Class II div 2
,
Mandibular retrognathia
,
Deep bite
,
Asymmetric arches
,
Maxillary midline deviation
,
Crowding

Distalization
,
Leveling curve of Spee
,
Extrusion
,
Intrusion
,
Expansion
,
Overtreatment
,
Elastics: Class II
Courtesy of Dr G. Thiesen, 2020
Before picture of treatment

Treatment Summary

Patient Information

  • Age: 43
  • Gender: male
  • Invisalign Treatment Option: Invisalign Full

Total Treatment Time

  • 24 months

Number of aligners

  • Maxillary: 87 + 29 = 116
  • Mandibulary: 87 + 29 = 116

Aligner Wear time

  • Weekly for most of the duration of treatment and twice a week during some period due to the use of accelerated devices

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 overbite
  • Midlines coincident
  • Curve of Spee leveled
  • Arches aligned and coordinated
  • Arch form improved
  • Aesthetic smile line was achieved 
  • All treatment goals were achieved case

Comments

  • Sequential distalization was done, associated with the use of Class II elastics. The sagittal jump accounted for 20% of the sagittal correction.
  • During the orthodontic treatment the maxillary and mandibular dental arches were aligned, and maxillary and mandibular incisor inclinations were improved.
  • Ideal overjet was obtained at the end of treatment.
  • Ideal overbite was obtained by intruding the mandibular anterior teeth mainly. For correction of the deep bite, leveling of the Curve of Spee was done initially, and only later lower IPR was performed.
  • Some vertical overcorrection was performed since proclination of the anterior teeth (relative intrusion) was not enough to level the severe Curve of Spee presented.
  • Gingival health has improved due to significant improvement of overbite.

Images

Initial and final

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upper
lower
right
front
left
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upper
lower
right
front
left
InitialFinal
Before picture of treatment
After picture of treatment
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Radiographs

Initial Final
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