Class III, Posterior crossbite, Anterior crossbite, Edge to edge bite, Open bite, Narrow arches, Asymmetric arches, Maxillary midline deviation, Mandibular midline deviation, Midline shift, Crowding, Rotations
Leveling Curve of Spee
, Extrusion
, Intrusion
, Expansion
, Retraction
, IPR
, Phase II treatment
, Elastics: Class III
Courtesy of Dr. K. Malekian
,
2023
![Before picture of treatment](https://global.invisaligngallery.com/wp-content/uploads/sites/2/2024/01/1843_photo_initial_front-768x414.jpg)
Treatment Summary
Patient Information
- Age: 33
- Gender: male
- Invisalign Submission Option: Invisalign Comprehensive
Number of aligners
- Maxillary: 32 + 13 = 45
- Mandibulary: 32 + 13 = 45
Aligner Wear time
- Sequential 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
- Posterior crossbite corrected
- Normal overjet and overbite achieved
- 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 expansion with upper teeth alignment and arch development was performed.
- The upper first molar crossbite was corrected with maxillary expansion.
- Upper incisor retraction was planned during upper arch expansion to correct the excessively proclined upper incisors.
- During upper incisor retraction, lingual root torque of the upper incisors was performed.
- Posterior IPR was planned for the lower premolars and canines to achieve space for retraction of severely rotated and mesially tipped lower canines.
- Lower arch IPR at lower incisors, canines, and premolars permitted space to retract lower incisors to achieve overjet.
- G4 multitooth extrusion attachments were planned to extrude upper incisors and canines to close the anterior open bite.
- Full-time wear of aligners (22 hours) with Class III elastics was used to correct the class III molar and canine and achieve class I molar and canine.
- G3 optimized rotation attachments helped to correct the severe rotation of lower canines.
- Tipping of lower central incisors was planned.
- Power ridges at lower incisors helped to correct lingual root control direction.