Viet Hoang

and 3 more

INTRODUCTIONDiastema or spacing in anterior teeth is one of the most complaints of patients for undergoing orthodontic treatment. Abnormalities in tooth size or shape discrepancy are common causes of tooth spacing. The most commonly presenting of these are small lateral incisors. The Bolton Analysis may be used to compare tooth size discrepancies1. This group is often treated by restoring the teeth to standard size and closing the remaining gaps by utilizing the correct inclination of the anterior teeth in case they are proclined.Nowadays, patients not only seek treatment to address their issues but also demand appliances that are both more aesthetic and comfortable2. Clear aligners meet the patient’s needs since the Clear Aligners system is more tolerable and more esthetic than ceramic or metal brackets3. However, orthodontic treatment with clear align presents challenges in controlling anterior mesiodistal tipping and buccolingual tipping. Kravitz et al. showed a mean accuracy of 41% for mesiodistal tipping, in which the maxillary central incisors (39%) had the lowest accuracy and 53% for labial crown tip4. Castroflorio et al.5described the accuracy of inclination (buccolingual tipping) and angulation (mesiodistal tipping) correction for maxillary central incisors as 32% and 22.9%, respectively. Control of mesiodistal tipping and buccolingual tipping is mandatory in cases requiring space closure and reduction of the protrusion of anterior teeth.In this case, the patient requires significant retraction of the incisors to close the gaps. Controlling the movement of the incisors in the buccolingual direction is crucial to ensure the root does not move outside of the alveolar bone, and to minimize root resorption. Additionally, the patient has several incisors with distally inclined roots (teeth 12, 21, 22), which makes it challenging to maintain the proper mesiodistal inclination when closing gaps and retracting the incisors. Clear aligners are not effective in controlling the buccolingual inclination of anterior teeth6.This objective of this case report is to describe an adult male patient with significant spacings and proclined anterior teeth successfully treated with clear aligners, along with some clinical tips we used to control the movement of maxillary central incisors.CASE REPORTA 21-year-old male patient came for consultation with chief complaints of spacing in anterior teeth which affects the aesthetics of his smile.His current overall health is good, and he is no longer affected by his previous condition. He has never had any dental treatment before.