Question:
The patient is 27 years old and hates her smile. The proposed treatment plan is to use a Fanscrew or a Midline Expander and some IPR to make room for the upper teeth. The goal is to advance the centrals and rotate and extrude the laterals. Once the whole frontal arch is aligned, a bonded wire will be placed for retention. IPR and an Inman Aligner will be employed to advance and align the lowers. Again a bonded lingual wire will be place for retention. Is this a suitable case for the Inman Aligner and is the treatment plan appropriate?

Answer:
This case is suitable and would be a nice case to do. I would treat the upper arch first using a combined midline Expander on the Inman Aligner to advance the centrals and derotate the laterals. This will be quicker than using a separate Fanscrew. Then I would retain with a bonded wire. I doubt you will have to attempt to extrude the laterals. They will just seem to do so as they align. Use an Inman Aligner on the lower teeth as well to advance the incisors and regain the the anterior stop. You may need composite anchors to ensure the bows sit on the incisal 1/3.

Tags: Class 2 Div 2 - Moderate, Mild Lower Crowding, Suitable Case, Combined Upper and Lower Treatment, Combined Inman and Expander, Composite Anchor, Fanscrew Appliance, Midline Expander