DH - 27 year old male. He is a regular attendee with his general dentist.
He was referred to Longwood as he was unhappy with the crooked upper teeth and open bite.
He did not want his lower teeth treated as he was happy with the alignment.
He also wanted to have his teeth whitened.
Class 3 skeletal base
Class 3 incisor relation with AOB - no tongue thrust.
Patient expectations - normal
TMJ - nad
MOM- non tender
Eo/ all ok
Io/ all ok
The anchorage teeth were acceptable and oh fair to good, diet - low sugar.
Patient was offered the following options for orthodontic treatment;
Orthodontics with specialist,
Or at Longwood:
Aims and treatment goals
( - The patient is informed that - cosmetic Orthodontics will not give the perfect result but will be able to achieve a improved smile.
The patient is informed of all risks and benefits - informed consent is obtained.)
Our aim is not to correct the class 3 - only to improve the AOB and level and align the upper teeth from premolar to premolar.
(Full orthodontic and dental/ periodontal examination is undertaken with an opg x-ray.)
Models and x-rays were used to create a clincheck plan by Invisalign - which is a video simulation of how the movements of the teeth will happen – and what the final position of the teeth will be. The Clincheck is shown to the patient before the treatment aligners are ordered.
The treatment for this patient took 8 months using Invisalign clear braces- each brace was worn for two weeks.
The Upper arch treatment was only undertaken -
Attachments were added to the upper teeth where needed and minimal interproximal reduction was undertaken.
The final aligner was removed and a bonded wire placed - followed by a clear retainer.
Retention- 2 months full time wearing of the clear retainer followed by night time only - for the rest of his life .
Teeth whitening- Was undertaken with 15% cpo Opalescence by Optident – The product as used in whitening trays for 3 nights only .The start shade was recorded as A3 and the final/ end shade achieved was B1 .
Post operative PA x-rays were then taken of the upper anterior teeth. This is to make sure that there had been no changes to the root structures during the Clear brace Orthodontic treatment.
The Results show good movements as predicted by the patient’s clincheck.
The patient is pleased with the results.
The patient is then instructed on care of the teeth and their retainer- and reviewed 2 months later. Throughout their treatment at Longwood they are advised when to see their own general dentist for dental checks and hygiene treatments.