{"id":4883,"date":"2024-04-18T11:13:02","date_gmt":"2024-04-18T11:13:02","guid":{"rendered":"https:\/\/ormcoeurope.com\/ro\/?p=4883"},"modified":"2025-05-09T11:25:29","modified_gmt":"2025-05-09T11:25:29","slug":"case-report-spark-treatment-of-a-growing-patient-with-class-ii-deepbite-and-crowding-in-constricted-arches","status":"publish","type":"post","link":"https:\/\/ormcoeurope.com\/ro\/case-report-spark-treatment-of-a-growing-patient-with-class-ii-deepbite-and-crowding-in-constricted-arches\/","title":{"rendered":"Treatment of a growing patient with Class II, deep bite and crowding in constricted arches"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_section][vc_row][vc_column width=&#8221;2\/3&#8243;][vc_column_text css=&#8221;&#8221;]<span class=\"text-dark-grey\">CASE REPORT<\/span><\/p>\n<h1><span class=\"text-spark\">Spark: Treatment of a growing patient with Class II, deep bite and crowding in constricted arches.<\/span><\/h1>\n<p>[\/vc_column_text][vc_empty_space height=&#8221;40px&#8221;][vc_column_text]This article describes the treatment with Spark Clear Aligners of a 13 years-old female patient, who presented a CLASS II DIV. 1 caused by mandible retrusion, hypodivergent profile, crowding and constriction in both arches, high positioned canines, 6mm of deep bite and strong curve of spee.[\/vc_column_text][vc_empty_space height=&#8221;40px&#8221;]<div class=\"before-after\"><div class=\"ba-slider\" data-component=\"ba-slider\">\n                                <div class=\"slider\">\n                                    <label for=\"slider-range\" class=\"slider-label\">Move image comparison slider<\/label>\n                                    <input type=\"range\" min=\"0\" max=\"100\" value=\"50\" class=\"slider-range\" id=\"slider-range\" data-ba-range=\"\">\n                                    <div class=\"slide slide--overlay\" data-ba-overlay=\"\">\n                                         <figure class=\"slide-figure slide-figure--overlay\">\n                                            <img loading=\"lazy\" decoding=\"async\" width=\"1460\" height=\"730\" src=\"https:\/\/ormcoeurope.com\/ro\/wp-content\/uploads\/sites\/31\/2025\/05\/Before-web-1460x730.jpg\" class=\"attachment-before-after size-before-after\" alt=\"\" \/>\n                                            <figcaption class=\"slide-caption slide-caption--before\">\n                                                  <span>BEFORE<\/span>\n                                             <\/figcaption>\n                                         <\/figure>\n                                    <\/div>\n                                    <div class=\"slide-toggle\" data-ba-toggle=\"\">\n                                        <span class=\"slide-thumb\">\n                                           <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"18\" height=\"10\"\n                                                viewBox=\"0 0 18 10\" fill=\"#fff\">\n                                              <path d=\"M12.121 4.703V.488c0-.302.384-.454.609-.24l4.42 4.214a.33.33 0 0 1 0 .481l-4.42 4.214c-.225.215-.609.063-.609-.24V4.703z\"><\/path>\n                                              <path d=\"M5.879 4.703V.488c0-.302-.384-.454-.609-.24L.85 4.462a.33.33 0 0 0 0 .481l4.42 4.214c.225.215.609.063.609-.24V4.703z\"><\/path>\n                                           <\/svg>\n                                        <\/span>\n                                    <\/div>\n                                    <div class=\"slide\">\n                                       <figure class=\"slide-figure\">\n                                            <img loading=\"lazy\" decoding=\"async\" width=\"1460\" height=\"730\" src=\"https:\/\/ormcoeurope.com\/ro\/wp-content\/uploads\/sites\/31\/2025\/05\/After-web-1460x730.jpg\" class=\"attachment-before-after