NimroDENTAL – Orthodontic Laboratory

Frequently asked questions

General

Some impressions may have drags, bubbles or holes in them. There are occasions when there is a slight distortion which can only be detected when we have another impression to compare it with. Always insure that the impression includes all the teeth and covers the whole palate. 

Please double-check the impressions before it leaves the practice. If in doubt please take more than one impression. 

See here: http://www.nimrodental.com/sites/default/files/Nimrodental%20Portal%20Us...   for a complete guide to our portal and contact us if you experience any problems. 

Retainers: 7 days
Clear Aligners: 14 days
Inman Aligner: 14 days
Orthodontic Removable Appliance: 10 days

Please contact us for details on our 3 day and 24hr services.

To fabricate your drill guide we require: a CT scan, study models or an intraoral surface scan, the brand of implants system you intend use & the sizes of the drills used and sleeve (if required).

Please always send us an upper and lower silicone impression and a wax bite. We always need an opposing arch to see if there is room for movement.

We merge your patient’s CT scan with the surface impression/scan meaning we plan the implant placement based on bone density, and print a highly accurate drill guide with bone level or teeth as reference. 

We recommend you send the impressions to us via Special Delivery or recorded post/courier so the parcel is traceable. 

If you are sending us a parcel from outside the UK, we recommend that you send the case via recorded post.

We use CoDiagnostix software which can be used for many implant brands.

Please email photos (front, occlusal, ‘chin-up’ and profile) or post impressions and indicate what the patient is concerned about.  We will contact you and advise different options for treatment. 

Due to the loss of many packages while posting using FreePost, we have had to start using a different system.
To obtain your postage label please go to : http://www.royalmail.com/track-my-return/create/1239
This new method means that now, we and you can track the package to ensure we always receive your package and provide the best service.

It is a piece of composite attached to the tooth in order to act as a grip or anchor on the tooth for the appliance.

Due to the loss of many packages while posting using FreePost, we have had to start using a different system.
To obtain your postage label please go to : http://www.royalmail.com/track-my-return/create/1239
This new method means that now, we and you can track the package to ensure we always receive your package and provide the best service.

To open the bite, place composite on the 6’s or 7’s of the opposing arch. It will take between 2-6 months for the teeth to over-erupt using the Dahl principle, creating an opening of around 3mm at the front. After this you can remove the composite.

Our Inman Aligners and bonded retainers contain nickel. We can make a bonded retainer with nickel free wire or recommend an alternative appliance to align the teeth using nickel free wire. Please always write clearly on the lab sheet if your patient has nickel allergy. 

Our 3D department provides digital scanning, 3D printing and treatment planning. If you have an Intraoral scanner this will enable you to send digital impressions saving time and money.

Only if it is not for the same arch, we cannot make both appliances from the same impression. We will make the Inman Aligner first in order to achieve alignment; and then we will require a new impression with a new lab sheet in order to make the retainer. 

Inman Aligner

The patient needs to wear the appliance for 20 hrs a day to achieve a quick and successful treatment. The duration of the treatment depends on the case but on average it takes between 8-14 weeks.  A successful treatment can depend on whether enough IPR has been carried out and on the patients dedication to the treatment. 

The palatal spring is 0.010 and the labial spring is 0.012, although this may vary depending on where the springs are placed. Please see the video on our website demonstrating how to change the springs on an Inman Aligner for more information. Please click here to view the video and here to purchase replacement springs.

You need to do IPR on the first appointment and progressively throughout treatment. We recommend seeing the patient every two weeks throughout the treatment.

There is a colour key on the guide relating to the line on the diagram of the upper and lower arch.  The total amount of IPR needed is written on the dotted line.

The instructions for adding composite buttons (anchors) are on the IPR guide. The position they need to be placed in will be indicated with coloured markers on the original model and should be placed in the following sequence:

  1. Place the anchors marked in red on the teeth as indicated on the model. 
  2. Once these teeth are aligned according to the set-up, attach the anchors marked in blue (if present) and remove the red anchors. 
  3. After those teeth are aligned, place the anchors marked in black on the teeth indicated. 

A bite plane is a temporary way to open the bite whilst the patient is wearing the appliance and is added to the posterior of the Inman Aligner. This is only an option when the patients bite has to be opened temporarily in order to allow the palatal bow to move without the lower incisors biting on it. If your patient’s bite has to be opened permanently please see the question ‘How do I open the bite?’

The power chain is used in the early stages of the treatment because a tooth is protruding and it is uncomfortable for the patient to wear the acrylic bow at that moment in time. The power chain is placed exactly where the acrylic bow would be placed and is used for approximately 6 weeks.

During this time you will need to continue to see the patient every 2 weeks and perform IPR as normal. If the power chain becomes loose because the teeth are retracting, you should re-hook the chain on another hole to make it tighter.

Once the tooth has retracted you can either send the Inman Aligner back to the lab or watch the demonstration video on the website to replace the power chain with the bow. If you are sending the appliance to the lab please include the set up model (usually a plastic model) and the acrylic bow in order to replace the power chain. The process will be completed within 3 days so there is no relapse. Although the service is free a delivery charge will be added. 

