Objectives: Tooth movement is caused by the application of force. In short, applied force strains structures present in the PDL space – cells, ligaments, blood vessels. Cells in the PDL are damaged by extension and by diminished oxygen supply due to compression of blood vessels. Compounds released from damaged or dead cells trigger an innate inflammatory response. One of the biomarkers of that response is increased formation of extracellular fluid (edema), specifically gingival crevicular fluid (GCF). Our goal is to monitor changes of GCF flow during the orthodontic treatment with Invisalign.

The objective of this retrospective longitudinal study is to evaluate the treatment effects of clear aligners in patients with deep bite malocclusion by examining the dental and skeletal changes between the initial and final treatment time points. Our null hypothesis states that there are no significant differences between the two-time points for the variables studied.

A clinical case managing undiagnosed diabetes, active chronic moderate periodontitis with severe localized contributions, moderate to severe attrition on lower natural dentition (managing parafunctional habit), existing full upper arch PFM and Gold crowns with recurrent decay and open margins and anatomically incorrect crowns that contributed to the progression of periodontal disease, loss of VDO, and high caries risk.

The patient was transferred to me by my “big sib” in order to proceed with implant FDPs oral rehabilitation. He presented with a complex medical history. Moreover, he felt self-conscious about his smile as a result of the deterioration of his oral health. The consequence of this led to the psychological impact of not being able to publicly smile. A multidisciplinary approach to this case was a foundation of clinical success. Rebuilding a patient’s confidence through a smile can be a life-changing experience. With dental implant and veneer rehabilitation, we were able to achieve the beautiful smile that the patient once had and wanted to regain. Once the treatment plan was completed, the patient agreed we had achieved our mutual goals.