size-before-after\" alt=\"\" \/>\n                                            <figcaption class=\"slide-caption slide-caption--after\">\n                                                <span>AFTER<\/span>\n                                            <\/figcaption>\n                                        <\/figure>\n                                    <\/div>\n                                <\/div>\n                           <\/div><\/div>[\/vc_column][vc_column width=&#8221;1\/3&#8243;][vc_widget_sidebar sidebar_id=&#8221;actualidad&#8221;][vc_btn title=&#8221;Go to case report gallery&#8221; style=&#8221;btn&#8221; color=&#8221;secondary&#8221; align=&#8221;left&#8221; i_icon_fontawesome=&#8221;fas fa-th&#8221; css=&#8221;&#8221; button_block=&#8221;true&#8221; add_icon=&#8221;true&#8221; el_class=&#8221;full-width&#8221; link=&#8221;url:https%3A%2F%2Formcoeurope.com%2Fro%2Fcase-reports%2F|title:Case%20reports&#8221;][\/vc_column][\/vc_row][\/vc_section][vc_section][vc_row][vc_column][\/vc_column][\/vc_row][\/vc_section][vc_section full_width=&#8221;stretch_row&#8221; css=&#8221;.vc_custom_1713437392169{background-color: #66615f !important;}&#8221;][vc_row equal_height=&#8221;yes&#8221; content_placement=&#8221;middle&#8221;][vc_column width=&#8221;2\/3&#8243;][vc_column_text el_class=&#8221;wpb_text_column&#8211;white&#8221;]<strong>Dr. Andr\u00e9 El Zoghbi*, France<\/strong><\/p>\n<p>Dr. Andr\u00e9 El Zoghbi* (Dr. Z) earned his dental degree from the Lebanese University of Beirut and his Master\u2019s degree in Orthodontics and Orthopaedics from the Paris VII University of France. After his speciality studies, he completed a 2 years research program on biomaterials in Orthodontics in the French National Health Research Institute (INSERM) followed by a four year Associate Assistant Lecturer in Orthodontics at the Paris VII University giving lectures for Postgraduate students along with giving Orthodontic Clinical training at the Hotel Dieu de Paris hospital in Paris. He is established in his private practice at Choisy le Roi in the suburbs of Paris and has treated more than 2000 patients with Clear Aligners. Since January 2020 he is a key expert and Speaker for Spark Clear Aligners.[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/3&#8243;][vc_single_image image=&#8221;4909&#8243; img_size=&#8221;full&#8221; style=&#8221;vc_box_circle&#8221; css=&#8221;&#8221;][\/vc_column][\/vc_row][\/vc_section][vc_section][vc_row][vc_column width=&#8221;1\/3&#8243; css=&#8221;.vc_custom_1715327738194{padding-top: 1px !important;padding-right: 1px !important;padding-bottom: 1px !important;padding-left: 1px !important;}&#8221;][vc_single_image image=&#8221;4886&#8243; img_size=&#8221;full&#8221; onclick=&#8221;link_image&#8221; css=&#8221;&#8221;][\/vc_column][vc_column width=&#8221;1\/3&#8243; css=&#8221;.vc_custom_1715327749675{padding-top: 1px !important;padding-right: 1px !important;padding-bottom: 1px !important;padding-left: 1px !important;}&#8221;][vc_single_image image=&#8221;4887&#8243; img_size=&#8221;full&#8221; alignment=&#8221;center&#8221; onclick=&#8221;link_image&#8221; css=&#8221;.vc_custom_1746789632120{margin-right: 0px !important;margin-left: 0px !important;}&#8221;][\/vc_column][vc_column width=&#8221;1\/3&#8243; css=&#8221;.vc_custom_1715327758910{padding-top: 1px !important;padding-right: 1px !important;padding-bottom: 1px !important;padding-left: 1px !important;}&#8221;][vc_single_image image=&#8221;4888&#8243; img_size=&#8221;full&#8221; alignment=&#8221;right&#8221; onclick=&#8221;link_image&#8221; css=&#8221;&#8221;][\/vc_column][\/vc_row][vc_row gap=&#8221;1&#8243;][vc_column width=&#8221;1\/2&#8243; css=&#8221;.vc_custom_1715327937047{padding-top: 1px !important;padding-right: 1px !important;padding-bottom: 1px !important;padding-left: 1px !important;}&#8221;][vc_single_image image=&#8221;4889&#8243; img_size=&#8221;full&#8221; onclick=&#8221;link_image&#8221; css=&#8221;&#8221;][\/vc_column][vc_column