Question:
This patient presents with moderate crowding of her upper and lower incisors. The UR2 is rotated and palatally placed. The LL1 and LR1 are rotated and the LR2 is lingually placed. In addition she has a midline cant. Is this case possible with the Inman Aligner?

Answer:
Opinion 1: For the upper, I would use a combined Inman and Expander, using IPR all the way from the distal of canine to canine. I think the midline cant will improve but it won't be perfect, so she should be made aware of this. The lower is very easy. Get an anchor on the palato-incisal of the UR2 to aid the rotation. Also there has been a fair degree of differential wear going on, so she will need to be aware that some bonding may be necessary afterwards.
Opinion 2: I think that you can do this case, but you can't solve the cant. It will get a little better but if she wants it perfect then she will need fixed orthodontics. I would use a combined Inman and Expander for the upper and you need to domino the canines quite a bit, so make sure you tell the lab to set 3-3. The lower should be easy once the upper is sorted. It's not an easy case though!

Tags: Moderate Upper Crowding, Moderate Lower Crowding, Suitable Case, Difficult Case, Combined Inman and Expander, Rotatio, Composite Anchor, Spacewize Analysis, Combined Upper and Lower Treatment, Differential Wear Post-Treatment