Class II div 1
,
Increased overjet
,
Mandibular retrognathia
,
Asymmetric arches
,
Maxillary midline deviation
,
Mandibular midline deviation
,
Midline shift
,
Crowding
,
Rotations

Distalization
,
Leveling Curve of Spee
,
Intrusion
,
Expansion
,
Retraction
,
First premolar extraction
,
Space Closure
,
Elastics: Class II
,
Elastics: Class III
,
Extraction
Courtesy of Dr W. Li, 2021
Before picture of treatment

Treatment Summary

Patient Information

  • Age: 118
  • Gender: female
  • Invisalign Treatment Option: Invisalign Comprehensive

Total Treatment Time

  • 21 months

Number of aligners

  • Maxillary: 40 + 19 + 16 = 75
  • Mandibulary: 40 + 18 + 30 = 88

Retention

  • Maxillary: Other
  • Mandibular: Other

Results achieved

  • Class I relationship achieved
  • Class I relationship maintained
  • Normal  overjet and overbite achieved
  • Significant improvement of overjet
  • 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

  • This patient was Angle class I malocclusion with an obvious protrusive maxilla, slight retractive mandible, and a severe gummy smile.
  • We chose to extract 4 first premolars and use 2 anchorage screws to improve the convex profile and gummy smile.
  • We kept the strong anchorage design of G6 for the mandible.
  • For the upper arch, based on G6, we changed several optimized attachments into traditional rectangular attachments to enhance retention.
  • At the same time, the vertical overcorrection of anterior teeth was designed, and the torque overcorrection of anterior teeth was added, to help achieve better control of the torque and vertical height of anterior teeth during the progress when the anterior teeth were retracted.
  • After 26 months of aligner treatment, the patient achieved great improvements.
  • Firstly, the normal occlusal relationship was established,
  • Secondly, the profile changed from convex to straight, and
  • Thirdly, a beautiful smile curve was established and the gummy smile was relieved.
  • This case suggests that adult cases with skeletal type II convex deformity can be quickly and effectively corrected by the Invisalign system.

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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