Class II div 2
,
Increased overjet
,
Mandibular retrognathia
,
Deep bite
,
Narrow arches
,
Asymmetric arches
,
Maxillary midline deviation
,
Mandibular midline deviation
,
Midline shift
,
Crowding
,
Rotations

Mesialization
,
Leveling Curve of Spee
,
Extrusion
,
Intrusion
,
Expansion
,
Proclination
,
IPR
,
Phase II treatment
,
Elastics: Class II
,
Elastics: Class II in Additional Aligners
Courtesy of Dr K. Malekian, 2021
Before picture of treatment

Treatment Summary

Patient Information

  • Age: 14
  • Gender: male
  • Invisalign Treatment Option: Invisalign Teen

Number of aligners

  • Maxillary: 33 + 20 + 16 = 69
  • Mandibulary: 33 + 20 + 16 = 69

Aligner Wear time

  • Progressive Aligner Change Interval : 14 Days - 10 Days- 7 Days

Retention

  • Maxillary: Vivera retainer
  • Mandibular: Vivera retainer

Results achieved

  • Class I relationship achieved
  • Class I relationship maintained
  • Functional canine guidance on both sides
  • Normal  overjet and overbite achieved
  • Deepbite improved
  • Overjet improved
  • 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

  • Maxillary and mandible arch expansion with simultaneous lingual torque of upper and lower Canine, Premolar, and Molars.
  • Power ridges at upper central teeth helped us in order to achieve a nice esthetic torque followed by upper and lower anterior intrusion for deep bite correction.
  • Precision bite ramps (G5) at lingual of upper 4 incisors was an important strategy in the correction of deep bite.
  • The midline shift was more than 2mm. For midline correction, we planned a combination of:
    a) Minimal IPR (0.2-0.3mm ) on the upper left side and lower right side.
    b) Asymmetric elastics: Class II elastics right side and Class III elastics on the left side.
  • Retention: the patient is wearing Vivera retainer: Upper and lower arch nightwear (8 hours) with fixed 0.15mm steel wire 3-3 bonded retainer.

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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