Treatment Plan for Bimaxillary Crowding
A 29-year-old Chinese lady (healthcare worker) requests orthodontic treatment (Fig.1-8). She is not interested in replacing the maxillary 2nd molars (Fig.6,8). Clinical and radiologic examination reveals mild chronic periodontitis. What are treatment options?
Model surgery may reveal a proper treatment option (Fig.9-23).
First is to establish baselines (Fig.9-11).
After extraction of LL8 and L4s (Fig.9-11 x), the lower anterior teeth are distalized (Fig.12-14); L7s are intruded (Fig.12 arrow). Since there is a space between L3 and L5 (Fig.13 *), the posterior teeth may be mesialized (Fig.13 arrow).
The upper arch are moved distally (Le Fort I, Fig.15-17) to correct exaggerated anterior overjet (Fig.12 double arrows). En bloc movement produces anterior midline discrepancy (Fig.16 black lines), one-sided posterior overjet (Fig.16 double arrows) and open bite on the other side (Fig.17 *).
It appears that upper segmental osteotomy is needed to improve occlusion (Fig.18-20).
Fine tune (orthodontics) is required to improve cosmetics (Fig.21-23).
Discussion with Dr. Ness.
The journey starts here. Progress Report, Zygomatic.
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Implant & Ortho
Xin Wei, DDS, PhD, MS 1st edition 02/22/2015, last revision 05/03/2017