.
As a general rule I prefer to crown teeth after aligners as I feel the aligner should provide certain occlusal protection during aligners but every situation is different pending occlusion type bite type ectMarch 23, 2019 at 7:38 am #642
Hi Dr John,
I hope you are doing well. I just wanted your advice regarding software set up for this patient. Can I send you the link here for her treatment plan as per the Smilecheck software?
NehaMarch 26, 2019 at 1:48 pm #709
We are currently upgrading the software across this forum to make it easier to communicate.
What is the best way for you to interact for faster responses?
Perhaps a dedicated email account for you to send to?
Best regards, John
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