DentaltownUK May 2018 - 19

An Openbite Case
by Dr Mohsen Tehranian
Mohsen Tehranian is
Practice Principal of Dream
Smile Dental Clinic (www.
dreamsmiledental.co.uk) in
South London.
He qualified from Carol
Davila Dental Institute with
distinction in 1998.
Since 2001, Mohsen has
been working as a private
associate in Boots Dental Care, The Dental clinic
and Swiss Smile aiming for high-quality,
minimally-invasive dentistry.
He is one of few Dentists in the UK to have achieved
the Diamond Award from Align Technology having
completed over 2,000 Invisalign cases and was the
first dentist in the UK to submit an Invisalign i7
case. Mohsen is passionate about the latest dental
technology and his was also one of the first practices to
use the Itero scanner for his digital impression taking.
He is a clinical speaker for Invisalign.

Prior to her own treatment, the patient
in this case had been accompanying her
husband to his visits. He had been referred to
me by a colleague for correction of moderate
crowding.
At one of his appointments we managed
to talk about her own teeth and we set-up an
examination date. She had already investigated
improving her malocclusion and was told
she would possibly need maxillary surgery,
fixed braces and implants.
The factors which most concerned her
were how invasive these treatments would be
and the length of time for all the procedures
to be completed.
The main presenting problems were
that she had an obvious openbite, a midline
shift/drift due to the missing upper right
canine and narrow arches. While there was
a significant inclination to the right of the
upper incisors, and crowding of the lower
teeth, these factors were of less concern.
I discussed three potential treatment
options with the patient:
Option 1: No treatment.
Option 2: Treatment with fixed braces. This
would involve the possible extraction of
UL4, correcting the midline and making
space for an implant at the UR3 area. The
possibility of bone grafting and healing time
were also discussed.
I had consulted our in-house Orthodontist
concerning this option and was told that the
openbite could be reduced without surgery,
but maybe not completely treated. Treatment
time of approximately 18-24 months was
estimated.
I also discussed the implant option for
the UR3 with our Oral Surgeon. A waiting
time of 6-12 months after completion of
orthodontic treatment was suggested before
any implant placement could take place.
This would be due to reduced bone
density in the newly created space.

The patient had already ruled out the
idea of fixed braces and implants even before
hearing the length of time that it would take
to complete, however it was important to
fully investigate this option.
Option 3: Treatment with Invisalign aligners
and minimal preparation veneers. Having
successfully treated similar cases, I felt
confident that this option would treat, or
at least significantly improve the openbite.
The midline shift, the midline inclination
and the missing canines were all complications
that had to also be taken into consideration.

dentaltownuk.com \\ MAY 2018

19
http://dreamsmiledental.co.uk http://www.dentaltownuk.com
Table of Contents for the Digital Edition of DentaltownUK May 2018
