Page 1
Page 2
Page 3
Page 4
Page 5
Page 6
Page 7
Page 8
Page 9
Page 10
Page 11
Page 12
Page 13
Page 14
Page 15
Page 16
Page 17
Ref. No. Clinician Patient Date Treatment Plan for Upper Dental classification Class I Skeletal classification Class I Anterior occlusion Class I Molar relationship Class I Average overjet 2mm Overbite Deviation of mid line Missing teeth Difficulty of alignment and estimated treatment time in weeks Total Space Creation 1.70 General Diagnosis 2mm Mandible shifted to the Left 1mm Severe 14 weeks Additional Requirements to the Inman Aligner Treatment A screw needs to be added to the Inman. Patient will do one turn per week. No more then fourteen times. Further Notes Aims of Treatment Align anterior segment Tooth Width Tooth Width 11 8.03 21 7.84 12 5.25 22 5.95 13 6.79 23 7.65 10 14 24 Tooth Rotation Angulation Inclination DistMesi 13 12 -20 0.5 0.2 0.6 11 24.5 1.2 2.4 1.6 21 -11.2 3 1.6 0.3 22 13.9 6 -0.5 23 Tooth width before IPR Tooth width after IPR 5.71 ExtInt -1.6 LabialPalatal 0.1 7.31 6.45 5.01 0.1 -0.4 0.3 7.76 7.57 Estimation in changes of tooth position and tooth width after alignment Please refer to colour key for the IPR StripDisc needed IPR Guide per Stage once space is closed move to the next stage Please refer to the diagrams below and strip the teeth accordingly to achieve the correct tooth width as indicated on the table previous page Strip 0.08mm Strip 0.10mm Strip 0.12mm StripDisc 0.15mm StripDisc 0.20mm PPR Guide Please reduce the width of the teeth marked in red for labial aspect and blue for lingual aspect using a polishing disc and refer to the align printed model for comparison 0.22 Total amout of Space creation per contact More than one appointment may be needed to achieve the required IPR 0.24 0.24 0.24 0.30 0.24 0.22 Clinician Notes Place the anchors marked in red on the teeth as indicated on the model More than one appointment may be needed to achieve the required alignment Start Position Before and After Please ensure that the movements represented in blue on the Before and After diagram are achieved prior to moving on to the next stage of the treatment Tooth Movement 1st phase When teeth marked with red anchors are aligned remove and place anchors marked in blue Start Position Before and After More than one appointment may be needed to achieve the required alignment Please ensure that the movements represented in blue on the Before and After diagram are achieved prior to moving on to the next stage of the treatment Tooth Movement 2nd phase Keep the anchors marked in red- blue and place anchor marked in black for rotation More than one appointment may be needed to achieve the required alignment Start Position Before and After Tooth Movement 3rd phase Please ensure that the movements represented in blue on the Before and After diagram are achieved prior to moving on to the next stage of the treatment AfterBefore Before After Before After Consent Treatment with the Inman Aligner has proven to be very successful but with every form of orthodontics there are certain risks involved which should be seriously considered before undertaking treatment. Please read the below statements and if you understand them and are fully aware of the risks please sign and date at the end. I understand that the result has been predicted before treatment has begun therefore the outcome may not exactly replicate the result discussed beforehand if the advised treatment plan hasnt been followed correctly. I understand that a lack of compliancy poor oral hygiene and missed appointments lengthen treatment time and these are all things I can prevent from happening. 100 cooperation is very important. I understand that the Inman Aligner must be worn full time for at least 16-20 hours a day apart from when eating or brushing teeth. Remember that the longer you wear the Inman Aligner the quicker the results. I understand that teeth have a tendency to return to their original position after treatment relapse and that at the end of treatment retention is required for life in order to preventthis. I accept the treatment plan recommended by Nimrodental and explained to me by my dental practitioner. Name............................................ Date The Inman Aligner Treatment Plan I.A.T.P is intended to be used as a guideonly. All measurements and the treatment time scale are estimates only. At times more than one appointment will be needed to achieve the required stage. The I.A.T.P may have to be modified as the treatment progresses. All responsibility for the results of the treatment for the above patient lies with the Dentist providing the treatment. Nimrodental bear no responsibility for the consequences resulting from using the I.A.T.P. All terms and conditions stated atwww.nimrodental.com apply. Please tick the box or confirm by writing that you would like to proceed with recommended treatmentplan.