PCC : Cross (Scissor) Bite on LHS

2022-12-23 Pre-Op

Analysis

• Class 2 Div 2 – 95% deep bite with
  • RHS : Molar and canine class 2
  • LHS : Molar and canine class 1
• completed cross bite on the LHS across 34,35, and 26 pal cusps have gouged out the occlusal of the 36
• Pegged 12,22
• Bimax retrusive

Treatment Plan

Staged Treatment

• Staged 1 – Level and Align to Class 2 occlusion – 9 to 12 months

• Stage 2 – Class 2 correction – 12 to 14 months

• Stage 3 Finishing – 4 to 6 months

Timing 2 to 3 years

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2023-05-15 – SA(13/27)

Progress Scan – 3 months

• Deep bite correcting and upper central detorquing

• LHS : Cross Bite not corrected yet

• RHS : Class II elastics LHS : Cross Elastics

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2023-08-16 SA(13/27)

Progress Scan – 6 Months

• RHS palatal – Open contact
• LHS palatal – Transitional Hyper contact as cross bite correcting

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2023-10-25 (Stage 1/3 )

SA (13/27) – Progress Scan – 8 Months

Hyper contact 26/36, 16/46 , 17/47

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2023-11-29 (Stage 1/3 )

SA (13/27) – Progress Scan 9 months

• Deep Bite correction

• Correction of upper central retroclination

• Bite Opening while class II correcting

• Cross Bite 24,25 correction

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2023-12-20 SA (13/27)

Progress Scan – 10 months end of stage 1

Remove attachments for Myobrace – 10 months end of stage 1

• Left attachments on 12, 22 to over correct rotation
• RHS : Bite Opening but molar Class II correcting

• LHS : Cross Bite corrected

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2024-01-03 Pre-Op for Stage 2 (Two Weeks Post Buttons Removal )

• ALLOWED 2 WEEKS FOR POSTURAL ADJUSTMENT OF POSTERIOR TEETH TO CAPTURE CURRENT OCCLUSION FOR THE SCAN FOR STAGE 2

Stage 2 of 3 SA(8/15)

• Hypercontact 16/46 as the open bite from previous (2023-08-16) review is closing on the RHS

• Cross bite correction – LHS premolars now in occlusion

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2024-06-04 – S2(8-15) Review 5 months into stage 2 – Start Myobrace

• RHS still correcting Class II
• LHS Class I but bite is still open

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2024-06-24 : Myobrace use to allow occlusion to settle

• Myobrace Settling in well
• 22 is slightly in hyper occlusion
• RHS is in Class I
• LHS is in Class II

Review in 3/12 for 3rd stage

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2024-10-08 Stage 3 of 3 post myobrace

Review Myobrace Result and Scan for Stage 3 of 3

• Myobrace 4 months wear – Compliance has been less than perfect so we will move onto stage 3 to correct Class II RHS

• Bite is still not settled in. Has not worn Myobrace regularly

• Compliance is not good even by patient’s admittance.

Stage 3 setup to aligner midline – S3(11-14)

• Correct Class II RHS

• 43 – TIP MESIALLY
• IPR 43/42/41/31 AND TIP MESIALLY EXCEPT 31

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