Class II div 2
,
Deep bite
,
Enge Zahnbögen
,
Asymmetrische Zahnbögen
,
Maxilläre Mittellinien-Abweichung
,
Mittellinienverschiebung
,
Engstand
,
Rotationen
,
Prärestaurativ

Nivellierung der Spee-Kurve

,

Intrusion

,

Expansion

,

Retraktion

,

ASR

,

Lückenschließung

,

Restaurativ

,

Elastics: Klasse II

Courtesy of Dr. R. Bordin, 2022

Treatment Summary

Patient Information

Age: 68
Gender: female
Invisalign Submission Option: Invisalign Comprehensive

Total Treatment Time

29 monate

Anzahl der Aligner

Maxillary: 42 + 25 = 67
Mandibulary: 42 + 25 = 67

Aligner Wear time

2 weeks in first set, 10 days in second set of aligners

Retention

Maxillary: Other clear
Mandibular: Other clear

Results achieved

Class II relationship maintained
Normaler Overjet und Overbite erzielt
Tiefbiss verbessert
Overjet verbessert
Richtige axiale Schneidezahninklination
Curve of Spee leveled
Zahnbögen begradigt und koordiniert
Alignment beider Zahnbögen durch De-Rotation
Zahnbogenform verbessert
Ästhetische Lachlinie wurde erzielt
Alle Behandlungsziele wurden erreicht für den Fall
Harmonie der Zahnbögen wurde erzielt

Bemerkungen

Patient wanted to improve her smile the best it could be done, without extracting any teeth, at this stage of her life (68 years old), as she said.
Afterward, she wanted to "clear" her teeth from the "dark" and old fillings she had.
I opted not to fully correct her Class II, but to give her proper overjet and overbite and to align and level her teeth the best I could.
I performed then a great amount of IPRs on the upper arch, to create room for her cusps and her remaining lateral incisor.
I did more than the recommended 0.5mm between teeth on some posterior teeth, which would later have their fillings re-done.
Even with the IPRs, I did some expansion on the upper arch, to improve its form and match the lower arch's planned expansion.
I also used bit ramps to help me correct the overbite and to help to level the Spee Curve.
In the lower arch, I performed some minor IPRs, but I did lateral arch expansion and lower anteriors' proclination, in order to create interference with the upper arch anteriors and also help to correct the Curve of Spee.
I also overcorrected the curve of Spee in the Clincheck to an edge-to-edge bite, to achieve a proper correct overbite.
She used Class II elastics full-time in the first set of aligners. In the second set, they were not needed anymore.
I was delighted with the outcome in the first set of aligners, where most of the alignment and overbite were already corrected.
I used a second set of aligners to correct some rotations, mainly on tooth #4.3, and better align and give proper torque on upper anteriors and tooth #2.4.
In the course of her treatment, some old fillings fractured or fell, so I had to replace a few of them, making them "fit" into the aligners. We finished the second set of aligners at the end of 2019.
In the course of the next two years, with the Coronavirus pandemic still on, we gradually replaced most of her dental fillings to more proper ones, and I let the occlusion settle. She's 72 now!