Case 2 (Figs. 5-16): Opening a previously closed space for a missing U2 Give the patient tooth-colored wax to place in each aligner because it " ain't my problem. " This is advantageous because the space of the missing laterals is constantly changing and increasing, which makes it impossible to use an acrylic pontic that would be transferred from one aligner to another. It also negates the laborintensive painting a pontic in each aligner that would be time-consuming for staff or doctor. FIG. 5: Initial. AMP Pearl #4: After pontic space is created and will no longer be changing, refer to restorative dentist to create a cantilever pontic before scanning for additional aligners. Ask for there to be 1 mm space between the pontic and adjacent tooth and if there is any remaining second order root tip of the abutment necessary, make the pontic 1.5 mm off the gingiva so it is shorter vertically. This will allow space for the pontic to move into the gingiva during the second-order movement, creating an ovate pontic. AMP Pearl #5: Assess which tooth adjacent to the space needs more second-order root movement and make that tooth the abutment tooth because of the biomechanical advantage of the extended lever arm created by the incisal edge of the pontic. This biomechanical advantage is why managing missing U2s is even better than the real thing. You can't do that with braces! FIGS. 8 AND 9 FIG. 6: 18 months progress, TAD-assisted expander aligners and Class 2 elastics. FIG. 7: 18 months progress; UR1 needs mesial root tip. JUNE 2023 | 28 | ORTHOTOWN.COMhttp://www.ORTHOTOWN.COM