Dear brainiacs at Spearville,

I have a case that I need to pick on your brains with. Female 31 y/o had presented to me with CC "I want straight teeth like the models on the magazines" and we all know what happens when we hear that. We all say to ourselves, "oh boy!! here we go. Let's set the expectation realistic first". You can see some pre-ortho photos, and a few post-ortho. She did not complete ortho Tx and quit about 4 or so months short of completion( She does have a mid-face deficiency, hence the proclination of her Maxillary teeth). Then she came back to me and wanted straighter teeth. I talked to her about returning to her orthodontist, however, she refused (not because she did not like the orthodontist or his treatment, but just that she did not want ortho tx anymore). So I thought I can find out what it takes to straighten her teeth. So I did some mock preparation of her teeth on the study models( facial and incisal prep only) and then waxed up myself (please do not critique my wax up, I am not Frank Spear and have not waxed up since dental school). I can get the results that she desires (hopefully), however here are my concerns:

1. The amount of preparation of the teeth is quite extensive, so obviously I will plan for crowns instead of veneers ( most preparation will be in dentin). But do you think that amount of tooth structure is adequate for retention?

2. She has already been warned about potential sensitivity post preparation and cementation. I have also informed her that as I am preparing her teeth, if I see myself getting closer to the pulp, I will stop immediately and there may be a compromise needed to be made with the angulation of her teeth.

3. Should I be concerned with the overjet and overlap?

Vikram

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