Class II div 1
,
Increased overjet
,
Mandibular retrognathia
,
Narrow arches
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Asymmetric arches
,
Mandibular midline deviation
,
Crowding

Mandibular advancement
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Pre Mandibular advancement phase
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Distalization
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Leveling Curve of Spee
,
Intrusion
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Retraction
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IPR
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Phase I treatment / Interceptive
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Phase II treatment
,
Elastics: Class II in Additional Aligners
Courtesy of Dr G. Thiesen, 2020
Before picture of treatment

Treatment in the Spotlight

Dr G. Thiesen

We would like to thank Dr. G. Thiesen for this Class III div 1 case submission, which provides insight into excellent treatment planning with a great treatment end result.

“The Invisalign appliance is my treatment of choice for growing patients with Class II mandibular deficiency: control of tooth movement and orthopedic effects being realized at the same time! Since it is comfortable, compliance is great. Therefore, the efficiency of Invisalign with mandibular advancement using the precion wings is incredible!"

Dr G. Thiesen

Treatment Summary

Patient Information

  • Age: 12
  • Gender: female
  • Invisalign Treatment Option: Invisalign Teen

Total Treatment Time

  • 17 months

Number of aligners

  • Maxillary: 32 + 36 = 68
  • Mandibulary: 32 + 36 = 68

Aligner Wear time

  • 1-week

Retention

  • Maxillary: Fixed/Bonded
  • Mandibular: Fixed/Bonded

Results achieved

  • Class I relationship achieved
  • Functional canine guidance on both sides
  • Normal  overjet and overbite achieved
  • Significant improvement of overjet
  • Midlines coincident
  • Proper axial inclination of incisors
  • Curve of Spee leveled
  • Arches aligned and coordinated
  • Alignment of both arches through derotation
  • Arch form improved
  • Aesthetic smile line was achieved 
  • All treatment goals were achieved case
  • Harmonic arches were achieved

Comments

  • The molar relationships were improved initially by the mandibular advance phase.
  • Lower Curve of Spee was improved during mandibular advance to allow proper sagittal correction.
    Sequential distalization was done with the additional aligners, associated with the use of Class II elastics. The sagittal jump accounted for 25% of the sagittal correction.
  • Maxillary and mandibular dental arches were aligned, and maxillary and mandibular incisor inclinations were improved.
  • Expansion was performed in both arches.
  • Ideal overbite was obtained by intruding the mandibular anterior teeth mainly.
  • Ideal overjet was obtained at the end of treatment.

Images

Initial and final

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Progress

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InitialFinal
Before picture of treatment
After picture of treatment
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Radiographs

Initial Final
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