Case 2 Treatment Plan Report

I. Facial Information

Average-angle, straight profile.

II. Intraoral Information

Maxillary teeth 11 and 21 are crowded and protrusive; teeth 12 and 22 are lingually inclined; narrow arch form. Mandibular teeth 3-3 are crowded and inclined; anterior occlusal plane is uneven. Teeth 18, 28, 38 and 48 are present.

III. X-ray Information

IV. Pathological Analysis

• Facial type: average-angle, straight profile.
• Lip soft tissues: aligned.
• Midline: deviated 1.7 mm.
• Maxillary arch: Class I crowding; mandibular arch: Class II crowding.
• Anterior occlusal relationship: Class I overjet; molar occlusal relationship: neutral occlusion.
• Maxillary teeth 11 and 21 are crowded and protrusive, and 12 and 22 are lingually inclined, with a narrow arch form leading to dental crowding.
• Mandibular teeth 3-3 are crowded and inclined, and the anterior occlusal plane is uneven.
• Teeth 18, 28, 38 and 48 are present.

V. Initial Diagnosis

1. This case is confirmed to be suitable for clear aligner treatment, and it is a case of ordinary difficulty. The platform must closely monitor the patient's aligner wear and schedule follow-up appointments on time.
2. This case focuses on correcting the anterior dental irregularity, optimizing the overall arch form, adjusting and stabilizing the molar occlusal relationship, optimizing the smile line, improving the facial profile, and enhancing aesthetics. Combined clear aligner techniques such as interproximal reduction (IPR), arch expansion, and intrusion will be used.
3. Treatment duration: maxillary arch 21 steps (10-11 months); mandibular arch 31 steps (15-16 months).
4. After treatment, a retainer must be worn for 1 year to prevent the treatment results from relapsing.

Note: All clear aligner treatments require good patient compliance. The aligners must be worn as instructed and in the correct order to ensure optimal treatment outcomes.

VI. Maxillary Treatment Procedure

Key points of maxillary treatment:

1. Seven attachments need to be bonded to the maxillary teeth to provide anchorage for the clear aligners.
2. Key challenges: aligning the anterior teeth and expanding the molars.
3. The bilateral incisors are labially moved to align the dentition and adjust the overjet to a normal state; buccal expansion of the molars stabilizes the molar occlusal relationship.

VII. Mandibular Treatment Procedure

Key points of mandibular treatment:

1. Seven attachments need to be bonded to the mandibular teeth to provide anchorage for the clear aligners.
2. Key challenges: derotating and aligning the anterior teeth, and expanding the molars.
3. Interproximal reduction and arch expansion are used to create space, then pressure ridges intrude the anterior teeth to align them and adjust the overbite while aligning the midlines; molar expansion further stabilizes the occlusion.

VIII. Orthodontic Procedure Explanation

1. The main function of pressure ridges is to help the clear aligners provide unidirectional force, such as intrusion and lingual movement.
2. The main function of bonded attachments is to help retain the clear aligners and to provide additional anchorage.
3. Interproximal reduction (also called enamel stripping or IPR) is polishing the spaces between teeth to create room for tooth movement.

IX. Orthodontic Treatment Result Comparison

Case 3 Treatment Plan (Final Version)

I. Basic Information

Name: Patient 3

Gender: Female

Age: 31

City: Zhengzhou

II. Facial Information

III. Intraoral Information

IV. X-ray - Lateral Cephalogram

Cephalometric analysis results:

• Maxilla relative to the anterior cranial base (down: retrognathic, up: prognathic): Normal
• Maxilla relative to the cranium (down: forward, up: backward)
• Maxillary length (down: short, up: long): Normal
• Mandible relative to the anterior cranial base (down: retrognathic, up: prognathic): Normal
• Mandible (down: retrognathic, up: prognathic)
• Posterior mandibular position (down: forward, up: backward)
• Maxilla relative to facial convexity (down: retrognathic, up: prognathic)
• Facial type (down: low angle, up: high angle)
• Mandibular plane inclination (down: small, up: large)
• Mandibular ramus length (down: small, up: large)
• Anterior cranial base (down: too short, up: too long)
• Growth pattern: Normal
• Chin development (down: underdeveloped/retrognathic, up: overdeveloped/protrusive)
• Skeletal Class I
• Maxillomandibular relationship (down: retrognathic, up: prognathic)
• Lower-to-total face height ratio (down: smaller, up: larger)
• Normal anteroposterior facial growth; no clockwise or counterclockwise rotation

