Question:
The patient is currently wearing an upper Inman Aligner with a composite anchor bonded to the buccal aspect of the UL1 and the mesio-palatal aspect of the UL2. I have removed the composite on the buccal of the UL1 because I believe that this has contributed to the intrusion of this tooth. Could you please advise me as to the best course of action?

Answer:
Don't worry. This is quite normal and I am going to show you how to sort it out very simply. Basically, place a new labial composite anchor on the UL1 about 1/3 to half way up from the incisal edge and then get the patient to seat the bow gingivally. This will tend to pull the tooth down, i.e. extrude it. Also on the palatal surface, put a new anchor about 3-4mm down from the incisal edge so the palatal bow sits more gingivally than normal. Get the patient back in a week and have a look. Here is an example of a very similar case. On the second image, notice the anchor about 4mm from the incisal edge; notice the labial bow has been hooked gingivally to it instead of labially. Also notice the palatal view. the palatal anchor is further up the tooth and the bow hooks under it which also encourages extrusion. This extrusion took 6 days.

Tags: Extrusion, Troubleshooting, Problem Solving, Tips on Extrusion, FAQ's