CASE REPORT

Spark™ treatment of teenager with moderate dento-maxillary discrepancy

This article describes a treatment with Spark Clear Aligners in a 14 year-old patient, with moderate DDM (Dento-Maxillary Disharmony), narrow arches, biproalveoli and hyperdivergence of the bony bases.

What was the purpose of the refinement order?

We note from the photos that the extrusion of 2.2 was not fully expressed at the end of the first series of treatment despite the placement of a beveled gingival attachment.

Since the extrusion movement on the upper lateral incisors “teeth with very little retentive due to their small size” is one of the most difficult movements to perform. For this, Dr. Pierre-Antoine Dian advises in this case to opt for the “Hamac” technique during the refinement phase.

This technique began two weeks before the end of the treatment and it consists of placing double buccal and palatal buttons on the tooth concerned after having previously cutouts on the aligner and attaching an elastic in „Hamac“ (Impala 6 Oz, 3/ 16‘‘) to help with extrusion and improve the fit of the tooth in the aligner (see photos below). The refinement required 7 active aligners with TruGEN XR™ as material.

• It should be noted that Dr. Dian removed the rectangular horizontal attachment during the “Hamac” technique, which was initially added in the refinement phase, in order to allow the extrusion of 2.2.
• During the 1st stages of refinement and as shown in the photos, Dr. Dian added a Caplin hook on the 3.3 during treatment in order to improve its bite with the opposite arch. For this he used button cutting pliers.
• Dr. Dian‘s advice for managing complex movements on small coronary surfaces is to put an attachment on these teeth, as large as possible in order to have maximum anchorage.