Case Report of CAPS
A 15-year-old female presents with a class 1 posterior relationship with significant crowding in her upper and lower anterior region and a 7 mm anterior open bite.
From a facial perspective, she has a slightly retrognathic mandible, Dolichofacial and vertical
growth pattern with a long lower facial height and demonstrated significant lip strain on closure.
Aligner therapy was considered, especially due to the anterior open bite.
Initial Digital Setup
The initial digital set up was returned and further attachments were placed, staging of treatment was modified significantly and most importantly over correction of the posterior segments was incorporated to provide the digital set up a posterior open bite.
Here is the digital set up and final treatment plan for the first set of aligners.
Through excellent treatment planning – and with a final plan of 17 upper aligners and 15 lower aligners, the following treatment result was achieved – an excellent correction of the anterior open bite and now a further modification is required to perfect the anterior alignment and in particular the crown tip of the lower right lateral incisor and also requiring further improvement in providing a nice socked in occlusion posteriorly and adding further buccal root torque to the upper second molar teeth.
To perfect the result, a refinement is planned with a further 15 upper aligners and 10 lower aligners – making the treatment in total of 32 upper aligners and 25 lower aligners – and the patient has been changing each aligner weekly, so we expect a total treatment time to be less than nine months.
Digital Setup and Final Treatment Plan
Here is the digital set up and final treatment plan for the first set of refinement.
This case demonstrates the value of a good diagnosis, excellent treatment planning which factors in ideal staging of treatment, understanding the use and biomechanics of different attachments, when and how to over correct different tooth movements and ensuring the set up provides predictable movements with aligners to allow a predictable outcome for your patients.