V. X-ray - Panoramic

VI. Pathological Analysis

1. The maxillary and mandibular midlines deviate 0.6 mm to the right; the chin point is basically aligned and the lip soft tissues are symmetrical. Facial type: average-angle, slightly convex profile. Maxillary arch: Class III crowding; mandibular arch: Class III crowding. Anterior occlusal relationship: Class II overjet; molar occlusal relationship: neutral occlusion.
2. Maxillary teeth 11 and 21 are excessively labially inclined, and 12 and 23 are rotated, with an overall narrow arch form. Mandibular teeth 31 and 41 are crowded and proclined, 32 and 42 are lingually inclined, and 43 is labially displaced out of the arch; the anterior occlusal plane is uneven. Teeth 18 and 48 are present.

VII. Initial Diagnosis

1. This case is confirmed to be suitable for clear aligner treatment, but it is a case of complex difficulty. The platform must closely monitor the patient's aligner wear and schedule follow-up appointments on time.
2. This case focuses on correcting the tilting caused by anterior crowding, stabilizing the molar occlusal relationship, optimizing the arch form, aligning the midlines, moderately retracting the anterior teeth, improving the facial profile, and enhancing aesthetics. Combined clear aligner techniques such as interproximal reduction (IPR), arch expansion, and elastics will be used.
3. Treatment duration: maxillary arch 45 steps (22-23 months); mandibular arch 37 steps (18-19 months).
4. After treatment, a retainer must be worn for 1 year to prevent the treatment results from relapsing.

Note: All clear aligner treatments require good patient compliance. The aligners must be worn as instructed and in the correct order to ensure optimal treatment outcomes.

VIII. Maxillary Treatment Procedure

Key points of maxillary treatment:

1. Six attachments need to be bonded to the maxillary teeth to provide anchorage for the clear aligners.
2. The key challenge is correcting the anterior protrusion and expanding the arch form.
3. Molar arch expansion and interproximal reduction are used to create space, retract the anterior teeth, and align the dentition, achieving an aesthetically aligned anterior segment and an optimized, stable molar occlusion.

IX. Mandibular Treatment Procedure

Key points of mandibular treatment:

1. Six attachments need to be bonded to the mandibular teeth to provide anchorage for the clear aligners.
2. Key challenges: aligning and intruding the anterior teeth; expanding the molars.
3. The arch is first expanded in the molar region for optimization, then interproximal reduction is used to create space to align the dentition and the midlines; pressure ridges intrude the anterior segment to establish a proper occlusal plane.

X. Orthodontic Procedure Explanation

1. The main function of bonded attachments is to help retain the clear aligners and to provide additional anchorage.
2. Interproximal reduction (also called enamel stripping or IPR) is polishing the spaces between teeth to create room for tooth movement.
3. The main function of pressure ridges is to help the clear aligners provide unidirectional force, such as intrusion and lingual movement.

XI. Orthodontic Treatment Result Comparison

Case 4 Treatment Plan (Final Version)

1. Basic Information

Name: Patient 4

Gender: Female

Age: 27

City: Guangzhou

2. Facial Information

3. Intraoral Information

4. Cephalometric X-ray (Lateral)

Cephalometric analysis results:

