Class III
,
Anterior crossbite
,
Edge to edge bite
,
Open bite
,
Midline shift
,
Crowding
,
Rotations

Distalization
,
Mesialization
,
Extrusion
,
Expansion
,
Proclination
,
IPR
,
Elastics: Class III
Courtesy of Dr. K. Malekian, 2016
Before picture of treatment

Treatment Summary

Patient Information

  • Age: 28
  • Gender: female
  • Invisalign Treatment Option: Full

Total Treatment Time

  • 25 months

Number of aligners

  • Maxillary: 34 + 17 = 51
  • Mandibulary: 34 + 17 = 51

Aligner Wear time

  • 2 weeks

Retention

  • Maxillary: Vivera
  • Mandibular: Vivera

Results achieved

  • Class I relationship achieved
  • Class I relationship maintained
  • Functional canine guidance on both sides
  • Anterior crossbite corrected
  • Normal overjet and overbite achieved
  • Overjet improved
  • Significant improvement ofoverbite
  • Midlines coincident
  • Proper axial inclination of incisors
  • Curve of Spee levelled
  • Arches aligned and coordinated
  • Alignment of both arches through derotation
  • Arch form improved
  • Aesthetic smile linewas achieved
  • All treatment goals were achieved case
  • Harmonic arches were achieved

Comments

  • Lower Wisdom teeth were extracted as a requirement in order to Clincheck Plan " LOWER SECUENTIAL DISTALISATION "
  • Esthetic Start was planned at clincheck from L1 to L5 in order to obtain partial alignement of lower anterior teeth in order to motivate the patient and obtain a high compliance aligner + class III elastics during the total treatment time.
  • During the Esthetic start we also plan " 4 in a Row" as can be seen at initial treatment Clincheck. " 4 in a row " is the bucal and lingual movement necessary in order to align lower premolars and molars " in a straight line " .The main aim of 4 in a row is to prepare the lower premolars and molars in a staright line so at L6 we can start to do pure distalisation.In my experience distalisation movement is much more predictable when we do a pure distal movement compared to when we do a combined movement of either expansión+distalisation or / lingual movement+ distalisation.
  • Mesialization of upper anterior and posterior teeth.
  • Full time aligner wear + Class III elastics during total treatment time.
  • Sequential bevelled attachments are placed at lower 2Molar and 1 Molar at the stage they finish and stop distalisation.
  • Staging Upper arch : a ) Expansion-Mesialisation and upper anterior alignment b) Optimized Extrusión attachments at Upper canines and incisors for open bite correction.
  • Full Class III molar and canine was corrected with the following combination : a) Lower Sequential Distalisation b) Upper Arch Mesialisation of posterior and anterior teeth c) Full time aligner+ Class III elastics wear during total treatment time.

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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right
front
left
InitialFinal
Before picture of treatment
After picture of treatment
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Radiographs

Initial
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