安氏 III 类
,
前牙反牙合
,
切对切咬合
,
深覆牙合
,
牙弓狭窄
,
后牙反牙合
,
牙弓不对称
,
上颌中线偏移
,
下颌中线偏移
,
中线移位
,
牙列拥挤
,
扭转

弹性牵引:安氏 III 类
,
远中移动
,
Leveling curve of Spee
,
伸长
,
压低
,
扩弓
,
唇倾
,
邻面去釉

治疗信息

  • 年龄: 30
  • 性别: 男性
  • Invisalign治疗选项: Invisalign Full

诊断概要

  • 安氏 III 类
  • 牙弓狭窄
  • 前牙反牙合
  • 后牙反牙合
  • 中线移位
  • 下颌中线偏移
  • 上颌中线偏移
  • 深覆牙合
  • 切对切咬合
  • 牙列拥挤
  • 扭转
  • 牙弓不对称

用于

  • 远中移动
  • 扩弓
  • 伸长
  • 压低
  •  平整 Spee 曲线
  • 唇倾
  • 邻面去釉
  • 弹性牵引:安氏 III 类
  • Optimized rotation attachment (G3) on Buccal 1.5 (UR5), Buccal 2.3 (UL3), Buccal 2.4 (UL4), Buccal 2.5 (UL5), Buccal 4.3 (LR3), Buccal 4.4 (LR4), Buccal 3.3 (LL3), Buccal 3.4 (LL4), Buccal 3.5 (LL5)
  • Optimized extrusion attachment (G3) on Buccal 1.3 (UR3)
  • Optimized root control attachments (G4) on Buccal 1.4 (UR4)
  • Optimized deepbite attachments activated for premolar extrusion (G5) on Buccal 4.5 (LR5)
  • Conventional bite ramp on Lingual 1.2 (UR2), Lingual 2.2 (UL2), Buccal 4.1 (LR1), Buccal 4.2 (LR2), Buccal 3.1 (LL1), Buccal 3.2 (LL2)
Courtesy of Dr K. Malekian 2018
Award 2019 Peer Review Award

相片

Click to compare enlarged
upper
初始状态
lower
right
front
left
Click to compare enlarged
upper
治疗后
lower
right
front
left
Click to compare enlarged
upper
进展
lower
right
front
left

X光片

ClinCheck治疗计划

video anterior
video right-left
video upper-lower

治疗总结

实现的结果

  • 达到安氏 I 类关系
  •  保持安氏 I 类关系
  •  两侧的功能性尖牙引导
  •  前牙反牙合已矫正
  • 后牙反牙合已矫正
  • 实现正常覆盖和覆牙合
  •  深覆牙合已改善
  •  覆盖已改善
  •  显著改善覆牙合
  •  显著改善覆盖
  • 中线对齐
  • 切牙达到合适的轴向倾斜
  •  Spee 曲线平整
  • 已对齐并协调牙弓
  • 通过去扭转对齐上下牙弓
  • 已改善牙弓形状
  • 已获得美观的微笑线 
  • 已实现所有治疗目标
  • 实现牙弓协调

总的治疗时间

  • 21 个月

矫治器数量

  • Maxillary: 32 + 33 + 20 = 85
  • Mandibular: 32 + 33 + 20 = 85

矫治器配戴时间

  • 10 day aligner change for treatment aligner. Refinement aligner change range between 7-5 days.

评论

  • Determine space selection was the key factor to resolve the severe crowding in the upper and lower arch
  • Staging was also a key factor: We started with high expansion of upper molars and premolars and when gained enough space we continued with arch development and retraction to extrude upper canines
  • IPR was planned at upper and lower premolars
  • Carefull IPR tracking with distalization movement of upper and lower premolars allowed space in order to align high angle rotation of canines 2.3,3.3 and 4.3 .
  • Conventional bite ramps at the buccal surface of lower four incisors were used in order to correct the deepbite
  • Class III elastics were used in order to improve the anterior/posterior relationship and turn Class III canine and molar into full class I molar and canine.
  • Proclination of upper laterals 1.2 and 2.2 in order to correct the anterior crossbite.
  • Arch coordination tool at clincheck Pro was very helpfull.
  • The maxilla and mandible arch form at stage U0-L0 were very asymmetric and required arch form coordination.
  • Lower incisor proclination and simultaneously lower canines were retracted and distalized

保留

  • Maxillary:
  • Mandibular: