Why does my patient still have a gap after treatment?

Occasionally, you may notice a small gap between the central incisors even after the patient has completed aligner treatment. This includes the so called "black triangles" that occur when the interdental gingiva doesn't fully fill the void between teeth at the gingival margin. If your patient read their informed consent & agreement form, they'll be aware of possible outcomes like this ahead of time. Although it doesn't happen often, it can be a disappointment for a patient who just went through months of treatment.

Black triangles can happen with any method of alignment, including traditional braces. This is a natural consequence of alignment correction, so it can't always be avoided. If a gap remains after the aligners come off, additional orthodontic treatment may be required to close it. Here are a few solutions that might work for your patient:

  • In the case of black triangles, perform IPR at the point of contact to allow the affected teeth to come together.
  • Restorative therapy might be in order to fill smaller gaps caused by insufficient interdental gingiva.
  • Reconstructive periodontal therapy, also known as "periodontal plastic surgery", may also be considered to increase interdental papilla height and volume to fill the black triangle void.
  • The digital power chain is a valuable technique that eliminates gaps by bringing the teeth closer together. If you have diastemata, you don't have to rely on traditional metal braces to do this! ClearCorrect has its own power chain that doesn't require elastics.

Before we go...

Just a friendly reminder - we don't accept stone models in your case submission materials; we only need the PVS impressions and some high quality photographs. If you'd like, you can even send us X-Rays, although it's not required.

Actually, one more thing...

A few doctors have told us they're having trouble viewing our treatment setups while using Google Chrome instead of Internet Explorer. Here's an easy troubleshooting solution that's been helpful to many of you.

  • Make sure you the have newest version of Adobe Reader (currently 11.0.06).
  • Type "chrome://plugins" into the search bar (without the quotes).
  • You'll see a list of plugins. Find the one labelled "Chrome PDF viewer" and deactivate it.
  • Close Chrome and bring it back up.

And that should do it! If you were having difficulty reading Treatment Setups in Google Chrome and this helped, let us know. As always, we love to hear from our providers, so if you have a question or a suggestion you'd like featured in one of our tech tips, drop us a line.

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