Radiographs

Initial Panorama

Final Panorama

Initial Lateral

Final Lateral

Summary

Results achieved

• Class I relationship achieved
• Normal overjet and overbite achieved
• Significant improvement ofoverbite
• Significant improvement of overjet
• Midlines coincident
• Proper axial inclination of incisors
• Arches aligned and coordinated
• Arch form improved
• Aesthetic smile linewas achieved
• All treatment goals were achieved case
• Harmonic arches were achieved

Comments

• The third molars were removed prior to commencement of treatment to eliminate the CO/CR discrepancy.
• The Class II buccal relationship was corrected by sequential distalisation of the upper premolar and molar segments.
• The anterior open bite was addressed through a combination of the intrusion of the posterior segments and relative extrusion of the upper anterior segments upon retraction after interproximal reduction (IPR) of the front teeth. Intrusion of the posterior segments was over-prescribed in order to obtain an over treatment effect.
• Crowding of the anterior segments was achieved through staging of IPR to avoid unwanted or 'round-tripping' tooth movement.
• The shaped of the arches was improved by expansion and rounding off.
  The patient was instructed to change aligner every 7 days during the whole treatment duration, and to wear heavy intra-oral Class II elastics during the distalisation stage.
• Class II elastics was continued in the Refinement stage as a form of retention.