width=&#8221;1\/2&#8243; css=&#8221;.vc_custom_1715327928385{padding-top: 1px !important;padding-right: 1px !important;padding-bottom: 1px !important;padding-left: 1px !important;}&#8221;][vc_single_image image=&#8221;4890&#8243; img_size=&#8221;full&#8221; alignment=&#8221;right&#8221; onclick=&#8221;link_image&#8221; css=&#8221;&#8221;][\/vc_column][\/vc_row][\/vc_section][vc_row][vc_column][vc_empty_space][vc_column_text]<\/p>\n<h3><span class=\"text-spark-orange\">Description of treatment plan<\/span><\/h3>\n<p><span class=\"text-dark-grey\">Having in mind the CS2 growth pattern presented by this patient, the treatment goal established was to correct the Class II by performing mandibular advancement \u2013 class II mechanics with elastics- together with upper arch retraction, while the deep bite was corrected through lower incisor intrusion and premolar extrusion. Also, expansion was planned to correct the arch constriction and create spaces to correct the crowding. <\/span><\/p>\n<p><span class=\"text-dark-grey\">To perform this, the following was planned in the Approver: expansion of both arches, applying buccal root torque in molars and premolars, derotation of 6s and flatten the curve of spee. In order to flatten the curve of spee, intrusion of incisors and second molars, together with premolar extrusion were requested. Also, identifying the need to have enough overjet for the planned movements, we had to overcorrect proclination of upper incisors and relative intrusion. Having identified that there was gum transparency in the root surface of lower incisors, also lingual root torque was requested for these teeth. Also, the auxiliaries used to apply class II biomechanics were buttons in both canines and molars.<\/span><\/p>\n<p><span class=\"text-dark-grey\">The first 4 aligners were worn for two weeks each as there was expansion planned. During this period no elastics were worn, to avoid cancelling the programmed expansion. Then, the next 10aligners were used according one week wear protocol and the patient started the elastics use(3.5oZ) during the night and after that full day elastic use. When the patient got to passive aligners, the protocol of elastics was 6oZ day and night, changing them every 12 hours until Class II is corrected.<\/span>[\/vc_column_text][vc_empty_space height=&#8221;40px&#8221;][\/vc_column][\/vc_row][vc_row full_width=&#8221;stretch_row&#8221; css=&#8221;.vc_custom_1713438310397{background-color: #f2f2f2 !important;}&#8221;][vc_column][vc_column_text]<\/p>\n<h3><span class=\"text-spark-orange\">After 8 months<\/span><\/h3>\n<p>When reviewed after 8 months, the patient still needed distal tip of tooth 2.3, but deep bite, crowding and class II were corrected. The archform achieved after this period was the one planned: parabolic Damon archform with constriction of second molars and derotation of first molars.[\/vc_column_text][vc_row_inner][vc_column_inner width=&#8221;1\/2&#8243; css=&#8221;.vc_custom_1715330754398{padding-top: 1px !important;padding-right: 1px !important;padding-bottom: 1px !important;padding-left: 1px !important;}&#8221;][vc_single_image image=&#8221;4891&#8243; img_size=&#8221;full&#8221; onclick=&#8221;link_image&#8221; css=&#8221;.vc_custom_1746789758541{padding-top: 0px !important;padding-bottom: 0px !important;}&#8221; el_class=&#8221;no-margin&#8221;][vc_single_image image=&#8221;4892&#8243; img_size=&#8221;full&#8221; onclick=&#8221;link_image&#8221; css=&#8221;.vc_custom_1746789768421{padding-top: 0px !important;padding-bottom: 0px !important;}&#8221; el_class=&#8221;no-margin&#8221;][\/vc_column_inner][vc_column_inner width=&#8221;1\/2&#8243; css=&#8221;.vc_custom_1715330743388{padding-top: 1px !important;padding-right: 1px !important;padding-bottom: 1px !important;padding-left: 1px !important;}&#8221;][vc_single_image