Question:
This patient is three weeks into her treatment with an upper Inman Aligner. The teeth are moving well, but she is slightly concerned about the black triangle present between the upper central incisors. There is still a mild rotation of the UL1. She is also interested in doing something with her lower teeth. The canines are very prominent and there is moderate crowding of the incisors. She has become more aware of this since the uppers have become more aligned. Are the lower teeth a suitable case for the Inman Aligner? Space calculations reveal that there is approximately 5.5mm of crowding.

Answer:
With cases like this, black triangles post-treatment are possible regardless of what type of orthodontics is carried out. Overlapped teeth often squeeze the papilla upwards. To address the black triangle problem, you can:
1. Do a little more paralleling IPR on the central teeth while the patient is still using the IA
2. Wait until the patient is using a Clear Aligner and then parallel the contacts then and squeeze the teeth together
3. Do nothing for now and just wait. It is common for these spaces to resolve themselves over time.
4. Do a little of options 1 and 3.
The lower case depends on how much room you have to advance the lower centrals after you have finished the uppers. If you have 1-2mm of space to advance them, then the case will be much easier and you will find the canines will improve as well. You should be able to tell from the models Nimrod sent you. If there is no room, you could consider adding an expander to the lower Aligner and doing some IPR to gain a little more space.

Tags: Mild Upper Rotation, Moderate Lower Crowding, Suitable Case, Expander, Black Triangles, Tips on IPR, Problem Solving, Check Occlusion