Orthotown October 2022 - 24

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davidharnick
Member Since: 08/28/02
Post: 3 of 14
Unfortunately, we all probably have similar cases. I would do Invisalign with signifi cant upper
IPR. It appears you aligned the teeth but they were fl ared some. I am better at planning with 3D
than trying to guess and remember to do IPR with fi xed. I would also minimize the extrusion
of UL1 and intrude on the others. The smile arc police will come after me! Having long-term
attachments on crowns doesn't seem like an answer to me. ■
5/28/2019
ToddS96
Member Since: 01/09/15
Post: 4 of 14
Fenrisúlfr
Member Since: 02/25/09
Post: 5 of 14
emac
Member Since: 11/21/11
Post: 6 of 14
Ha-ha, Charles. You said what I was thinking! ■
Can you post the rest of the records, including the ceph? ■
Tough problem. As you know, retention is the key to success here. Any chance you or the GP
could grind a groove in the crowns, once aligned, to help retain the bonded retainer? I have done
that once or twice. Use a material that bonds to porcelain ... or at least claims to! ■
5/28/2019
kaziii
Member Since: 09/26/08
Post: 7 of 14
Vertical relapses of the incisors are some of the worst cases. Unlike Class IIIs, you don't always
see them coming because they are so rare. They also make you look bad when you don't deserve it.
Once they are realigned, I second the idea of seeing if the GP can cut a trough in the lingual
of the crown for your defi nitely necessary lingual wire.
I would add the addition of an anterior bite plane removable retainer.
I believe you mentioned vertical bite relapse. I don't think we can always cure deep bites
wanting to relapse, thereby causing other problems. In those instances, I am straightforward
with the patient in letting them know that they will need a bite plane retainer forever, or until
they meet Charlie's conditions. ■
5/28/2019
fesdds
Member Since: 05/22/08
Post: 8 of 14
Did you do upper and lower ortho? It sounded like you did upper only for " straightening/
limited. " If that is the case, the lowers also need to be aligned into better occlusion to help. Could
retry a bonded retainer if the overbite is much more shallow, and maybe try a different material
for bonding. I have a perio-compromised patient I did limited on years ago (upper only) and I see
her about two or more times a year to either rebond her U1-1 that breaks because of deep bite
or adjust/remake her Hawley. We just made her two Hawleys a week ago or so. In retrospect, we
should have done full treatment because of the time and so, so many repairs we have done, but
we were trying to get in and out quickly because of her perio history. ■
5/29/2019
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5/28/2019
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24 OCTOBER 2022 // orthotown.com

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