image=&#8221;4893&#8243; img_size=&#8221;full&#8221; onclick=&#8221;link_image&#8221; css=&#8221;&#8221; el_class=&#8221;no-margin&#8221;][vc_single_image image=&#8221;4894&#8243; img_size=&#8221;full&#8221; onclick=&#8221;link_image&#8221; css=&#8221;&#8221; el_class=&#8221;no-margin&#8221;][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_section][vc_row][vc_column][vc_column_text]<\/p>\n<h3><span class=\"text-spark-orange\">At 10 months<\/span><\/h3>\n<p>[\/vc_column_text][vc_empty_space height=&#8221;40px&#8221;][\/vc_column][\/vc_row][vc_row][vc_column width=&#8221;1\/4&#8243; css=&#8221;.vc_custom_1715331339080{padding-top: 1px !important;padding-right: 1px !important;padding-bottom: 1px !important;padding-left: 1px !important;}&#8221;][vc_single_image image=&#8221;4895&#8243; img_size=&#8221;full&#8221; onclick=&#8221;link_image&#8221; css=&#8221;&#8221;][\/vc_column][vc_column width=&#8221;1\/4&#8243; css=&#8221;.vc_custom_1715331347406{padding-top: 1px !important;padding-right: 1px !important;padding-bottom: 1px !important;padding-left: 1px !important;}&#8221;][vc_single_image image=&#8221;4896&#8243; img_size=&#8221;full&#8221; onclick=&#8221;link_image&#8221; css=&#8221;&#8221;][\/vc_column][vc_column width=&#8221;1\/4&#8243; css=&#8221;.vc_custom_1715331368722{padding-top: 1px !important;padding-right: 1px !important;padding-bottom: 1px !important;padding-left: 1px !important;}&#8221;][vc_single_image image=&#8221;4897&#8243; img_size=&#8221;full&#8221; onclick=&#8221;link_image&#8221; css=&#8221;&#8221;][\/vc_column][vc_column width=&#8221;1\/4&#8243; css=&#8221;.vc_custom_1715331364163{padding-top: 1px !important;padding-right: 1px !important;padding-bottom: 1px !important;padding-left: 1px !important;}&#8221;][vc_single_image image=&#8221;4898&#8243; img_size=&#8221;full&#8221; onclick=&#8221;link_image&#8221; css=&#8221;&#8221;][\/vc_column][\/vc_row][vc_row][vc_column width=&#8221;1\/4&#8243; css=&#8221;.vc_custom_1715331339080{padding-top: 1px !important;padding-right: 1px !important;padding-bottom: 1px !important;padding-left: 1px !important;}&#8221;][vc_single_image image=&#8221;4899&#8243; img_size=&#8221;full&#8221; onclick=&#8221;link_image&#8221; css=&#8221;&#8221;][\/vc_column][vc_column width=&#8221;1\/4&#8243; css=&#8221;.vc_custom_1715331347406{padding-top: 1px !important;padding-right: 1px !important;padding-bottom: 1px !important;padding-left: 1px !important;}&#8221;][vc_single_image image=&#8221;4900&#8243; img_size=&#8221;full&#8221; onclick=&#8221;link_image&#8221; css=&#8221;&#8221;][\/vc_column][vc_column width=&#8221;1\/4&#8243; css=&#8221;.vc_custom_1715331368722{padding-top: 1px !important;padding-right: 1px !important;padding-bottom: 1px !important;padding-left: 1px !important;}&#8221;][vc_single_image image=&#8221;4901&#8243; img_size=&#8221;full&#8221; onclick=&#8221;link_image&#8221; css=&#8221;&#8221;][\/vc_column][vc_column width=&#8221;1\/4&#8243; css=&#8221;.vc_custom_1715331364163{padding-top: 1px !important;padding-right: 1px !important;padding-bottom: 1px !important;padding-left: 1px !important;}&#8221;][vc_single_image image=&#8221;4902&#8243; img_size=&#8221;full&#8221; onclick=&#8221;link_image&#8221; css=&#8221;&#8221;][\/vc_column][\/vc_row][vc_row][vc_column width=&#8221;1\/4&#8243; css=&#8221;.vc_custom_1715331339080{padding-top: 1px !important;padding-right: 1px !important;padding-bottom: 1px !important;padding-left: 1px !important;}&#8221;][vc_single_image image=&#8221;4903&#8243; img_size=&#8221;full&#8221; onclick=&#8221;link_image&#8221; css_animation=&#8221;none&#8221; css=&#8221;&#8221;][\/vc_column][vc_column width=&#8221;1\/4&#8243; css=&#8221;.vc_custom_1715331347406{padding-top: 1px !important;padding-right: 1px !important;padding-bottom: 1px !important;padding-left: 1px !important;}&#8221;][vc_single_image image=&#8221;4904&#8243; img_size=&#8221;full&#8221; onclick=&#8221;link_image&#8221; css_animation=&#8221;none&#8221; css=&#8221;&#8221;][\/vc_column][vc_column