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Dental Tribune Middle East & Africa No. 5, 2017

E2 ORTHO TRIBUNE Dental Tribune Middle East & Africa Edition | 5/2017 Insignia™ Resolves Adult Open Bite with Straight-Wire™ Finishing Case Study By Dr. David González Zamora, Spain INITIAL Pretreatment Diagnosis Adult female, mesofacial, skeletal class I, open bite. Patient suffered from fre- quent headaches. Treatment Plan Objectives Close her open bite while maintaining vertical relationship of upper anterior incisors. Appliance Used: Insignia SL Treatment plan notes submitted with this case: • Insignia Archform • Laterals should be shorter than centrals • Align marginal ridges • 3mm of overbite • Expansion through molars and premolars • IPR between premolars TREATMENT SEQUENCE FINAL INITIAL Treatment Discussion The patient had a complete open bite due to the habit of atypical swal- lowing. To perform a bite closure, it is necessary to achieve perfect align- ment and leveling of the teeth as well as obtaining accurate torque. Only then can we face the upper and lower occlusal planes. In addition, the two arches have been expanded at pre- molars and molars. The key to mak- ing a bite close quickly and easily is applying forces mesial to the arcade center of resistance, just so get a rota- tion of both occlusal planes. Despite using an extrusive mechan- ics with previous elastics, you can see in the photo finish smile that the re- lationship of the upper incisors has not worsened, thanks to the relative position of the brackets at the time of cementation. The patient also followed a rehabilitation treatment neuromuscular speech pathologist, to ensure the future stability of the case. Finishing Notes No debonds, no wire bends. Just oc- clusal adjustment. APPOINTMENT 3 2 WEEKS APPOINTMENT 7 57 WEEKS ÿPage E3

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