The arms on the Inman Aligner are usually because the laterals are too rotated for the Inman to align them. The arms will be in contact with the teeth and will help push them labially. It is common that the patient will need Clear Aligners to improve the position of the rotated tooth after the Inman Aligner treatment. 

  • To create more space in overcrowded arches.
  • To prepare the arch for final alignment.
  • To reduce the amount of IPR required.
  • To correct a cross bite.
  • To widen a narrow arch.
  • To correct arch asymmetry.

The patient has to take the appliance out of their mouth and turn the screw in the direction of the arrow with the key provided.

Please turn the screw once per week no more than 14 times or as instructed by the technician who assessed your case.

Send the appliance back to the lab with a new impression and the models we made it on. We do try to return adjustments and repairs within 3 day.

Please indicate on the lab sheet if you would like us to confirm if there will be a charge and how much it will be. Please note we will not be able to tell you over the phone.  

This is the new Inman Aligner design which has the springs inside the tube. To test to see if the springs are present, push the palatal bow downwards a few times to see if it springs back.

We cannot do a set up if the patient needs expansion first because we cannot predict how compliant the patient will be and cannot fully predict the way the arch will be after expansion. We can do set up after the patient has had expansion if required.

This could be because you have had a treatment plan which contains all the information regarding IPR and composite stops.  If this is not the case it may have been an oversight. Because we scan the models, all you would need to do is email us with the details and we will be able to send you a scanned copy of the IPR guide.

Clear Aligner

Yes, Nimrodental do provide an online Clear Aligner course. It may be ordered through our online store. Although you do not have to do a course to treat patients with Nimrodental Clear Aligners, we do recommend purchasing it. This course has been qualified for the equivalent of 3 CPDs, and once the questions have been answered correctly, Nimrodental will issue a certificate. 

Each Clear Aligner needs to be worn for two weeks.

You will need to take a new impression and send everything back to us along with a lab sheet explaining the issue. 

The Clear Aligners are 1mm thick.

A stent is a guide to help you place a composite anchor on the tooth. To bond the composite you must:

  • Etch and seal the tooth surface
  • Fill the pocket of the stent with composite
  • Fit over the teeth
  • Light cure the composite to the tooth
  • Remove the stent and polish any excess.  

You will need to ensure that the final aligner of the first set fits and the teeth are in desired position. As long as the treatment is progressing as expected, you will not be required to take a new impression. Please send written confirmation to the lab indicating that you would like to proceed with the next set of Clear Aligners. 

We do not advise that you use a Clear Aligner in place of a retainer because the Clear Aligner will wear and not last long.

Clear Aligners are also known as Invisible Aligners, Clear Braces and Invisible Braces but they are the same type of appliances. 

On the first appointment and then at each stage after.

An explanation of the Clear Aligner guide is as follows: 

  • It will illustrate the total amount of IPR per contact for each stage.
  • The guide is split into stages depending on the number of Clear Aligners needed.
  • Each stage has a set number of Clear Aligners which will be clearly indicated.
  • The lines on the diagram relate to the size of the IPR strip/disc.
  • There is a colour key for reference.

Expansion

It depends on the case but the average duration is 6-8 weeks. 

The patient needs to turn the ‘Expander’ an average of twice a week (every 3-6 days) with the supplied key.

The patient needs expansion first because we cannot predict how compliant the patient will be or exactly where the patient’s teeth will be after expansion. Once the patient has finished with expansion we will need a new impression to assess how many clear aligners the patient will need.

Even though the patient turns the screw themselves we would still recommend seeing the patient at regular intervals in order to monitor the treatment. 

Brackets

We can supply a wide range of labial and lingual brackets, arch wires and accessories.

Models are scanned, teeth aligned, virtual brackets placed, set up emailed to dentist for approval, transfer trays made and brackets inserted into the transfer tray.

Retainer

Essix retainer:

  • 1mm thick.
  • Clear material.
  • Easy to remove and clean.
  • Worn full time for 3 months and then at night after. 
  • 3 month warranty if the appliance breaks.

Long term:

  • 2mm thick.
  • Clear and strong material.
  • Recommended for patients with a deep bite.
  • Recommended for patients who cannot wear a fixed bonded retainer (allergy to metal).
  • Easy to remove and clean.
  • Cut buccally half way from 3-3 and above gingivally from 4’s to molars. 
  • Nightwear only.
  • Correction of small relapses possible.
  • Better resistance to bruxism.

The standard twistflex bonded retainer is 0.0175. We do have other thicknesses if we agree it is necessary or if requested.

The bonded retainer is supplied with a custom made positioning jig that allows easy hands free bonding to the teeth.

Accounts

Yes we do. Please make sure you have supplied us with the correct email address and that you have added us to your address book. An unpaid bill may incur late payment fees and may delay your future cases. Please see the terms and conditions for more details. 

You will receive the invoice at the end of each month (last working day of month). We cannot submit an invoice before this date. You will also receive a statement shortly after to the same email address, which is a summary of your account. 

Payments can be made in the following ways:

  • BACS  – details are on the monthly invoices.
  • Card – including Amex (there is a 2.5% sur-charge for all card payments except Visa Debit). Card payments can be made over the phone and online by clicking on the Sagepay button is at the bottom right corner of your statement and following the steps. 
  • Cheque.