Question:
The URQ is aligning well, but the movement of the UL1 has slowed down. Palatal movement of the UL1 is still necessary to align it with the arch. The buccal springs have been tightened as much as possible, the contacts between the upper incisors are not tight, and composites have been added to the lower canines to remove any interferences from the lower teeth. I am unsure where to go from here. Do I need to make another Inman Aligner for the final movements?

Answer:
If the springs are fully loaded and there is not any obvious pressure on the front teeth, then there is a chance the bow is flexed and it needs resetting. You could consider making a temporary Clear Aligner for the patient to wear while you sort the fit of the Aligner with the lab. Take off the anchors, take a new impression of the teeth and send this impression along with the old models and Aligner to Nimrod and ask him to reset the bow. In the meantime, it is important that the patient wear the Clear Aligners as a form of retention. If the patient is willing, it might even be worth asking for a metal wire in the labial bow as this reduces flex. It is not pretty, but it is more effective than the clear bows.

Tags: FAQ's, Teeth Not Moving, Retraction, Composite Anchors, Spring Adjustments, Bow Position, Bow Resetting, Problem Solving, Troubleshooting