Class II div 2, Surplomb accru, Deep bite, Décalage des lignes médianes, Encombrement, Rotations, De pré-restauration
Treatment Summary
Patient Information
- Age: 35
- Gender: male
- Invisalign Submission Option: Invisalign Full
Total Treatment Time
- 43 months
Nombre d'aligners
- Maxillary: 39 + 35 + 56 = 130
- Mandibulary: 39 + 35 + 56 = 130
Aligner Wear time
- 2-weeks
Rétention
- Maxillary: Other clear
- Mandibular: Other clear
Results achieved
- Guidage fonctionnel des canines des deux côtés
- Surplomb normal et recouvrement obtenu
- Supraclusion améliorée
- Surplomb amélioré
- Les axes médians coïncident
- Inclinaison axiale correcte des incisives
- Curve of Spee leveled
- Arcades alignées et coordonnées
- Forme de l'arcade améliorée
- Ligne de sourire esthétique obtenue
- Obtention d’arcades harmonieuses
Commentaires
This case was very difficult to obtain a good result, and it took a long time, 3 years and a half, as the client refused to treat with extractions.
At the first set of aligners, billateral distalization in "V" pattern and IPRs were done, with Class II elastics throughout the whole treatment. A lot of anchorage was lost, and the Class II relationship was not corrected at all, but crowding, alignment, half of levelling of the curve of spee and most of the derotation of teeth were achieved, although there was still some rotations on upper incisors.
At the second set of aligners, again distalization in "V" pattern was done with aid of full-time Class II elastics. Curve of spee improved a lot, midline was still deviated, Class II relationship improved but there was still there was some room to improvement, and overjet to be reduced.
At this point, the client had a pause in the treatment, had his teeth bleached, and had the stained fillings on the upper anteriors re-done, and also, the incisal edges of both #1.1 and #2.1 were re-built with composite resin. After this restorative phase was done, I did the last set of aligners (the second refinement)
In this last clincheck I on purpose overcorrected in excess a lot the curve of spee to the edge-to-edge limit, and distalized again billaterally in a "V" pattern, this time in excess until close to Class III relationship, this time with aid of TADS, placed between #1.5. and #1.6 and #2.5 and #2.6. FInally, the curve of spee was flattened correctly, class II was completely corrected in the left side, and in the right side almost all of it, and overjet and overbyte were corrected. All left rotations were corrected. The client at the end was really satisfied, despite the long time of treatment. And so was I !
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