Adult Orthodontic Case
- Anterior Open bite 3mm, 2mm Overjet (clinically & from study model)
- Upper and lower anterior crowding
- A slight shift of the lower midline toward the left side. 2mm shift of the upper midline to the right due to missing UR4
- Wide buccal corridor space
- Canine class I bilaterally
- Missing LR6, LL6 + UR4
- Over erupted UR6 toward space of the missing LR6
- Mesially tilted LR7, LL7 and UR5
Diagnosis
- Skeletal open bite (long face syndrome) associated with anterior dental open bite 3mm
- Dolichofacial (vertical) growth pattern
- Skeletal Class II associated with bimaxillary protrusion
Treatment Plan
- Fixed orthodontic appliance therapy which includes intrusion of the upper 1st molars by the aid of RCS wires or micro-screws TADs which in the same time lead to correction of the anterior open bite
- Relief upper & lower incisor crowding by means of interproximal stripping as the patient refused the EXO. Option to recline upper & lower incisors & relief crowding beside the advantage of closing the ant. Open bite plus centre midlines shift
- Long retention of the upper arch by using Hawley retainer with posterior bite plate or crowning of the upper 1st molars, plus upper & lower fixed permanent retention
- Restoration of LL6,LR6 missing space by dental prosthesis at the end of orthodontic treatment
