Assessment of Crowded Dentition Accompanied by Deep Bite and Overbite
- Age:22
- Gender:Male
- Chief complaint:Malocclusion
- Use product:PT ZERO self-ligating brackets
- Treatment cycle:18 months
Issues:
- Oral hygiene condition is acceptable.
- The upper dental arch is ovoid, and the lower dental arch is squarish.
- Crowding of 4mm in both upper and lower jaws.
- Anterior teeth with Class II deep bite and Class III deep coverage.
- Molar relationship: Distal relation on both left and right sides; left side posterior teeth in normal occlusion.
- Spee's Curve: 4.5mm.
- The height of both ascending rami is basically consistent, and the morphology of both condyles is basically consistent.
- Impaction of teeth 18, 28, 48.
- Supernumerary tooth located buccally at the root tip area of teeth 35, 36.
Diagnosis:
- Cranial Coordinates: Straight facial profile.
- Jawbone Coordinates: Skeletal Class I, average angle.
- Dental Coordinates: Anterior teeth in both upper and lower jaws are labially inclined.
- Anterior teeth with deep bite and deep coverage.
Treatment Approach and Plan:
- Extraction of the supernumerary tooth in the left lower posterior area and bilateral upper wisdom teeth.
- Elevate the occlusion, use anchorage screws and cross-arch traction to resolve the posterior teeth lockbite (left lower anchorage screw to correct the lingual tilt of the lower posterior teeth).
- Align teeth and level the Spee’s Curve.
- Use bilateral maxillary anchorage screws to push the molars backward, improving the molar relationship.
Treatment Progress
30, Jun. 2022
30, Nov. 2022
23, Oct. 2023
Summary:
- For patients with a straight facial profile and minimal crowding, avoid designing an extraction orthodontic treatment whenever possible, as it is beneficial in maintaining the facial profile.
- Ectopic teeth in the root apex area might affect tooth movement during orthodontic treatment; consider extraction before treatment.
- Choosing the correct indications, combining self-ligating brackets with low-friction system and anchorage screws, pushing the molars backward to improve Class II molar and canine relationships, can achieve good treatment results while maintaining facial aesthetics.
- Make rational use of anchorage screws, correcting lockbite without disrupting the three-dimensional vertical relationship.
Last: Severe Crowding Non-Extraction Case
Next: Orthodontic Camouflage Treatment for Skeletal Class III Patient
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