Solano Mendoza, Beatriz

This case report describes the successful multidisciplinary orthodontic retreatment of a patient with failed space closure with a thin periodontal phenotype from previous premolar extractions, which was achieved by performing corticotomy and alveolar augmentation procedures. The subject was a 31-year-old woman with skeletal asymmetry and biprotrusion, with half-closed spaces from previous extraction of the maxillary second and mandibular first premolars and presenting generalised recession in the first quadrant in particular due to her thin phenotype. Phase 1 consisted of a simultaneous gingival graft and orthodontic treatment, followed by phase 2 of the corticotomy procedure along with alveolar augmentation to make the planned movements and space closure possible within the bone boundaries with a clear removable appliance (Invisalign, Align Technology, San Jose, CA, USA). Extraction spaces were closed during the first 8 months, although the total treatment time was 19 months since carrying out detailed finishing is difficult in such cases. The final results were effective space closure with parallel roots, an improved periodontal phenotype through total coverage of gingival recession, and correctly inclined incisors. Keywords: aligners, corticotomy, gingival graft, multidisciplinary treatment, recession, space closure

This case report describes a successful two-stage orthodontic treatment combined with a previous restorative treatment. A 45-year-old man, with attrition on the cervical-buccal and occlusal surface of the teeth with the consequent decrease of the vertical dimension, due to severe bruxism. Phase one consisted of an increase of the vertical dimension following the principles of the bioesthetic with a restorative treatment, before a second phase of orthodontic treatment with a clear removable appliance (Invisalign). The total treatment period was 18 months, and the final result was the patient's facial muscle pain and parafunctional movement disappearing. Keywords: Invisalign, multidisciplinary treatment, orthodontics, vertical dimension