Correção da mordida aberta anterior utilizando o sistema Invisalign®: relato de caso

Abstract

Orthodontic treatment of open bite remains one of the most difficult challenges orthodontists face nowadays, as vertical incompetence of the arches due to poor dental or skeletal position does not allow correct occlusion between antagonistic teeth. A relatively new technology, called Invisalign® (Align Technology, Santa Clara, CA, USA), has been widely used in orthodontics for approximately 20 years. The comfort and aesthetics provided by this system become quite attractive, especially for adult patients. The objective of this study is to report a case of anterior open bite in adult treated with Invisalign®. A 40-year-old patient had the chief complaint of anterior open bite. The extra oral evaluation revealed the presence of an active lip seal, increased lower third of the face along with anterior open bite. The treatment objective was to correct anterior open bite, posterior crossbite and to promote proper teeth leveling and alignment. Because the patient was reluctant of orthognathic surgery approach, the orthodontic treatment focused on dental compensation even though a skeletal problem was diagnosed. After an initial phase with the lingual spur, which lasted 5 months, it was possible to observe a considerable closure of the anterior open bite. After that, the patient used a series of 25 aligners, besides interproximal reduction (IPR) in the region of upper and lower incisors, along with optimized attachments. The patient changed aligners with an interval of 15 days. It was necessary to use additional aligners so that the case would be better finalized. At the end of the treatment the initial anterior open bite was completely closed.