CORRECTION OF OPEN BITE

The below case was submitted by the doctor to correct the open bite. The pre-treatment clinical photos reveal:

1) Posterior open bite with the appearance of an end-on relationship

2) The midlines were not coinciding

3) Space between the upper central incisors

4) Edge to edge anterior bite

5) Spaces in the maxillary premolar region

The First ClinCheck Received showed the following treatment outcome:

TREATMENT PLAN BY ALIGN: TREATMENT PLAN #1

In spite of the special instructions provided by the doctor, at stage 39 it was apparent that occlusion was not achieved. Surprisingly, at stage 40 an occlusion was seen both anteriorly and posteriorly indicating a bite jump without the use of any driving force.

The treatment plan also lacked:

1) Upper and lower midlines were not co-inciding

2) The lateral occlusion was not so interdigitated especially in the canine region on both sides.

TREATMENT PLAN BY ALIGNER CONCIERGE: MODIFIED PLAN #1

To meet the clinical preferences of the doctor and achieve attainable clinical results we asked Align to remove the bite jump. Following are the other modifications and enhancements made by Aligner Concierge:

In the frontal view:

1) Achieve 1.5mm overjet and achieve optimum overbite.

2) Correction of upper and lower midlines so that they coincide.

3) Since it was instructed by the doctor to not move UR1, the upper anteriors were leveled accordingly.

4) The lower anteriors were extruded and attachments were added to support the movement.

5) Change of attachments on upper and lower canines to help in extrusion and rotation correction.

In the right and left occlusion view:

1) Tighter occlusion posteriorly

2) Change of a few attachments

3) A better canine relation

The new ClinCheck received after modification was immediately approved by the doctor. As per his feedback, he did not have to spend his clinical time making any changes as he was satisfied by the treatment plan modified by Aligner Concierge. His clinical preferences and expectations were achieved after modification.