width=&#8221;1\/4&#8243; css=&#8221;.vc_custom_1715331368722{padding-top: 1px !important;padding-right: 1px !important;padding-bottom: 1px !important;padding-left: 1px !important;}&#8221;][vc_single_image image=&#8221;4905&#8243; img_size=&#8221;full&#8221; onclick=&#8221;link_image&#8221; css_animation=&#8221;none&#8221; css=&#8221;&#8221;][\/vc_column][vc_column width=&#8221;1\/4&#8243; css=&#8221;.vc_custom_1715331364163{padding-top: 1px !important;padding-right: 1px !important;padding-bottom: 1px !important;padding-left: 1px !important;}&#8221;][vc_single_image image=&#8221;4906&#8243; img_size=&#8221;full&#8221; onclick=&#8221;link_image&#8221; css_animation=&#8221;none&#8221; css=&#8221;&#8221;][\/vc_column][\/vc_row][vc_row][vc_column][vc_empty_space][\/vc_column][\/vc_row][\/vc_section][vc_row][vc_column][vc_column_text]At 10 months after start of treatment a refinement was requested with movements to correct the canine torque and tip while the patient kept using elastics allowing for the overcorrection of deepbite induced by the overcorrection of Class I and elastics mechanics.<\/p>\n<p>The right timing for the treatment along with the effective and predictable aligner protocols led to achieving all objectives in less than a year proving aligners being a promising alternative to conventional appliances.[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_empty_space height=&#8221;40px&#8221;][vc_column_text]<span class=\"text-small\">* Dr. Andr\u00e9 El Zoghbi is a paid consultants for Ormco. The opinions expressed are those of Dr. Andr\u00e9 El Zoghbi. Ormco is amedical device manufacturer and does not dispense medical advice. Clinicians should use their own professional judgment intreating their patients.<\/span>[\/vc_column_text][vc_row_inner][vc_column_inner][vc_empty_space height=&#8221;40px&#8221;][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_section][vc_row][vc_column width=&#8221;2\/3&#8243;][vc_column_text css=&#8221;&#8221;]CASE REPORT Spark: Treatment of a growing patient with Class II, deep bite and crowding in constricted arches. [\/vc_column_text][vc_empty_space height=&#8221;40px&#8221;][vc_column_text]This article describes the treatment with Spark Clear Aligners of a 13 years-old female patient, who presented a CLASS II DIV. 1 caused by mandible retrusion, hypodivergent profile, crowding and constriction in both arches, [&hellip;]<\/p>\n","protected":false},"author":45,"featured_media":4401,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[46,43],"tags":[48],"class_list":["post-4883","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-class-ii","category-spark-clear-aligners","tag-case-report"],"acf":[],"_links":{"self":[{"href":"https:\/\/ormcoeurope.com\/ro\/wp-json\/wp\/v2\/posts\/4883","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ormcoeurope.com\/ro\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ormcoeurope.com\/ro\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ormcoeurope.com\/ro\/wp-json\/wp\/v2\/users\/45"}],"replies":[{"embeddable":true,"href":"https:\/\/ormcoeurope.com\/ro\/wp-json\/wp\/v2\/comments?post=4883"}],"version-history":[{"count":4,"href":"https:\/\/ormcoeurope.com\/ro\/wp-json\/wp\/v2\/posts\/4883\/revisions"}],"predecessor-version":[{"id":4911,"href":"https:\/\/ormcoeurope.com\/ro\/wp-json\/wp\/v2\/posts\/4883\/revisions\/4911"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ormcoeurope.com\/ro\/wp-json\/wp\/v2\/media\/4401"}],"wp:attachment":[{"href":"https:\/\/ormcoeurope.com\/ro\/wp-json\/wp\/v2\/media?parent=4883"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ormcoeurope.com\/ro\/wp-json\/wp\/v2\/categories?post=4883"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ormcoeurope.com\/ro\/wp-json\/wp\/v2\/tags?post=4883"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}