• Maxilla position relative to anterior cranial base (downward = retrusion, upward = protrusion)
• Maxilla position relative to anterior cranial base: normal
• Maxilla position relative to cranium (downward = anterior, upward = posterior)
• Maxillary length: normal (downward = shorter, upward = longer)
• Mandible position relative to anterior cranial base: normal (downward = retrusion, upward = protrusion)
• Mandible (downward = retrusion, upward = protrusion)
• Maxilla relative to facial convexity (downward = retrusion, upward = protrusion)
• Posterior mandible position (downward = anterior, upward = posterior)
• Facial type (downward = low angle, upward = high angle)
• Mandibular plane inclination (downward = small, upward = large)
• Mandibular ramus length (downward = small, upward = large)
• Anterior cranial base (downward = too short, upward = too long)
• Growth pattern: normal
• Chin development (downward = underdeveloped/retrusive, upward = overdeveloped/protrusive)
• Skeletal Class I
• Maxillomandibular relationship (downward = retrusion, upward = protrusion)
• Lower-to-total facial height ratio (downward = smaller, upward = larger)
• Normal anterior-posterior facial growth, no clockwise/counterclockwise rotation

5. Panoramic X-ray

6. Pathological Analysis

1. Maxillary and mandibular midlines deviate 2mm to the left; chin point essentially centered; lip soft tissues symmetrical; facial type: dental bimaxillary protrusion; maxillary arch crowding Class I, mandibular arch crowding Class I; anterior occlusion: increased overjet and overbite; molar occlusion: tendency toward Angle Class II;
2. Maxillary 11 and 21 excessively labially inclined and protruded; 14 and 24 lingually inclined; 15 buccally displaced; overall dental arch narrow and elongated; mandibular 31, 41 and 42 crowded and protruded; 18, 28, 38 and 48 present;

7. Initial Diagnosis

1. This case can be treated with clear aligner therapy, but it is a case of complex difficulty requiring close monitoring of the patient's aligner wear and timely follow-up;
2. This case focuses on correcting bimaxillary protrusion of the anterior teeth, stabilizing molar occlusion, optimizing arch form, significant retraction, and improving facial profile and aesthetics. Combined clear aligner techniques such as mesial movement, expansion and extraction will be adopted;
3. Treatment duration: maxillary 61 steps (30-31 months), mandibular 59 steps (29-30 months);
4. After treatment, a retainer should be worn for 1 year to prevent relapse;

Note: All clear aligner treatments require good patient compliance. Aligners must be worn in order as instructed to ensure optimal treatment results.

8. Maxillary Treatment

Key points of maxillary treatment:

1. 9 attachments need to be bonded on the maxillary teeth to enhance anchorage for the aligners;
2. The key difficulty is correcting the protrusion of the anterior teeth and optimizing the overall arch form;
3. Extraction spaces of bilateral first premolars will be used to retract the anterior teeth, resolving lip protrusion; mesial movement of the molars will then close the remaining spaces and optimize the molar occlusion;

9. Mandibular Treatment

Key points of mandibular treatment:

1. 8 attachments need to be bonded on the mandibular teeth to enhance anchorage for the aligners;
2. Key difficulties: anterior teeth retraction and space reservation for prosthetic restoration;
3. Extract carious tooth 47; use the extraction space and the early missing site for retraction synchronized with the maxilla, achieve proper overjet and overbite, align the dentition, move 48 mesially to establish occlusion, and reserve space for the restoration of 46;

10. Orthodontic Operation Notes

1. The main function of bonded attachments is to help the aligners with retention, and they also provide anchorage;
2. The main function of pressure ridges is to provide unidirectional forces for the aligners, such as intrusion and lingual movement;

11. Treatment Outcome Comparison

Case 5 Treatment Plan (Final Version)

1. Basic Information

Name: Patient 5

Gender: Female

Age: 27

City: Xi'an

2. Facial Information

3. Intraoral Information

4. Cephalometric X-ray (Lateral)

Cephalometric analysis results:

