Class II div 1
,
Increased overjet
,
Mandibular retrognathia
,
Deep bite
,
Narrow arches
,
Mandibular midline deviation

Mandibular advancement
,
Leveling curve of Spee
,
Intrusion
,
Expansion
,
Elastics: Class II
Courtesy of Dr J. WENG, 2021
Before picture of treatment

Treatment Summary

Patient Information

  • Age: 11
  • Gender: male
  • Invisalign Treatment Option: Invisalign Teen with MA

Total Treatment Time

  • 18 months

Number of aligners

  • Maxillary: 35 + 40 = 75
  • Mandibulary: 35 + 40 = 75

Aligner Wear time

  • 1-week

Retention

  • Maxillary: Other clear
  • Mandibular: Other clear

Results achieved

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

Comments

I intended to use MA to correct Class II occlusion and guide the mandible forward at first, but the precision wings were broken frequently.
The patient wore 35# MA aligners, but Class II occlusion and deep bite still existed and the effect of upper arch expansion was not ideal. I think that MA is not good for upper arch expansion and Spee curve leveling. So I turned to MCC.
Actually, three dimensional adjustment on the upper and lower arches is very important in Class II occlusion. Horizontally, I used aligners to expand the upper arch by 3mm per side. Vertically, I used G5 to level Spee curve and correct deep bite. Sagitally, light force(3/16,3.5oz) Class II elastics were used to guide the mandible forward.

Images

Initial and final

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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
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