Orthotown June 2022 - 32
CASE STUDY 1
Diagnosis and treatment plan
This patient (Fig. 1) presented with a deep
bite, severe crowding, anterior attrition and
a chipped incisor. She also has an implant on
the lower right, which challenged how much
movement we could get in that quadrant.
We discussed combination treatment:
first using braces to handle the rotations
and correct the crowding, then finishing up
the case with a short series of clear aligners.
Treatment progression
We put braces on this patient in January
2021, using Pitts21 to correct the rotations
and crowding. She responded beautifully and
started clear aligner therapy in August 2021,
finishing in just four months. With combo
treatment, this case finished in one year.
Case notes
As I mentioned earlier, the patient
had a small chip on her top right incisor.
Many orthodontists steer clear of restorative
work because it can take significant time,
but I was able to reconstruct it in about
10 minutes using uLab's Add/Subtract
feature. I 3D-printed the model and used
it to thermoform a template; then, using
composite, I was able to quickly restore the
tooth. By undertaking it myself, I saved the
patient money and time coordinating the
restorative work with her dentist. The chip
was so small she might have just left it, but
restoring it definitely improved her final
results. (Plus, I had fun finding a new use
for the technology.)
Adult deep bites are notoriously tough,
and this case is no exception because her right
occlusion was particularly challenging for
me. The patient was referred to a periodontist
for gingival recontouring after treatment to
further refine her smile aesthetic (Fig. 2).
Her case would have taken 18-24 months
using a single treatment modality. With
combination treatment, we completed the
case in 12 months, with no delays and a
smooth transition between fixed appliances
and clear aligners at the three-quarter mark.
With combo treatment,
I can more accurately
predict how quickly we
can get to our treatment
goals because I'm able
to use the most efficient
tool for the movement
desired.
Fig. 1
Fig. 2
32 JUNE 2022 // orthotown.com
http://www.orthotown.com
Orthotown June 2022
Table of Contents for the Digital Edition of Orthotown June 2022
Orthotown June 2022 - Intro
Orthotown June 2022 - Cover1
Orthotown June 2022 - Cover2
Orthotown June 2022 - 1
Orthotown June 2022 - 2
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Orthotown June 2022 - 4
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