Invisalign Treatment for a 38-Year-Old with Crowded Lower Front Teeth and Malocclusion

Lekulu Tanchigegn, a 38-year-old patient from Ethiopia, visited Dr. Namratha Chandrahari at her Enamel Dental Clinic in Banjara Hills, after years of living with crowded lower front teeth. The teeth overlapped and sat out of line. She wanted a straighter, more balanced smile without the look of traditional metal braces.

Crowding in adults rarely stays a purely cosmetic problem. Teeth that overlap are harder to clean and can sit in a bite that does not close evenly. After a clinical examination and radiographic assessment, Dr. Namratha recommended Invisalign clear aligners to correct both the alignment and the bite, gradually and discreetly.

Clinical examination and OPG assessment confirmed malocclusion with crowding of the lower front teeth. The findings indicated that a planned, stepwise alignment of the teeth with clear aligners would correct the crowding and improve how the upper and lower teeth fit together.

The treatment plan was built around Invisalign and covered the following steps:

• Records and digital planning: Photographs, the OPG and a digital scan of both arches were used to plan the tooth movements from the current position to the target alignment.
• Custom clear aligners: A series of removable, transparent aligners was made for the patient. Each one moves the teeth a small step towards the planned result.
• Correction of lower anterior crowding: The aligner sequence was designed to bring the crowded and rotated lower front teeth into a smooth, even arch.
• Bite improvement: Alongside the alignment, tooth movements were planned to improve how the upper and lower teeth meet.
• Regular review visits: Progress was checked at planned appointments to confirm the teeth were moving as planned, and the aligners were refined where needed.
• Retention: Retainers were planned for the end of active treatment to help hold the final position.

Invisalign is a non-surgical treatment, so no anaesthesia or incisions were needed. After the records and digital scan, the custom aligners were fitted and the patient was shown how to wear, remove and clean them. She was advised to wear them for the prescribed hours each day and to switch to the next aligner in the series on schedule.

At each review, the fit of the aligners and the movement of the teeth were checked against the digital plan. Throughout treatment, the crowded lower front teeth moved gradually into a more even line, and the arch form of both jaws became smoother

Dr. Namratha Chandrahari gave detailed guidance to help Lekulu get the most from her treatment:

• Wear time: Aligners are to be worn for the number of hours advised each day and removed only for eating, drinking anything other than water, and cleaning.
• Aligner hygiene: Clean the aligners daily and store them in their case whenever they are out of the mouth.
• Oral hygiene: Brush and floss before putting the aligners back in, so that food and plaque are not trapped against the teeth.
• Dietary guidelines: Avoid eating or drinking anything other than water while wearing the aligners, to protect them and the teeth.
• Retainer wear: Wear the retainers as advised after treatment to keep the teeth in their new positions.
• Long-term follow-up: Attend review and check-up visits so that the teeth, gums and bite can be monitored.

With consistent retainer wear, good oral hygiene and regular check-ups, the aligned teeth are expected to stay stable. Retainers are an important part of long-term success, as teeth can drift back towards their old positions without them. Routine professional cleaning and review visits with Dr. Namratha Chandrahari will help keep the teeth, gums and bite healthy over the years.