How often do you use Invisalign during cosmetic treatments? Maybe not as often as you think is necessary. Our patients don’t always choose optimal or even the most conservative treatment.
The case described below was such a great experience for me and my whole team because the patient was so amenable to ideal treatment modalities.
Keep reading for the details:
Case #28: Invisalign for Maximum Aesthetics
Clinician: Dr. Mike Smith, Phoenix, AZ
My patient wanted to correct crowding by expanding her arch. Her primary goal was to improve her smile by changing the shape, length, and color of her teeth while still being conservative.
We initiated her treatment plan with basic disease removal leading to Invisalign. Pre-operatively, her arches were lingually inclined, giving her a collapsed and deflective smile line. In order to idealize her arch form for conservative overall treatment, her curve of spee and curve of Wilson needed to be flattened and widened.
We needed to re-establish her canine guidance and balance out her occlusion forces. With her Invisalign orthodontic treatment completed, the challenge was how to get the aesthetic result she wanted with the prior worn teeth and restoration. Tooth #7 was endodontically treated with a failing PFM crown.
To maximize aesthetics, the Gold Dust Aesthetic Team and I discussed restorative materials. We chose to fabricate a “color correction coping” from e.max to blend perfectly with the upper 9 minimal prep Empress veneers. Handling the block out with an MO ingot allowed the ceramist to completely control color and opacity.
Mock Up & Preview
The patient was deprogrammed and pre-adjusted with T-scan to remove any posterior interferences and balance her remaining occlusion. To get her approval on prescribed length, contour, and function, we mocked up with direct composite and designed her smile, prescribing a wax up for transfer to the mouth.
I temporized the patient utilizing Discus Perfect Temp for spot bonding and cemented with Ivoclar Telio cement. This enabled a cosmetic/functional preview based on the wax up. We were also able to test phonetics with the additional length and new position of the incisal edge.
Lab Fabrication & Result
Gold Dust fabricated the coping and veneers in approximately 2 weeks. I bonded the case with Variolink Veneer cement in a +2 for the coping first. The remainder of the case balanced warmth with 0 trans and -2 on the canines. The patient wanted a bright shade of 020/010 that fit her cosmetic goal.
The patient’s occlusion was equilibrated with T-Scan to ideal and polished. Post-operatively, I fit her with a lower Invisalign retainer and a discluding/orthodontic retainer on the upper arch to facilitate long term retention and decrease any parafunctioning damage.
Gold Dust knocked it out of the park with this case! The patient is so pleased and it certainly shows.
Read the last Case of the Month on veneers esthetics here!