Class III
,
Posterior crossbite
,
Anterior crossbite
,
Open bite
,
Asymmetric arches
,
Maxillary midline deviation
,
Mandibular midline deviation
,
Midline shift
,
Rotations
,
Spacing
,
Diastema

Distalization
,
Mesialization
,
Leveling Curve of Spee
,
Extrusion
,
Intrusion
,
Expansion
,
Retraction
,
Proclination
,
IPR
,
Space Closure
,
Pre-surgical
,
Elastics: Class II
,
Elastics: Class III
Courtesy of Dr. B. Wang, 2021
Before picture of treatment

Treatment Summary

Patient Information

  • Age: 20
  • Gender: male
  • Invisalign Treatment Option: Invisalign Full

Total Treatment Time

  • 18 months

Number of aligners

  • Maxillary: 39 + 16 = 55
  • Mandibulary: 39 + 16 = 55

Aligner Wear time

  • 1-week

Retention

  • Maxillary: Hawley
  • Mandibular: Hawley

Results achieved

  • Class I relationship achieved
  • Functional canine guidance on both sides
  • Anterior crossbite corrected
  • Posterior crossbite corrected
  • 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

  • Pre-surgical orthodontic treatment, upper and lower dental arch shape coordination, retract upper anterior teeth for sagittal decompensation with existed spacing and upper posterior teeth distalization.
  • Crown labial torque combined with root lingual torque was used for lower anterior teeth for sagittal decompensation with the help of power ridge design in order to prevent gingival recession, fenestration, and dehiscence during orthodontic treatment.
  • IPR was carried out to correct Bolton discrepancy in the upper and lower anterior region, lower premolar extrusion combined with anterior teeth intrusion to help level Curve of Spee, move the upper dental midline to coincide with facial midline, and move the lower dental midline to coincide with the middle of the mandible, impacted 8s were all extracted before pre-surgical orthodontics
  • Le fort I osteotomy was carried out for maxilla advancement, Bilateral sagittal split osteotomy was carried out for mandible setback and derotation.
  • Post-surgical orthodontic treatment for stabilizing maxilla, mandible relationship, and position as well as detailing the final occlusions.

Images

Initial and final

Click to compare enlarged
upper
lower
right
front
left
Click to compare enlarged
upper
lower
right
front
left

Progress

Click to compare enlarged
upper
lower
right
front
left
InitialFinal
Before picture of treatment
After picture of treatment
Thumbnail, click to compare enlarged Thumbnail, click to compare enlarged
Thumbnail, click to compare enlarged Thumbnail, click to compare enlarged
Thumbnail, click to compare enlarged Thumbnail, click to compare enlarged
Thumbnail, click to compare enlarged Thumbnail, click to compare enlarged
Thumbnail, click to compare enlarged Thumbnail, click to compare enlarged

Radiographs

Initial Final
Click to compare enlarged320
Click to compare enlarged314