Dr Jorge Carlos Li Wong
16 year old female patient, went for consultation with antecedent of interceptive orthodontics (guide of eruption).
At clinical intraoral examination, an anterior open bite was observed, class II molar relationships, class I canine relations, lower middle line was deviated 2 mm to the right, diastema between upper central incisors, triangular superior arch, and quadrangular inferior arch. The ideal (orthognathic surgery) and compensatory treatment (molar intrusion) was proposed. The patient chose the compensatory treatment. Mini-screws were placed in the palatal area, a TPA was also placed to generate intrusion of the posterior sector, extrusion and intrusion, and intermaxillary elastics as well (IME) to obtain an adequate OB and OJ. At the end of the treatment, the interconsultation was performed by the specialty of Periodontics and Implants for Smile design.
The patient was evaluated periodontally in an integral manner and it was observed that there was a discrepancy between the zeniths of sextant 2 and the radiographic evaluation showed minimal bone loss. The corresponding evaluation was made in order to choose the digital smile design and the treatment was done through gingivectomies and gingivoplasties to bring back the gingival contour and smile harmony. Follow ups were done and currently the patient shows a nice and healthy gingiva.
