Deep bite, Class II div 2, Resalte aumentado, Arcadas estrechas, Arcadas asimétricas, Desviación de la línea media maxilar, Desplazamiento de la línea media, Apiñamiento, Rotaciones
Elásticos: Clase II
, Distalización
, Nivelado de la curva de Spee
, Intrusión
, Expansión
, Proinclinación
, IPR
Courtesy of Dr M. Pedernera,
2019
Treatment Summary
Patient Information
- Age: 13
- Gender: male
- Invisalign Submission Option: Invisalign Teen
Total Treatment Time
- 22 meses
Número de aligners
- Maxillary: 49 + 13 + 18 = 80
- Mandibulary: 49 + 13 + 18 = 80
Aligner Wear time
- 1 semana
Results achieved
- Consecución de una relación de Clase I
- Guía canina funcional en ambos lados
- Normal overjet and overbite achieved
- Significant improvement ofoverbite
- Coincidente con líneas medias
- Curve of Spee leveled
- Arcadas alineadas y coordinadas
- Forma de la arcada mejorada
- Aesthetic smile linewas achieved
- Todos los objetivos del tratamiento alcanzados
Comentarios
- 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