Not all cases that exhibit bimaxillary proclination require extraction. The first step is the diagnosis of such cases.
In any diagnostic process, excellent records must be taken. Please click here for our video on record taking.
Starting with the extraoral records, we can gather that the patient has a pleasing skeletal profile. The E – Line, where the tip on the nose, upper lip, lower lip and chin point lie along the same line can provide a rough guideline for profile aesthetics.
From this we can gather that the presence of dental bimaxillary protrusion does not have a strong skeletal component. Retraction of the incisors from the space obtained from premolar extractions are not needed.
In order to create space within the arch, we will be performing interproximal reduction of 0.5mm per contact point, and arch expansion of 3mm which will retrocline the upper incisors.
Judicious use of interproximal reduction and limited expansion has provided an acceptable result. Total treatment time 15 months.
Total aligners – 30 (including refinement)