In the era of rapid digitalization, modern dentistry is developing as one of the most dynamic areas of clinical practice, actively integrating digital tools into everyday work.
The implementation of digital protocols ensures treatment predictability and patient convenience, allows standardization of diagnostic and therapeutic stages, and also minimizes the risks of exacerbation of concomitant pathology through virtual validation of plans.
The use of intraoral scanning, computed tomography and standardized clinical photography is considered not as disparate stages, but as a single navigational protocol for comprehensive planning.
TRIOS scanning provides high accuracy of digital impressions, CBCT 15×15 cm gives three-dimensional information on bone architecture and base relationships, standardized photographs record aesthetic and soft-tissue parameters — all these data are integrated into a digital model, speeding up communication with the patient and allowing prediction of the clinical outcome.
Clinical case: a 66-year-old female patient presented with a progressive crossbite of the lower right canine and displacement of the dental arch against a background of bruxism and controlled lichen planus.
Examination revealed restorations with gold and porcelain crowns, endodontically treated molars, moderate upper crowding and pronounced lower crowding, a 3 mm displacement of the mandibular midline — all these factors necessitate planning minimally invasive movement of the anterior teeth while preserving the posterior occlusion.
Radiologically a Class I skeletal base was established, no TMJ pathology was detected — this allowed limiting intervention in the distal segments and relying on the preserved posterior restorations when formulating the orthodontic plan.
The choice of system in this case was justified not only by the possibility of tooth movement, but also by the patient’s biological and behavioral characteristics — the presence of porcelain and gold crowns, the risk of irritation with lichen planus, and the need for a comfortable wearing protocol.
ClearCorrect was used as a clinical tool with the three-layer material ClearQuartz, characterized by an elongated trimline for increased retention, reduced insertion force and more prolonged delivery of active force — this reduces the need for a large number of attachments and increases comfort when placing and wearing the aligners.
Planning was performed in a digital environment with an initial setup of 12 steps and planned interproximal reduction (IPR) of 1.4 mm from canine to canine, which allowed resolving crowding and correcting the crossbite of the lower right canine with minimal intervention in the distal segments.
Aligners were prescribed to be worn 22 hours per day with a change cycle every 14 days, the refinement stage included three additional aligners for precise detailing of the canine position and optimization of the canine guidance — such a protocol demonstrates high predictability of the digital route and complies with the evidence-based standards of orthodontic therapy in adult patients.
Clinical dynamics: the patient completed the initial phase of 12 steps in six months, completed the entire course with 15 sets of aligners in nine months — these indicators reflect the effectiveness and reproducibility of the chosen digital protocol in the setting of multidisciplinary management.
The final clinical result included improvement of arch symmetry, resolution of crowding, correction of excessive vertical overlap and reduction of horizontal overlap — this indicates a purposeful transformation of occlusal status while maintaining functional stability.
The patient reported no exacerbation of TMJ symptoms and high satisfaction with the aesthetic result; minimal use of attachments and selective IPR contributed to maintaining healthy soft tissue condition and oral hygiene during treatment.
The combination of high-precision scanning, CBCT and digital planning provides the dentist with tools for personalized, reproducible treatment in adult patients with a complex dental history, while the choice of aligner material and design should take into account the presence of restorations, soft tissue condition and parafunctions.
Recommendations: when managing such cases, consider the necessity of interdisciplinary cooperation — general dentist, orthodontist, prosthodontist, endodontist — plan IPR in an amount sufficient to resolve crowding without compromising the coronal structure, and also use materials with prolonged force control in the presence of sensitive restorations or mucosal diseases.
In an era of rapid digitalization, contemporary dentistry is developing as one of the most dynamic fields of medicine, actively
Modern dentistry is undergoing a large-scale digital transformation in which digital tools and integrated workflows are restructuring professional roles and
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