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An orthodontist told her the only fix was surgery to break and reset her jaw. She wasn't willing to go that far, so we tested other options digitally before anyone touched a tooth.
Mindy had never had orthodontic treatment. Her teeth were crooked, she still had all four wisdom teeth, and her upper and lower back teeth on the left side met the wrong way around. When she went for an orthodontic consult, she was told the only way to fix it was jaw surgery. Her reaction: "I don't think I ran out of there faster."The crossbite wasn't stopping her from eating, and it didn't bother her enough to go through surgery. She still wanted it fixed, just not that way.
Dr. Lawnin suggested running Mindy's case through Digital Smile Design first. It lets us move her teeth on a digital model and see where they'd end up, so the decision about surgery could be based on what her mouth could actually do. Daniel Ramos, the orthodontist on our team, reviewed the case with him.
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The digital workup came first. Everything after it followed the plan it gave us.
We moved her teeth on the digital model to see what was possible. The workup showed she had enough bone to correct the crossbite by moving the teeth themselves, without moving the jaw.
Because we could see the full plan from start to finish, we could use clear aligners to carry it out, so Mindy didn't need traditional brackets.
To bring the tooth out of crossbite, Mindy wore a small rubber band stretched from the inside of her mouth across to the other side. Most aligner cases don't need this. Hers did.
We knew from the start this would take a while, and we made some refinements along the way to keep it on track.
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