Class I
,
Class III
,
Increased overjet
,
Open bite
,
Narrow arches
,
Midline shift
,
Crowding
,
Rotations

Distalization
,
Extrusion
,
Expansion
,
Retraction
,
Elastics: vertical
Courtesy of Dr. K. Malekian, 2016
Award 2017 Peer Review Award
Before picture of treatment

Treatment Summary

Patient Information

  • Age: 15
  • Gender: female
  • Invisalign Treatment Option: Teen

Total Treatment Time

  • 51 months

Number of aligners

  • Maxillary: 50 + 52 + 20 + 16 = 138
  • Mandibulary: 50 + 25 + 25 + 16 = 116

Retention

  • Maxillary: Vivera
  • Mandibular: Vivera

Results achieved

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

  • Treatment aligner change every 14 days. Refinement aligner change every 7 days
  • This is probably one of the most difficult and challenging treatments I have done. The patient father is a doctor and before starting treatment we talked that this treatment required:
  • 1.Extraction of upper premolars in order to align highly erupted upper canines.We wanted to avoid extractions since it was not a good solution for the final profile and upper lip of the patient.
    2.The 5mm anterior open bite required surgery and the father obviously wanted to avoid the surgery for his daughter.
  • The treatment was long but the results are excellent regarding the starting point. I used all CC strategies possible in order to achieve this result (Upper Sequential distalisation of 4-5mm of UR7,UL7).The patient compliance during the total treatment time has been excellent.

Images

Initial and final

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upper
lower
right
front
left
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upper
lower
right
front
left

Progress

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

Initial
Click to compare enlarged314