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Clear Aligner Correction of Severe Crowding and a Canted Smile

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Chief Concerns

  • Severe crowding
  • Narrow upper arch
  • Dark lateral corridors
  • Misalignment
  • Uneven, canted smile line
  • Locked-out central incisors

Initial Presentation

The severity of the canting across both the upper and lower smile lines created a clear aesthetic disturbance. Achieving a smile that properly supports and scaffolds the face depends on correct diagnosis, which is why treatment here, as with all our cases, was facially driven rather than purely dental.

Diagnosis

Projecting to the face, the diagnosis was:

  • Severe crowding
  • Narrow upper arch
  • Dark lateral corridors
  • Misalignment
  • Midline canting
  • Maxillary plane (smile line) canting

Treatment Approach

Correct diagnosis was the foundation of the solution. Treatment was completed over 12 months using Periodontally Accelerated Osteogenic Orthodontics (PAOO) with clear aligner technology, avoiding traditional braces entirely. PAOO accelerated the orthodontic tooth movement while reducing the risk of gum recession throughout treatment.

Treatment Outcome

  • Severe crowding: corrected
  • Narrow upper arch: corrected
  • Dark lateral corridors: eliminated
  • Misalignment and locked-out central incisors: corrected
  • Midline canting: dental midline now parallel to the facial midline
  • Maxillary plane canting: smile line now parallel to the interpupillary line

Translated to the face, this delivered improved lip support, reduced nasolabial folds from expansion of the maxilla, and improved lower facial height and balance.

Aftercare and Maintenance

An incorrect diagnosis leads to incorrect treatment, and puts a patient’s life on hold. Experience and expertise are essential to achieving an optimal outcome and reducing the risk of future recession, malalignment, crowding and retreatment. Patients are advised to follow a strict treatment protocol and maintain post-treatment retention, with six-monthly assessments helping to reduce these risks over time.

Dr. Sarkis Nalbandian

Registered Specialist
Prosthodontist & Implant Surgeon

B.D.S. (Hons), Dip. Clin. Dent. (Oral Implants) Uni Syd, M. Clin. Dent (Prosth) King’s College, Uni London D. Clin. Dent (Prosth) Uni Syd, FRACDS, MRACD (Prosth)

What Our Patients Say

Here are just a few reflections from patients featured in our case studies. Every story is different, but each one speaks to the power of feeling proud of your smile again.

I've been a customer of Designer Smiles for over 20 years and I cannot say enough good things about them! From the moment you walk into the office, you are greeted with a warm and friendly atmosphere that immediately puts you at ease. The staff is knowledgeable, professional, and caring. They use the latest technology and take the time to explain everything. I highly recommend them!

Ken Baumli

Dr Sarkis is the maestro of cosmetic dentistry….for years I suffered with 2 slightly darker front teeth due to a childhood accident. I’ve had composite veneers before but nothing compared to the composite veneers Dr Sarkis did……now I feel so confident smiling again……Dr Sarkis I can’t thank you enough…

Monica McKenzie

Quite literally the best dentist I’ve been to in a lifetime. Dr Natasha Koelmeyer specifically is just a wonderfully kind and gentle Doctor. Must also mention that the head specialist here is also second to none. Their knowledge (goodness they know their stuff) their approach, their kind and gentle manner - my daughter actually enjoys going to the dentist. They’ve got a really considered patient centric mentality. I wouldn’t go anywhere else, every single person there including the reception staff is a star. Thank you Designer Smiles!

Michelle Lacasse

My journey with Dr Sarkis began about 10 years ago. I did not realise that I had lacked self confidence and shone away from "my true smile". Dr Sarkis was honest, reassuring and professional throughout my process and not only was he able to achieve that perfect smile but achieve same without compromising the health of my teeth and gums.The ongoing care at Designer Smiles is 5 star whether it is a routine check, clean minor or major dentistry. Thank you Dr Sarkis and also your team.

Christina Vergotis

I found Designer Smiles from one of their YouTube videos showcasing the Icon treatment to fix white spots on teeth. Dr. Sarkis Nalbandian's consultation provided me with a thorough plan and showed me how their practise could give me predicable results for my concerns. I knew I was in safe hands. I had Kristy Gupta perform both of my procedures and she was very professional and so kind. I am very happy with my results!

Winsome Kain

I cannot express how grateful I am for Sarkis and the team at Designer Smiles. Around 11 years ago my life changed when Sarkis first transformed my smile with composite veneers. This month, with my original teeth in tact I returned to have my composite veneers upgraded to porcelain. I was amazed that Sarkis and his team could do this without an injections, no pain and whilst still keeping my original teeth in tact. I absolutely love the result and I would highly recommend that anyone that is unhappy with their smile in any way, must visit designer smiles

Matt Williams

Started my treatment with the team at Designer Smiles in 2019. Had other dental treatments including Maxillofacial, expanders, straightening and gum grafting but out of all the procedures and surgeries Dr. Sarkis was the key as he was applying the ‘finishing product’ which included composite veneers. I am gobsmacked by the incredible job done. He talks the talk and definitely walks the walk. And his support team there are simply incredible and make you feel part of a family not just another dental clinic to take your money. Can not recommend highly enough. Customer for life here!!

Shaun Meader
Get In Touch

(02) 9953 4189

Mon to Fri: 8.00AM-5.00PM
Sat-Sun: Closed

Address: 17 Gerard St, Cremorne, Sydney,NSW, 2090

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