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Special Issues
July/August 2024
Volume 45, Issue 1
Peer-Reviewed

An “Align, Bleach, and Bond” Orthodontic-Restorative Case With SureSmile®

A 28-year-old patient was treated for esthetic reasons and also differential tooth wear, determined to be caused by a constricted envelope of function. The "align, bleach, and bond" process allows for simultaneous functional and esthetic improvements for a stable, long-term outcome. SureSmile® (Dentsply Sirona, suresmile.com) software provides a cross-sectional view of the "before" and proposed "after" envelope situations. In this orthodontic relapse case, decisions on orthodontic-restorative landmark teeth were made according to IAS Academy (iasortho.com) protocols. Scans were taken, and the case submitted. The setup was reviewed, horizontal and vertical landmark points were confirmed, and a 0.5-mm flat trimline was chosen to minimize attachments. Staged interproximal reduction (IPR) was carried out to create space and improve the shape of the central incisors. The case used 22 maxillary and 20 mandibular aligners. No refinements or mid-course corrections were needed. Simultaneous in-aligner whitening was started at aligner 10. Seeing the improvement in the appearance of her teeth, the patient opted for composite edge bonding. No-preparation edge bonding was done using TPH Spectra® ST (Dentsply Sirona) using the reverse triangle technique.* Polishing was performed, and retainers were bonded. Final SureSmile Essix retainers were created.

KEY TAKEAWAYS

Combining orthodontic alignment, whitening, and direct bonding can provide patients a smile makeover result similar to porcelain veneers without damage to teeth.

Using orthodontic-restorative parameters and a predictable aligner system, the envelope of function can be controlled, correct guidance provided, and excellent esthetics achieved.

Often when patients are able to see progressive improvements in their smile through the combined treatment of whitening and aligners, only bonding is needed to complete the case, thus reducing cost and potentially expanding the clinician's demographic of care.

Tif Qureshi, BDS
Founder and Clinical Director, IAS Academy;
Past President, The British Academy of Cosmetic Dentistry

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