The chief concern was that it the patient was not able to bite properly (through food) with the anterior teeth.
The patient didn't accept the use of TAD's so she challenged me and asked me to try with anterior extrusion and posterior intrusion with the help of chewies
The patient moved to another country during treatment.
My treatment plan was to expand both arches to improve the narrow arch situation
In the first Clincheck I asked to close the anterior open bite through Anterior Extrusion, combined with posterior intrusion and it worked just perfect.
I ordered the extraction of all wisdom teeth, and that has reduced the open bite significantly, allowing the premolars and anterior teeth to contact for the first time in her life
Once we arrived in the final stage of additional aligners (last 4 aligners), there was an issue with 1.2 and 2.2 not fitting well
I've managed to force eruption with buttons and elastics as you can see in the intermediate pictures
The orthodontic treatment was combined with a lingual reeducation working hand to hand with a Speech Therapist
We finalized the treatment with fixed retainers from cuspid to cuspid and Vivera retainers on top and bottom.
This site is optimized for viewing on IE10, IE11, and the latest Chrome, Firefox, Safari and Edge browsers