• Maxilla position relative to anterior cranial base (downward = retrusion, upward = protrusion)
• Maxilla position relative to anterior cranial base: normal
• Maxilla position relative to cranium (downward = anterior, upward = posterior)
• Maxillary length: normal (downward = shorter, upward = longer)
• Mandible position relative to anterior cranial base: normal (downward = retrusion, upward = protrusion)
• Mandible (downward = retrusion, upward = protrusion)
• Maxilla relative to facial convexity (downward = retrusion, upward = protrusion)
• Posterior mandible position (downward = anterior, upward = posterior)
• Facial type (downward = low angle, upward = high angle)
• Mandibular plane inclination (downward = small, upward = large)
• Mandibular ramus length (downward = small, upward = large)
• Anterior cranial base (downward = too short, upward = too long)
• Growth pattern: normal
• Chin development (downward = underdeveloped/retrusive, upward = overdeveloped/protrusive)
• Skeletal Class I
• Maxillomandibular relationship (downward = retrusion, upward = protrusion)
• Lower-to-total facial height ratio (downward = smaller, upward = larger)
• Normal anterior-posterior facial growth, no clockwise/counterclockwise rotation

5. Panoramic X-ray

6. Pathological Analysis

1. Maxillary and mandibular midlines deviate 1.9mm to the right; chin point essentially centered; lip soft tissues symmetrical; facial type: normal angle with straight profile; maxillary arch crowding Class III, mandibular arch crowding Class III; anterior occlusion: overjet Class II; molar occlusion: tendency toward Angle Class II;
2. Maxillary anterior teeth 3-3 are crowded, causing overlapping rotation; 21 is severely rotated and labially inclined; mandibular 31, 32 and 42 are crowded and protruded; 41, 33 and 43 are lingually inclined; the overall arch is crowded with an uneven occlusal plane in the anterior region; 18, 28, 38 and 48 are present; 48 is impacted;

7. Initial Diagnosis

1. This case can be treated with clear aligner therapy, but it is a case of complex difficulty requiring close monitoring of the patient's aligner wear and timely follow-up;
2. This case focuses on correcting the crooked teeth caused by anterior crowding, stabilizing molar occlusion, optimizing arch form, aligning the midline, and improving facial profile and aesthetics. Combined clear aligner techniques such as interproximal reduction, expansion and elastics will be adopted;
3. Treatment duration: maxillary 41 steps (20-21 months), mandibular 37 steps (18-19 months);
4. After treatment, a retainer should be worn for 1 year to prevent relapse;

Note: All clear aligner treatments require good patient compliance. Aligners must be worn in order as instructed to ensure optimal treatment results.

8. Maxillary Treatment

Key points of maxillary treatment:

1. 8 attachments need to be bonded on the maxillary teeth to enhance anchorage for the aligners;
2. The key difficulty is correcting the crowded, crooked anterior teeth and optimizing the overall arch form;
3. Strong anchorage elastics will be used for molar distalization and expansion; interproximal reduction will create space for anterior retraction and alignment, achieving aesthetically aligned anterior teeth and optimizing the molar occlusion;

9. Mandibular Treatment

Key points of mandibular treatment:

1. 8 attachments need to be bonded on the mandibular teeth to enhance anchorage for the aligners;
2. Key difficulties: anterior teeth alignment and intrusion, and molar expansion;
3. Elastics will first optimize the molar arch; spaces created by interproximal reduction and expansion will then align the dentition and align the midline; pressure ridges will intrude the anterior teeth to establish a proper occlusal plane;

10. Orthodontic Operation Notes

1. The main function of bonded attachments is to help the aligners with retention, and they also provide anchorage;
2. The main function of Class II elastics is to facilitate effective mesiodistal movement of the aligners;
3. Interproximal reduction (also called stripping or IPR) is to polish the interproximal surfaces of teeth to create space for correction;
4. The main function of pressure ridges is to provide unidirectional forces for the aligners, such as intrusion and lingual movement;

11. Treatment Outcome Comparison

Case 6 Treatment Plan (Final Version)

I. Basic Information

Name: Patient 6

Gender: Female

Age: 25

City: Guangzhou

II. Facial Information

III. Intraoral Information

IV. X-ray - Lateral Cephalogram

Cephalometric analysis results:

