Dr. Lorena Mingotti
• She graduated with a degree in Dentistry from the Santa Maria University in Caracas, Venezuela.
• She is a Master in Implant Prosthesis and Prosthesis at the Mississippi Institute and University of Alcalá, with a Graduate Certificate in Dental Aesthetics at New York University.
• She is Invisalign Go certified and a Member of the Spanish Society of Estomatological and Aesthetic Prosthesis, who has completed various courses on aesthetics and dental prosthetics.
the case
the case
The patient, a 45-year-old man, did not like his smile owing to the colour and positioning of his teeth. He wanted a white but natural smile with ceramic veneers. His teeth showed staining, making him a good candidate for this type of treatment.
We performed a bite study with our scan and saw that he didn’t have enough space to install veneers without touching his teeth. We decided to treat him first with Invisalign Go™, building an orthodontic foundation with future restorations in mind. All the patient’s treatment was planned with Invisalign Smile Architect™. We aimed to improve the deep bite, overjet and overbite and create enough space to avoid needing to touch the teeth in future restorations.
ORTHO RESTORATIVE DESCRIPTION
ORTHO RESTORATIVE DESCRIPTION
ClinCheck® details: 11 weeks of alignment treatment. We based all the ortho movements on the restorative design from Invisalign Smile Architect™.
It is important to consider the material of the restorations and the communication with our laboratory. Knowing that we wanted to work with feldspathic ceramic in this case, the space that we planned was ideal.
Together with the patient, we decided the anatomy of the veneers, the length and the gum aspects – all based on the ClinCheck InFace Visualisation tool.
We created an overjet of 4 mm and an overbite of 45% to improve the space and increased the vertical dimension to improve the deep bite.
RESTORATIVE TREATMENT DETAILS
RESTORATIVE TREATMENT DETAILS
Guided facial restorations.
REDUCTION AND ADDITION
REDUCTION AND ADDITION
Without alignment, it would have been necessary to touch about 2 mm of the surface of the central incisors and about 1.5 mm of the other teeth.
Thanks to Invisalign Smile Architect™, we were able to plan the movements and the space we needed to offer minimally invasive dentistry.
FINAL TREATMENT
FINAL TREATMENT
We completed 11 weeks of Invisalign Go™ treatment.
In the lower arch, we intruded the anterior incisors to increase the vertical dimension and improve the deep bite. The patient had several gaps that were closed with the treatment.
In the maxilla, we aligned the arch and closed several gaps. The upper arch was expanded, and that improved the overjet and overbite that we wanted for the aesthetic phase.
When the patient was on his 9th aligner, we started the aesthetic treatment.
The laboratory already had the STL of the restoration design that we planned with Invisalign Smile Architect™.
MULTIDISCIPLINARY SUCCESS
MULTIDISCIPLINARY SUCCESS
We planned this treatment as multidisciplinary dentistry.
- 11 weeks of Invisalign Go™. We planned all the movements and restorations with Invisalign Smile Architect™ with our laboratory to assess the space we needed. On the IDS, we have all the software in one place, which improves communication and planning with our patient, as well as our teamwork.
- We made a live mock-up based on our Invisalign Smile Architect™ design.
- After 11 weeks, the aligners were removed, and a Vivera™ retainer was provided for the lower arch.
- Using the mock-up to guide us, the design and fabrication of the veneers were very easy. The veneers were made with the minimum thickness (0.3 mm).
- After placing eight superior veneers, a Vivera™ retainer was provided for the upper arch.
“Thanks to Invisalign Smile Architect™, we were able to plan the movements and the space we needed to offer minimally invasive dentistry.”
We achieved our goal – minimally invasive treatment. With this kind of software, you can plan the ortho movements based on the patient’s goals and desired restorations.
This software improved our communication, both with the team and with the patient, because showing our patients what they look like before and after the treatment is easy. They become part of the process and the planning.
Listening to the expectations and concerns of our patients is very important. In this case, we informed this patient of our need to create enough space to avoid touching his teeth structure.
In the end, we achieved adhesive dentistry, and that only means one thing: successful long-term treatment.
SOURCES
1) Mangano FG, Admakin O, Bonacina M, Lerner H, Rutkunas V, Mangano C. Trueness of 12 intraoral scanners in the full-arch implant impression: a comparative in vitro study. BMC Oral Health. 2020 Sep 22;20(1):263. doi: 10.1186/s12903-020-01254-9.
2) Mangano F, Lerner H, Margiani B, Solop I, Latuta N, Admakin O. Congruence between Meshes and Library Files of Implant Scanbodies: An In Vitro Study Comparing Five Intraoral Scanners. J Clin Med. 2020 Jul 9;9(7):2174. doi: 10.3390/jcm9072174.
3) Lerner H, Mouhyi J, Admakin O, Mangano F. Artificial intelligence in fixed implant prosthodontics: a retrospective study of 106 implant- supported monolithic zirconia crowns inserted in the posterior jaws of 90 patients. BMC Oral Health. 2020 Mar 19;20(1):80. doi: 10.1186/s12903-020-1062-4.
4) Revilla-León M, Supaphakorn A, Barmak AB, Rutkunas V, Kois JC. Influence of print orientation on the intaglio surface accuracy (trueness and precision) of tilting stereolithography definitive resin-ceramic crowns. J Prosthet Dent. 2023 Apr 25:S0022-3913(23)00186-5. doi: 10.1016/j.prosdent.2023.03.020. Online ahead of print.
5) Corbani K, Hardan L, Eid R, Skienhe H, Alharbi N, Ozcan M, Salameh Z. Fracture Resistance of Three-unit Fixed Dental Prostheses Fabricated with Milled and 3D Printed Composite-based Materials. J Contemp Dent Pract. 2021 Sep 1;22(9):985-990.