クラスⅡ分類1
,
臼歯部クロスバイト
,
過大なオーバージェット
,
Deep bite
,
歯列弓非対称
,
上顎正中のずれ
,
下顎正中のずれ
,
正中のずれ
,
叢生
,
捻転

遠心移動
,
近心移動
,
スピー湾曲のレベリング
,
挺出
,
圧下
,
拡大
,
リトラクション
,
唇側傾斜
,
First premolar extraction
,
その他の抜歯
,
IPR
,
クラスⅡエラスティック
,
Elastics: Class II in Additional Aligners
,
クラスⅢエラスティック
,
垂直エラスティック
,
抜歯
Courtesy of Dr C. Hock Lou, 2021
Before picture of treatment

Treatment Summary

Patient Information

  • Age: 16
  • Gender: female
  • Invisalign Submission Option: Invisalign Full

Total Treatment Time

  • 24 数ヶ月

アライナー数

  • Maxillary: 52 + 23 = 75
  • Mandibulary: 52 + 23 = 75

Aligner Wear time

  • 7-14 days

保持

  • Maxillary: Other clear
  • Mandibular: Other clear

Results achieved

  • クラスⅠ関係達成
  • 機能的な犬歯誘導(左右側)
  • 臼歯部クロスバイト改善
  • 正常なオーバージェット&オーバーバイト達成
  • オーバーバイトの大きな改善
  • オーバージェットの大きな改善
  • 正中一致
  • 切歯の適切な歯軸角
  • Curve of Spee leveled
  • 歯列の配列およびコーディネーション
  • アーチフォーム改善
  • 審美的スマイルの達成 
  • 全ての治療目標を達成した症例
  • 調和のとれた歯列を達成

コメント

  • This difficult class II div 1 case with severe deep bite, asymmetrical & constricted arches was treated successfully in 24 months with excellent results.
  • Extraction: 1.4, 2.4, 3.8 & 4.8.
  • The lingual crown torque of upper posterior teeth and hyper-erupted teeth made it impossible to place buccal attachments on the lower teeth.
  • Lingual conventional attachments (Rectangular & Ovoid) were utilized to control the movement of the lower teeth & to improve retention of aligners.
  • At stage 10: Buttons were bonded at the mesiobuccal side of 3.6 & 4.6 after some intrusion & buccal crown torque of 2.6 were achieved.
  • Class II elastics (4.5oz 1/4") on both sides applied from U3 Hooks to Buttons on L6.
  • Tooth 4.5 (Lingual Ovoid) became intruded & off tracked during stages 15-20. The lingual attachment was removed.
  • As the expansion at the lower right side was a lot more than the lower left, sequential expansion of lower right posterior teeth was performed first to improve the predictability of asymmetrical expansion.
  • To assist correction of lower midline (2mm to left) from stage 45 onward: Right class III elastic + anterior elastic + left class II elastic.
  • At stage 49, Buttons were placed at 4.5(B), Cleat at 4.4(L) & 4.5(L) for application of force couple to derotate 4.5 and extrusion of 4.5. Button was also placed at 3.5(B) & 2.6(B) for vertical elastic.
  • Additional aligners were utilized to flatten the Curve of Spee, create a nice smile arc, get coincident midlines and finalize the occlusion.
  • The lower 2nd molars were moved successfully despite only partial coverage by aligners throughout the whole treatment!
  • The keys to success for this difficult case were correct diagnosis & ClinCheck planning. and good patient compliance!

Images

Initial and final

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進捗

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本治療治療後
Before picture of treatment
After picture of treatment
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レントゲン写真

本治療 治療後
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