Shilda: 

• Chief Complaint : Spacing getting larger, feels like she will lose her teeth

Examination: 

• Periodontal exam slight mobility lower anterior related to tongue thrust,

• Full Clinical exam missing teeth implants planned.

• Panoramic xray

Evaluation:

• Class I molar

• Anterior crossbite and end to end on some teeth

• tongue thrust

• spacing excessive mandibular arch

Treatment:

• Invisalign Comprehensive case with implant planning

• acceledent used during treatment

• Munchie for seating aligner

• 1 refinement

• 11 months of treatment

• vivieras to be completed after prothetics

• temporary essex.