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The current instructions for use contains the following: "precautions - a tooth that has been previously traumatized or significantly restored may be aggravated.In rare instances, the useful life of the tooth may be reduced, the tooth may require additional dental treatment such as endodontic and/or additional restorative work, and/or the tooth may be lost.".No root cause provided.Align's clinical review that this tooth had a dental crown, and the panoramic radiograph shows findings consistent with prior endodontic therapy.The mesial root demonstrates a periapical radiolucency, suggestive of possible endodontic failure and a guarded overall prognosis.Prescription records indicate the patient used 20 aligners during the initial series and five in a subsequent set prior to the reported extraction.Both treatment plans included a button cutout designed for elastic use.While the programmed tooth movements for #3.6 appear minimal, the application of class ii elastics via the bonded button may have introduced additional forces, potentially exacerbating the already compromised condition of the tooth.There is no conclusive evidence provided that supports or opposes whether the invisalign system caused or contributed to the reported permanent damage.Based on the available information, the patient had permanent damage, and the invisalign system was being used.Therefore, an mdr will be filed in the united states per 21 cfr 803.The exact date of the event is unknown.Despite reasonable efforts, no conclusive information was available to determine when the event occurred.The date (b3) provided corresponds to the date the event was reported to the manufacturer and does not necessarily reflect the actual date of occurrence.
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