The Use of High Frequency Vibration and Clear Aligners in Management of an Adult Patient with Class III Skeletal Malocclusion with Open Bite and Severe Bimaxillary Protrusion: Case Report.

Tarek El-Bialy

doi:10.3390/dj8030075

Abstract

Adult orthodontic patients with skeletal Class III malocclusion, open bite and bimaxillary dentoalveolar protrusion are complex problems that normally require surgical intervention to correct. This is a report of an adult female with a skeletal Class III jaw relationship; in addition, the patient had anterior open bite and bimaxillary dentoalveolar protrusion. The patient also had three premolars in the lower left quadrant. Treatment involved extracting the extra premolar distal to lower left canine, retraction of lower anterior teeth, closing extraction space and anterior open bite utilizing Invisalign clear aligners. The patient initially changed aligners every week before this was changed to 3–5 days after starting to use a high frequency vibration (HFV = 120 Hz) device. Satisfactory results were achieved in a relatively shorter period. Comparing before and after treatment cone beam computed tomography revealed that new bone has been formed labial to the lower incisors after their retraction/correction of their initial proclined position and the use of HFV and myofunctional therapy without gingival graft. The present case report shows the comprehensive multidisciplinary team approach in treatment for such cases and the advantage of using HFV to improve bone formation.

Highlights

Class III malocclusion is challenging to treat with satisfactory results especially in adults
Clear aligners provide less pain and are more hygienic as well as being more acceptable by adult patients compared to fixed orthodontic appliances
The first reported anterior cross bite case treated by serial clear aligners was in 2009 by Park and Kim [1] that showed serial clear aligners made in the laboratory were able to move teeth sequentially into normal occlusion

Summary

Introduction

Class III malocclusion is challenging to treat with satisfactory results especially in adults. A recent study showed that clear aligners are as effective as fixed orthodontic appliances in correcting open bite cases [2]. Recent case reports showed that clear aligners could be successfully used to correct Class III malocclusion and open bite cases with or without surgery. Clear aligners have been successfully used for the correction of the skeletal Class III jaw relationship in adults by surgery first clear aligners were used to finish the patient’s occlusion [3,4,5]. Extraction of lower incisor has long been reported to be an acceptable treatment approach in Class III malocclusion cases especially in adults [6,7,8].

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Results

Conclusion