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
Before picture of treatment

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

Images

Initial and final

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upper
lower
right
front
left
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upper
lower
right
front
left

Progreso

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upper
lower
right
front
left
InicialFinal
Before picture of treatment
After picture of treatment
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Radiografías

Inicial Final
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