Question:
This patient has a retained upper right primary canine. The permanent UR3 is palatally placed. The plan is to extract the primary canine and labially move the UR3 with an Inman Aligner. The patient is very keen on getting treatment with the Inman Aligner because of the reduced treatment time involved and has rejected fixed orthodontics. The UR1 width is 8.9mm.

Answer:
This case is possible but it is more tricky. With the help of a Bite Raising Appliance, you can get an Inman Aligner to push the canine out. The Aligner will have a different than the usual because it will need to engage behind the canine. Nimrod will modify the design for this; he may advise against the case after looking at the models. You may find yourself adjusting and replacing the lingual springs to ensure the force on the canine is consistent and gentle. With the amount of movement required, the springs may be too tight to start and may become too slack as the treatment progresses. A composite anchor is definitely needed on the palatal of the canine. The patient should be aware that they will need a couple of Clear Aligners after to move the canine into the final position. Afterwards, you won't need retention on the UR3 as the occlusion will hold the tooth in place. You will need to retain the opposite lateral if you decide to align it. This is not an ideal case, but it is treatable.

Tags: Crossbite, Canine Crossbite, Difficult Case, Bespoke Appliance, Clear Aligners to Finish, Spring Adjustment, Bite Raising Appliance