LD Class 3 w AOB

you can align and improve the cross bite but the AOB will not correct

you can treat the lower arch independently of the upper...so just a lower arch with IPR and a bonded retainer may be the way to go as expansion in the upper will mean Hawley retention... which he didnt wear... so may be no point doing it again... and lowers will align fine on their own

Ian

Hi Ian,

Could you give me some advice on this case?
Pt C/O: lower teeth crowded, uppers a little as well but not so concerned about these although willing to have brace on both.
HPC: had ortho as a teen but didn't wear retainers - had upper expansion on URA and lower fixed. Reports no problem with his bite or function.

Summary of findings:
Class 3 on skeletal base 3 with LAFH increase, NLA within avg (slighty acute)
Crowding v mild upper, mod lower 3-3
OJ normal, AOB
Buccal segments class 3 1/2 unit RHS, LHS class 1 xbite (from 3-6)
canine RHS class 3 1/2, LHS class 1
upper arch a little narrow and V shaped
OH poor
some decal lowers from ortho previous

Problem list: crowding lowers, xbite LHS, AOB, R buccal and canine relationship

Aims of tx: relief of crowding, align, xbite correction, level, AOB reduction. Buccal segment RHS class 1

Quite a bit going on. It is feasible to expect a correction to this malocclusion or is he orthognathic or compromised option?

Photos: https://www.dropbox.com/sh/098w6x86s64r69k/AADaqTpRnEu1rVoBgulA2EHka?dl=0