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Aesthetic treatment with in-house aligners

Digital models printed in-house using a SprintRay Pro 2 3D printer. (All images: Drs Miloš Ljubičić and Marija Živković)

A female adult patient visited our clinic with the primary concern of the aesthetics of her maxillary anterior teeth. She was particularly dissatisfied with the position of her central and lateral incisors and was seeking a conservative, discreet orthodontic solution that would not involve traditional fixed appliances.

Upon clinical and photographic evaluation, it was observed that the lateral incisors were proclined, while the central incisors were slightly retroclined and exhibited minor rotation (Figs. 1–8). After discussing treatment options, the patient opted for aligner therapy for its aesthetic appeal and minimal lifestyle disruption. We proposed an in-house aligner solution that enables a streamlined workflow, cost-effective treatment and complete clinical control.

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Digital workflow and treatment planning

The procedure began with an intra-oral scan, capturing precise 3D data of the patient’s dentition. These scans were uploaded to SprintRay Cloud Design, a digital planning platform. Within just two working days, we received a proposed aligner treatment plan that mapped out the movements across ten aligners (Figs. 9a–c).

Figs. 9a–c

Figs. 9a–c

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After thoroughly reviewing and confirming the virtual treatment set-up, we received STL files for each step of the aligner sequence. The digital models were then printed in-house using the SprintRay Pro 2 3D printer (Fig. 10). The entire set of ten models was printed in approximately 1 hour and 30 minutes, demonstrating the efficiency of chairside 3D-printing technology. Postprocessing followed in two quick and effective steps: placement in the washing unit for 11 minutes and then in the curing unit for 1 minute and 22 seconds (Fig. 11). This rapid workflow allowed us to complete and prepare the models for thermoforming within the same day.

Aligner fabrication and treatment delivery

Using a thermoforming machine, the aligners were fabricated on the printed models (Figs. 12–15). Composite attachments were bonded to specific teeth according to the digital set-up to enhance the effectiveness of specific movements (Figs. 16–18).

The patient was instructed to wear each aligner for ten to 14 days, depending on fit and comfort, and to follow up regularly for assessment. After completion of the tenth aligner, a final appointment was scheduled for the removal of the attachments and delivery of the night-time retainer.

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Final outcome

The aesthetic goals were fully achieved: the central incisors were uprighted and aligned, and the lateral incisors were repositioned to a harmonious arch form. The patient was satisfied with the outcome and particularly impressed by the comfort, speed and discretion of the treatment process (Figs. 19–26). This case highlights how a digitally integrated in-house workflow, using tools like SprintRay Cloud Design and the SprintRay Pro 2 3D printer, can offer efficient, predictable and patient-friendly orthodontic care, all while maintaining control within the dental practice.

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