[VIDEO] – Clear Aligner Finishing After Canine Replacement in Derby: Case by Dr Trishan Malhi

 Derby patient case from The Park Brace Clinic: space was created and restored for a missing upper canine, then finished with Spark clear aligners to improve tooth position and bite.

Replacing a missing tooth in the smile line needs planning as well as straightening. At The Park Brace Clinic in Derby, Dr Trishan Malhi used a staged approach for this patient: first creating and restoring space for a missing upper canine, then using clear aligners — specifically our preferred system, Spark Aligners — to refine the smile and bite.

The Patient’s Starting Point

This Derby patient had:

• A missing upper right canine
• Tipped upper front teeth
• A smile that looked shorter on one side because of the missing tooth

The aim wasn’t just to straighten — it was to complete the smile and make everything look balanced.

Step 1: Create and Restore the Space

The first stage was to make sure there was enough room for the missing tooth to sit in the right place.

• Space was carefully opened on the upper right, where the canine should have been.
• Once the space was right, the team placed a bridge (a fixed false tooth) to replace the missing canine.
• This immediately gave the patient a full set of teeth on that side, matching the left.

Doing this first meant the replacement tooth could be the correct size and shape — not squeezed in as an afterthought.

Step 2: Finishing with Spark Aligners

With the bridge in place, Dr Malhi then used Spark Aligners to tidy and fine-tune the overall smile.

Using aligners at this stage allowed us to:

• Upright the two upper front teeth so they looked more natural
• Improve the midline so the smile sat more centrally
• Tidy the lower teeth for a neater overall look
• Improve the bite so left and right sides worked together

Because the new tooth was already in position, the aligners could bring the natural teeth into harmony with it — that’s one of the big advantages of combining restorative work with orthodontics.

The Final Result

After treatment, the patient had:

• Six visible upper teeth on the right side instead of five
• A bridge that blended in because the space had been created properly
• Upper front teeth that were more upright and even
• A smile that looked fuller, straighter and more symmetrical

The whole case took around 18 months, which is normal when we’re opening space, restoring a tooth and then finishing with aligners. The patient was delighted with the result.

Why This Order Matters

Doing it in the order space → replace → refine with aligners meant:

1. The replacement tooth could be the right size.
2. The smile looked complete earlier.
3. The aligners could focus on finishing rather than fighting for space.

It’s a great example of how cosmetic, restorative and orthodontic treatment can work together.

Thinking About Aligners in Derby?

If you’re in Derby and have a missing tooth, crowding or an uneven smile, we can often use this same staged approach. You can read more about our clear aligner system here: Spark Aligners at The Park Brace Clinic.

📅 Schedule Your Appointment: Phone 01332 299700
📍 Visit Us At: Park Brace Clinic, Derby

Your dream smile is just one treatment plan away!