A case study of retroclined upper anteriors & anterior open bite OrthoPath Clear Aligners

A case study of retroclined upper anteriors & anterior open bite OrthoPath Clear Aligners

A case study of retroclined upper anteriors & anterior open bite OrthoPath Clear Aligners

A 24-year-old female patient was reported with a chief concern of anterior malalignment of both jaws. Her primary concern revolved around the misalignment and retroclination of her anterior teeth, as well as the crowding she experienced when smiling.

She wanted to improve her smile by reducing the upper crowding & leveling of upper incisors. She was successfully treated with OrthoPath Clear Aligners with her chief complaint resolved and improved facial and smile aesthetics.


Invisible braces are becoming increasingly popular in Australia. Initially, it was thought that aligners could only treat a limited number of minor malocclusions but now their scope has increased. The following case study is an example of results and patient satisfaction achieved with OrthoPath Clear Aligners.

Case History

A 24-year-old female patient reported to a private practice, with the chief concern of anterior crowding in both jaws & retroclination in the upper jaw. The patient did not have any relevant medical condition and her general health was good. She had undergone no dental work & periodontal health of her teeth was good without any mobility. A full orthodontic examination was carried out and records were organized for analysis including intra-oral and extra-oral photographs, OPG, and lateral cephalogram with upper and lower alginate impressions for study models.


Analysis revealed retroclined upper centrals and crowded lower anterior teeth. Right and left molars were in class I relation and the canine relationship was not applicable. The upper midline was centered and the lower slightly shifted towards the left.

Orthodontic clinical records along with PVS impressions and PVS bite registration were sent to OrthoPath. A treatment plan including the extraction along with before and after treatment animations with the expected treatment outcome was provided by OrthoPath to be thoroughly evaluated and discussed with the patient.

After a discussion with the patient, the treatment plan provided by OrthoPath was approved without any modifications.

Once the treatment plan was approved the aligner movement record form and an EBT record form arrived from OrthoPath in two weeks.



Treatment Objectives

As per the patient's concern, the treatment objectives for Orthodontic treatment were:

  • To improve the patient's smile.
  • Alignment and leveling of both arches to achieve the ideal arch form.
Treatment Alternatives

The following treatment options were discussed with the patient in detail:

  • Arch alignment with conventional braces
  • OrthoPath Clear Aligners for both upper and lower arches

The patient being 24 years old did not like the idea of using conventional braces as it would have been socially embarrassing for her. She wanted to treat the malocclusion in a hassle-free and invisible way that did not pose any social dilemma for her, therefore she chose OrthoPath Clear Aligners.

An Orthodontic treatment and diagnostic form were discussed with her in detail as well as the need for the upper & lower premolar extraction to eliminate the crowding in both jaws. The patient was comfortable with extractions hence the treatment proceeded accordingly.

Treatment Progress

Extraction of all 1st premolars was required before wearing the 1st aligner and the patient was kept on zero aligners provided by OrthoPath.

For this case, 17 upper and 16 lower aligners were required. The aligners were worn 22 hours per day and only removed while eating or cleaning teeth. Each upper and lower aligner was worn for a period of 2 weeks before moving to the next set.

The patient was seen every 2 weeks initially till she became comfortable with the aligner treatment. A lot of emphasis was placed on keeping good oral hygiene and It was maintained and monitored. The patient showed compliance and the case progressed well without any ill-fitting or mid-treatment concerns. Elastics were suggested for space closure & the customer wore the elastics compliantly & complete space closure, leveling & alignment was achieved. EBT was placed from the 8th aligner on the buccal aspects of the canines and first molars.

Results & Discussion

After the use of all aligners, both upper and lower arches were re-evaluated for any residual issue since refinement aligners for any residual movement are also provided. The patient was happy with the treatment result and did not wish to undergo refinement and hence was provided with retainers. Following are the final results of the patient.


The treatment of a seemingly complex case with increased over jet and deep bite was completed using OrthoPath Clear Aligners in 14 months.

Removable retainers were provided at the end of aligner treatment to retain the position of teeth and prevent any relapse. Patient was instructed to wear the retainers full time for the two months and then at night for the last 4 months.

The patient was happy with the treatment outcome and there was no relapse found after the 6 monthly visit.

Aligners can provide an excellent option for treating malocclusion in adults where the biggest hindrance is age and social commitments. Aligners can treat moderate malocclusions and the biggest factor in success of treatment is patient's compliance and dentist vigilance in maintaining a firm eye on case progress.

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