Class II div 1
,
Increased overjet
,
Mandibular retrognathia
,
Deep bite
,
Narrow arches
,
Maxillary midline deviation
,
Midline shift
,
Crowding
,
Rotations
,
Spacing

Distalization
,
Mesialization
,
Leveling Curve of Spee
,
Extrusion
,
Intrusion
,
Expansion
,
Retraction
,
Proclination
,
First premolar extraction
,
IPR
,
Space Closure
,
Elastics: Class II
,
Elastics: Class II in Additional Aligners
,
Elastics: vertical
,
Extraction
Courtesy of Dr B. Wang, 2021
Before picture of treatment

Treatment Summary

Patient Information

  • Age: 10
  • Gender: female
  • Invisalign Submission Option: Invisalign Full

Total Treatment Time

  • 32 months

Number of aligners

  • Maxillary: 83 + 25 + 15 = 123
  • Mandibulary: 83 + 25 + 15 = 123

Aligner Wear time

  • 1-week

Retention

  • Maxillary: Hawley
  • Mandibular: Hawley

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
  • 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

  • Orthodontic camouflage treatment was carried out for this adolescent patient: 14 and 24 were extracted to retract upper anterior teeth in order to correct maxillary protrusion
  • Deep anterior overjet as well as upper and lower dental arch shape discrepancy
  • Class II elastics were used on both sides for mandibular growth stimulation and anchorage control.
  • Different anchorage design for upper extraction sites on both sides to help correct upper dental midline deviation.
  • Lower premolars extrusion combined with lower anterior teeth intrusion to help correct deep anterior overbite as well as level the Curve of Spee.
  • Power ridge design was used for both upper and lower anterior teeth during treatment in order to prevent gingival recession, alveolar bone dehiscence, and fenestration because of soft and hard periodontal tissue hypoplasia.
  • Additional aligners were used according to the patient‘s mandibular growth reactions from Class II elastics
  • Waited with 17, 27, 37 and 47  until erupted enough into dental arches then included in orthodontic treatment with the help of additional aligners

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

Initial Final
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