NH: Class III mild crowding and anterior crossbiteQST Fixed Appliances

Treatment time 7 months

History

NC was a 41 year old female who was concerned that her, “upper teeth stick out,

compared to the other teeth.” She preferred to have aesthetic fixed brace treatment in time for her cousin’s wedding (9 months)

Extra-oral examination

Class III skeletal base

Increased Frankfort-Mandibular Planes Angle

Average nasolabial angle

Competent lips

No facial asymmetry

Intra-oral examination

Class III incisors, class I canines

Several previously extracted teeth

Reduced overjet

Lower anterior spacing 2.5mm and upper arch crowding 1.5 mm

Anterior crossbite 12 and 22. Initial contact on 12 and 22 in CO/CR and forward displacement into ICP

Summary

NH was concerned that her upper teeth stick out compared to other teeth. She presented

with a class III incisor relationship on a skeletal III base, with a reduced overjet. There

was mild crowding in the upper and mild spacing in the lower arch. 12 and 22 were in

crossbite and there was a mandibular displacement on closing, with an anterior

displacement from CO to ICP

Treatment Options

1.  Comprehensive orthodontic treatment. Estimated treatment time 12 months. This would not be achieved within her timeframe

2.  Q fixed appliances. Estimated treatment time 6-7 months. Accept the torque/gingival margin height of 12 and 22 may not be ideal

Treatment Plan

1.  Q fixed appliances. Cement on upper first molars to prop the bite and allow 12 and 22 to procline into a positive overjet

2.  Close lower arch space and allow some retraction/space closure to help with correction of the class III incisors

3.  Indefinite retention with fixed and removable retainers

Post-orthodontics

Before

After

Post-orthodontic treatment plan

1.  Bonding of 12,22 to reduce the black triangle

2.  Lower denture to replace missing posterior teeth

3.  Whitening

Summary

A well aligned upper and lower anterior arch, achieved within the given timeframe

Class I incisor relationship

Treatment duration 7 months