• Maxilla relative to the anterior cranial base (down: retrognathic, up: prognathic): Normal
• Maxilla relative to the cranium (down: forward, up: backward)
• Maxillary length (down: short, up: long): Normal
• Mandible relative to the anterior cranial base (down: retrognathic, up: prognathic): Normal
• Mandible (down: retrognathic, up: prognathic)
• Posterior mandibular position (down: forward, up: backward)
• Maxilla relative to facial convexity (down: retrognathic, up: prognathic)
• Facial type (down: low angle, up: high angle)
• Mandibular plane inclination (down: small, up: large)
• Mandibular ramus length (down: small, up: large)
• Anterior cranial base (down: too short, up: too long)
• Growth pattern: Normal
• Chin development (down: underdeveloped/retrognathic, up: overdeveloped/protrusive)
• Skeletal Class I
• Maxillomandibular relationship (down: retrognathic, up: prognathic)
• Lower-to-total face height ratio (down: smaller, up: larger)
• Normal anteroposterior facial growth; no clockwise or counterclockwise rotation

V. X-ray - Panoramic

VI. Pathological Analysis

1. The maxillary and mandibular midlines deviate 2.1 mm to the left; the chin point is basically aligned and the lip soft tissues are symmetrical. Facial type: average-angle, slightly convex profile. Maxillary arch: Class II crowding; mandibular arch: Class III crowding. Anterior occlusal relationship: Class II overbite and overjet; molar occlusal relationship: tending toward Angle Class II occlusion.
2. Maxillary teeth 11 and 21 are excessively labially inclined, and 12 is rotated; the bilateral premolar regions are inclined inward of the arch. Mandibular teeth 31 and 41 are crowded and proclined, and 34, 44 and 45 are lingually inclined; overall crowding is present and the anterior occlusal plane is uneven.
3. Teeth 18, 28, 38 and 48 are present.

VII. Initial Diagnosis

1. This case is confirmed to be suitable for clear aligner treatment, but it is a case of complex difficulty. The platform must closely monitor the patient's aligner wear and schedule follow-up appointments on time.
2. This case focuses on correcting the anterior overbite and overjet, stabilizing the molar occlusal relationship, optimizing the arch form, aligning the midlines, improving the facial profile, and enhancing aesthetics. Combined clear aligner techniques such as interproximal reduction (IPR), arch expansion, and elastics will be used.
3. Treatment duration: maxillary arch 45 steps (22-23 months); mandibular arch 42 steps (21-22 months).
4. After treatment, a retainer must be worn for 1 year to prevent the treatment results from relapsing.

Note: All clear aligner treatments require good patient compliance. The aligners must be worn as instructed and in the correct order to ensure optimal treatment outcomes.

VIII. Maxillary Treatment Procedure

Key points of maxillary treatment:

1. Six attachments need to be bonded to the maxillary teeth to provide anchorage for the clear aligners.
2. The key challenge is correcting the anterior protrusion and optimizing the overall arch form.
3. Strong anchorage elastics are used for molar distalization and arch expansion, and then interproximal reduction creates space to retract and align the anterior teeth, achieving an aesthetically aligned anterior segment and an optimized, stable molar occlusion.

IX. Mandibular Treatment Procedure

Key points of mandibular treatment:

1. Six attachments need to be bonded to the mandibular teeth to provide anchorage for the clear aligners.
2. Key challenges: aligning and intruding the anterior teeth; labial inclination of the premolars.
3. Elastics are used first to optimize the arch form in the molar region, then the space is used to align the dentition and the midlines; pressure ridges intrude the anterior segment to establish a proper occlusal plane.

X. Orthodontic Procedure Explanation

1. The main function of bonded attachments is to help retain the clear aligners and to provide additional anchorage.
2. The main function of Class II elastics is to assist the clear aligners in effective mesiodistal tooth movement.
3. Interproximal reduction (also called enamel stripping or IPR) is polishing the spaces between teeth to create room for tooth movement.
4. The main function of pressure ridges is to help the clear aligners provide unidirectional force, such as intrusion and lingual movement.

Note: If you do not understand any of the professional details, the platform will arrange a professional doctor to explain the plan by phone.

XI. Orthodontic Treatment Result Comparison