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Case study Durin-Leo-case-study-1

Case details


Orthodontics – General crowding, inverted bite, dystopia of multiple teeth

Before / After

A before and after image

Durina-before-1 Durina-after

Case description

The patient came to us with a problem of general crowding in the upper and lower dental arch, and with an inverted bite of the upper left, second incisor.


The space to align teeth with an orthodontic appliance, any appliance, can be achieved by one of three ways. By expanding the dental arches, by minimally narrowing the teeth via air rotor stripping method and teeth extraction. Even though the expanding of dental arches sounds like the best option and it’s the easiest to do, there are consequences to moving the teeth outwards too much. A long-term consequence is the withdrawal of bone and gums on the teeth which were moved which, from a medical standpoint, puts them in a worse position than they were at the start of orthodontic treatment.


By completing an exhaustive analysis (model analysis, orthopantomogram, LL craniogram) it was calculated that the optimal way of attaining space for alignment, without moving them outside of the bone, was removing 4 premolars.

The case was finished in ideal occlusion where the upper incisors lean against the lower ones, the middles of the dental arches are in alignment, the upper canines are behind the lower canines in the ideal class I, the teeth are aligned in ideal arches, and the inverted bite of the upper left second incisor was corrected. The level of occlusion quality in which this case ended is one of the more important prerequisites for long-term stability.