Deep bite
,
Classe II Div 2
,
Aumento do trespasse horizontal
,
Arcos estreitos
,
Arcadas asimétricas
,
Desviación de la línea media maxilar
,
Mudança da linha média
,
Acavalamento
,
Rotações

Elásticos: Classe II
,
Distalização
,
 Nivelación de la curva de Spee
,
Intrusão
,
Expansão
,
Vestibularização
,
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 alinhadores

  • Maxillary: 49 + 13 + 18 = 80
  • Mandibulary: 49 + 13 + 18 = 80

Aligner Wear time

  • 1 semana

Results achieved

  • Relação de Classe I obtida
  • Orientação canina funcional em ambos os lados
  • Normal overjet and overbite achieved
  • Significant improvement ofoverbite
  • Linhas médias coincidentes
  • Curve of Spee leveled
  • Arcos alinhados e coordenados
  • Forma de arco melhorada
  • Aesthetic smile linewas achieved
  • Todos os objetivos de tratamento foram casos alcançados

Comentários

  • 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

Click to compare enlarged
upper
lower
right
front
left
Click to compare enlarged
upper
lower
right
front
left

Progresso

Click to compare enlarged
upper
lower
right
front
left
InicialFinais
Before picture of treatment
After picture of treatment
Thumbnail, click to compare enlarged Thumbnail, click to compare enlarged
Thumbnail, click to compare enlarged Thumbnail, click to compare enlarged
Thumbnail, click to compare enlarged Thumbnail, click to compare enlarged
Thumbnail, click to compare enlarged Thumbnail, click to compare enlarged
Thumbnail, click to compare enlarged Thumbnail, click to compare enlarged

Radiografías

Inicial Finais
Click to compare enlarged396
Click to compare enlarged390