Class II div 2
,
Deep bite
,
Narrow arches
,
Midline shift
,
Crowding
,
Rotations

Distalization
,
Leveling Curve of Spee
,
Extrusion
,
Intrusion
,
Expansion
,
Proclination
,
IPR
,
Elastics: Class II
,
Elastics: Class II in Additional Aligners
,
Elastics: vertical
Courtesy of Dr V. Laoamata, 2023
Before picture of treatment

Treatment Summary

Patient Information

  • Age: 33
  • Gender: female
  • Invisalign Submission Option: Invisalign Comprehensive

Total Treatment Time

  • 30 months

Number of aligners

  • Maxillary: 17 + 60 + 14 = 91
  • Mandibulary: 17 + 53 + 12 = 82

Aligner Wear time

  • 1-week

Retention

  • Maxillary: Vivera retainer
  • Mandibular: Vivera retainer

Results achieved

  • Class I relationship achieved
  • Functional canine guidance on both sides
  • Normal  overjet and overbite achieved
  • Deepbite improved
  • Significant improvement of overbite
  • 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

  • For this case, to use Class II elastics, we should evaluate the force vector from the upper canines which could be in the unfavorable direction and worsen the rotation of the upper canines.
  • Hence, changing the position of Class II elastics from the upper canines to the upper first premolars was more suitable, at the early stage of treatment, than using Class II elastics from the lingual side of the upper canines, when we can access the bonding site at the area to facilitate Class II correction together with the de-rotation force vector of the upper canines.

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 enlarged316
Click to compare enlarged310