CASE REPORT
CASE REPORT
This article describes the treatment of a 15-year-old female patient with Spark aligners.
She presented with a skeletal Class II due to maxillary prognathism combined with mild mandibular retrognathia. This was associated with incisor compensation, retroclined upper incisors and proclined lower incisors, an hypodivergent profile, upper and lower crowding, narrow arches, a 6 mm deep bite, a 4 mm overjet, canine and molar Class II, a slight mandibular deviation to the right, and a pronounced curve of Spee.
Dr. Virginie Tuerlings*, Belgium
Virginie Tuerlings earned her Master’s degree in Dental Sciences with High Distinction and received the Periodontology Prize from the Université Libre de Bruxelles (Belgium) in 1996. She went on to complete a Master’s in Orthodontics and Dentofacial Orthopedics at the University of Liège in 2001, graduating with The Highest Distinction. Her dissertation, “The Prevalence of Temporomandibular Joint Dysfunction in the Mixed Dentition”, was published in the European Journal of Orthodontics in 2004.
From 2001 to 2021, she worked as an independent consultant at CHU Sart-Tilman in Liège, where she was involved in complex, multidisciplinary cases. In 2018, she established her own private practice in Ottignies-Louvain-la-Neuve, Belgium.
A Spark system user since 2021, she was won over by the system’s efficiency and predictability, and has not used any other aligner brand since.
As the patient no longer had growth potential but presented with maxillary prognathism and only mild mandibular retrognathia, the treatment goal was to correct the Class II via upper arch distalization only, to correct the deep bite and level the curve of Spee by intruding the upper and lower incisors, and extruding the upper and lower premolars and molars. Expansion was planned to resolve the dental crowding.
Expansion of both upper and lower arches, derotation of the first molars (6s), upper distalization with 50% pattern, and implementation of the PIR protocol (proclination of upper incisors, followed by intrusion and then retraction).
Bite ramps were planned on the upper canines after torque correction to facilitate posterior extrusion movements.
Class II elastics were planned to be used starting from the distalization of teeth 15 and 25 (with hooks on 13 and 23, and button cutouts on the lower molars).
The first two aligners were worn for 10 days each to allow the patient to adapt to aligner wear, then switched to 7-day time of wear.
Class II elastics (6 Oz) were introduced starting from aligner 14, to be worn full-time.
Delaying the elastics wear was planned to enable the upper incisors proclination and to help later applying retraction forces to the canines and anterior teeth.
At the end of the 53-aligner series (13 months of treatment), thanks to an optimized distalization protocol with Spark aligners, the Class II was effectively corrected. The deep bite was resolved, leading to a significant improvement in occlusion. Overjet and overbite were restored to physiological values, ensuring better function and aesthetics. The incisor angulation was corrected, resulting in harmonious alignment, and the curve of Spee was fully leveled, promoting a stable and balanced occlusion.
This case highlights the precision and efficiency of Spark aligners in managing complex malocclusions without the need for refinement.
* Dr. Virginie Tuerlings is a paid consultant for Ormco. The opinions expressed are those of Virginie Tuerlings. Ormco is a medical device manufacturer and does not dispense medical advice. Clinicians should use their own professional judgment in treating their patients.
