安氏 II 类 2 分类
,
深覆牙合
,
牙弓狭窄
,
牙弓不对称
,
上颌中线偏移
,
下颌中线偏移
,
牙列拥挤
,
扭转
,
Impacted canines

弹性牵引:安氏 II 类
,
远中移动
,
Leveling curve of Spee
,
唇倾
,
邻面去釉

治疗信息

  • 年龄: 11
  • 性别: 男性
  • Invisalign治疗选项: Invisalign Teen

诊断概要

  • 安氏 II 类 2 分类
  • 牙弓狭窄
  • 下颌中线偏移
  • 上颌中线偏移
  • 深覆牙合
  • 牙列拥挤
  • 扭转
  • 牙弓不对称
  • Impacted canines

用于

  • 远中移动
  •  平整 Spee 曲线
  • 唇倾
  • 邻面去釉
  • 弹性牵引:安氏 II 类
  • Reverse cross elastics
  • Optimized rotation attachment (G3) on Lingual 2.3 (UL3)
  • Optimized root control attachments (G4) on Buccal 1.1 (UR1), Buccal 2.1 (UL1)
  • Optimized deepbite attachments activated for premolar extrusion (G5) on Lingual 1.4 (UR4), Lingual 2.4 (UL4)
  • Precision bite ramp (G5) on Buccal 1.1 (UR1), Buccal 1.2 (UR2), Buccal 2.1 (UL1)
Courtesy of Dr M. Masoud 2019
Award 2018 Summit Shoot out

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
  • 实现正常覆盖和覆牙合
  •  深覆牙合已改善
  •  覆盖已改善
  • 中线对齐
  •  Spee 曲线平整
  • 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

  • 20个月

矫治器数量

  • Maxillary: 45 + 33 + 11 = 89
  • Mandibular: 45 + 33 + 11 = 89

矫治器配戴时间

  • 1 周

评论

  • This patient lives on a boat, spending most of her time in the middle of the ocean with no access to care.
  • The patient is the daughter of explorers on a global climate mission and lives on a 50 foot aluminum sailboat traveling around the world climbing the highest peak on each continent.
  • She had a concussion and multiple traumatic injuries to her upper central incisors due to her activities on the boat in severe weather.
  • During the course of treatment she was caught in a storm and their sailboat/home was wrecked and the family had to be rescued.
  • The crowding, lip retrusion, and incisor retro-clination were addressed by dental expansion and advancement of the upper and lower incisors.
  • The patient had an upper right canine that was much more labial displaced than the left one. That was the same side that had a lingual displaced lower left first premolar
  • Both teeth had button cut outs and the patient used reverse cross elastics from the buccal of the upper right canine to the lingual of the lower right first premolar
  • The bite was opened by A) proclining the upper and lower teeth, B)Anterior bite turbos allowing posterior eruption in the presence of ramus growth (Relative Intrusion)
  • The elastics and the dis-occlusion helped the mandible grow favorably.
  • More space was opened on the right side to help make space for the impacted teeth on the right side and shift both mid lines to the left.
  • Power ridges were used to control the inclination of the upper and lower incisors.
  • Additional upper spaces were opened around the upper lateral incisors to allow for upper lateral incisor buildups.
  • The Initial round of aligners was discontinued at aligner 45 (out of 62) because multiple primary teeth had exfoliated and we wanted to to start the refinement before her next mission.
  • Two refinements (additional aligners) were needed to achieve the treatment goals.