Class II div 2
,
Posterior crossbite
,
Deep bite
,
Asymmetric arches
,
Maxillary midline deviation
,
Midline shift
,
Crowding
,
Rotations

Distalization
,
Leveling curve of Spee
,
Extrusion
,
Intrusion
,
Expansion
,
Proclination
,
IPR
,
Elastics: Class II
,
Elastics: Class II in Additional Aligners
,
Elastics: vertical
Courtesy of Dr S. Okano, 2021
Before picture of treatment

Treatment Summary

Patient Information

  • Age: 17
  • Gender: female
  • Invisalign Treatment Option: Invisalign Teen

Total Treatment Time

  • 24 months

Number of aligners

  • Maxillary: 54 + 25 + 15 = 94
  • Mandibulary: 52 + 25 + 13 = 90

Aligner Wear time

  • 1-week

Retention

  • Maxillary: Other
  • Mandibular: Other

Results achieved

  • Class I relationship achieved
  • Functional canine guidance on both sides
  • Posterior crossbite corrected
  • Normal  overjet and overbite achieved
  • Deepbite improved
  • Significant improvement of overbite
  • 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

Despite the fact that the roots of UR1 and UL1 were too short, we were able to minimize the damage by minimizing the amount of movement
To improve scissorsbite(UR4) and posterior crossbite(left side) we aligned and coordinated the arches, which proved to be very effective
In initial aligners, sequential distalization was performed to improve Class II
We continued using Class II elastics (3/16 inch, 4.5 OZ) in initial aligners
Optimized extrusion attachments for molars were effective for detailing on the left side molars

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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Radiographs

Initial Final
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