Question:
This patient originally came in with severe crowding of her lower central incisors. She was given an Inman Aligner with with a built-in Expander to wear. The patient failed to return for observation for an extended period of time and when she did come back for a check up, there was obvious spacing between her incisors. It was an obvious case of over expansion. Do we need to make her a new appliance?

Answer:
The first thing is to tell the patient to stop turning the screw as no more expansion is needed. Another appliance is not needed. I would suggest tightening up the side springs by flowing composite onto the labial spring housing to shorten the springs. This will result in pulling the centrals in and will close the spaces. Smooth out the lingual bow so that the fit surface is more even, thus allowing the incisors to drop back a little. After trying these adjustments with the IA, use a Clear Aligner to intrude and align.

Tags: Over Expansion, Retraction, Severe Lower Crowding, Problem Solving, Trouble Shooting, Tightening Springs