Class II div 2, Deep bite, Arcadas estrechas, Arcadas asimétricas, Desviación de la línea media maxilar, Desplazamiento de la línea media, Apiñamiento, Rotaciones, Anterior a restauración
Nivelado de la curva de Spee
, Intrusión
, Expansión
, Retracción
, IPR
, Cierre de espacios
, Restauración
, Elásticos: Clase II
Courtesy of Dr. R. Bordin,
2022
Treatment Summary
Patient Information
- Age: 68
- Gender: female
- Invisalign Submission Option: Invisalign Comprehensive
Total Treatment Time
- 29 meses
Número de aligners
- Maxillary: 42 + 25 = 67
- Mandibulary: 42 + 25 = 67
Aligner Wear time
- 2 weeks in first set, 10 days in second set of aligners
Retencion
- Maxillary: Other clear
- Mandibular: Other clear
Results achieved
- Class II relationship maintained
- Resalte normal y sobremordida conseguida
- Mordida profunda mejorada
- Resalte mejorado
- Inclinación axial adecuada de los incisivos
- Curve of Spee leveled
- Arcadas alineadas y coordinadas
- Alineación de dos arcadas mediante desrotación
- Forma de la arcada mejorada
- Consecución de una línea de la sonrisa estética
- Todos los objetivos del tratamiento alcanzados
- Se han conseguido arcadas armónicas
Comentarios
- 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!
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