Deep bite, Class II div 2, Erhöhter Overjet, Enge Zahnbögen, Asymmetrische Zahnbögen, Maxilläre Mittellinien-Abweichung, Mittellinienverschiebung, Engstand, Rotationen
Elastics: Klasse II
, Distalisation
, Nivellierung der Spee-Kurve
, Intrusion
, Expansion
, Proklination
, ASR
Courtesy of Dr M. Pedernera,
2019
Treatment Summary
Patient Information
- Age: 13
- Gender: male
- Invisalign Submission Option: Invisalign Teen
Total Treatment Time
- 22 monate
Anzahl der Aligner
- Maxillary: 49 + 13 + 18 = 80
- Mandibulary: 49 + 13 + 18 = 80
Aligner Wear time
- 1 woche
Results achieved
- Klasse I-Relation erzielt
- Funktionale Eckzahn-Führung auf beiden Seiten
- Normal overjet and overbite achieved
- Significant improvement ofoverbite
- Mittellinien symmetrisch
- Curve of Spee leveled
- Zahnbögen begradigt und koordiniert
- Zahnbogenform verbessert
- Aesthetic smile linewas achieved
- Alle Behandlungsziele wurden erreicht für den Fall
Bemerkungen
- This case was very challenging for me because it had the most severe deep bite I've ever treated
- This challenge includes a Severe Brachyfacial and Class II skeletal pattern
- Significantly favorable is that the patient is very young and the retroclination of both upper and lower incisors will virtually improve the deep bite itself
- My treatment plan was to expand both arches and de-rotating (especially the 1.6) to improve the patients narrow arches
- Combined with distalization (aesthetic beginning) of the 1st quadrant.
- Up to 4 teeth moving together to not only create the distalization of the 1st quadrant but increase anchorage and provoke proclination of the lower incisors
- I used Class II elastics to increase the anchorage 3/16" 4 and 6 Oz - Nigh time wear
- IPR was performed in order to minimize the necessity of distalization of the 1st quadrant.
- Expansion of the lower arch (especially of the premolar area) and proclination of the lower incisors to align the anterior teeth and improve the deep bite
- Note that in the pictures of intermediate stage I show how I did the intercuspation of the posterior sector by cutting of the molar part of the upper and lower aligner, placing buccal buttons in labial of 1st and 2nd molars using 1/8 6 Oz vertical elastics for 2 weeks