Class I
,
Narrow arches
,
Crowding
,
Rotations

Restorative
,
Leveling curve of Spee
,
Retraction
,
IPR
,
Space Closure
Courtesy of Dr. R. Bordin, 2020
Before picture of treatment

Treatment Summary

Patient Information

  • Age: 52
  • Gender: female
  • Invisalign Treatment Option: Invisalign Full

Total Treatment Time

  • 26 months

Number of aligners

  • Maxillary: 33 + 22 = 55
  • Mandibulary: 33 + 22 = 55

Aligner Wear time

  • 15 days - 10 days

Retention

  • Maxillary: Fixed/Bonded
  • Mandibular: Other clear

Results achieved

  • Class I relationship maintained
  • Functional canine guidance on both sides
  • Normal  overjet and overbite achieved
  • Overjet improved
  • Midlines coincident
  • Proper axial inclination of incisors
  • Arches aligned and coordinated
  • Arch form improved
  • Aesthetic smile line was achieved 
  • Harmonic arches were achieved

Comments

  • Because of mobility and mesial deep bone loss, the patient received advice from an implantologist to extract tooth 2.1 and place an implant
  • We decided to first treat orthodontically and align all teeth, to give her a proper stable occlusion especially 2.1, so, even if she loses the tooth in the future, the implant can be placed in a favorable desirable position.
  • Two stages and IPR were needed to completely resolve the crowding of lower incisors, especially tooth 4.2
  • IPR and retraction was needed to align and correct the flared upper anterior teeth
  • Because of the anterior bone loss, we took our time with the correction
  • Endodontic treatment was performed on tooth 2.1 throughout the treatment, and patients' bone loss condition began to improve
  • Heavy contacts on anterior were evaluated during the treatment with our focus on tooth 2.1
  • Occlusal adjustments on the palatal surface were performed as needed
  • At the end of the treatment, the black triangle between 1.1 and 2.1 was improved aesthetically by means of restoring the mesial surfaces using composite resin which closed the remaining gap
  • With the correction of the anterior occlusion, the bone loss on the mesial surface of tooth 2.1  and mobility improved a lot
  • As for now, the implant of tooth 2.1 is on hold. We hope for forever
  • We chose to place a palatal fixed retainer between #1.1 and #2.1 together with clear vacuum-formed retainers for now (Vivera will be done later)

Images

Initial and final

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upper
lower
right
front
left
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upper
lower
right
front
left

Progress

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upper
lower
right
front
left
InitialFinal
Before picture of treatment
After picture of treatment
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ClinCheck treatment plan

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Smartforce features

  • Optimized rotation attachment (G3) on Buccal 1.4 (UR4), Buccal 2.3 (UL3), Buccal 2.4 (UL4), Buccal 2.5 (UL5), Buccal 4.4 (LR4), Buccal 4.5 (LR5), Buccal 3.3 (LL3), Buccal 3.4 (LL4), Buccal 3.5 (LL5)
  • Optimized extrusion attachment (G3) on Buccal 4.2 (LR2)
  • Optimized root control attachments (G4) on Buccal 1.3 (UR3), Buccal 1.5 (UR5), Buccal 2.2 (UL2)
  • Optimized deep bite attachments for anchorage (G5) on Buccal 4.5 (LR5)
  • Pressure areas (G5) on Buccal 2.2 (UL2), Lingual 2.2 (UL2)
Download ADF files:
Initial
Additional Aligners