Class I, Class III, Crowding, Increased overjet, Narrow Arches, Midline Shift, Openbite, Rotations

Expansion, Extrusion, Distalization, Retraction, Elastics: Vertical

Treatment Information

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

Diagnostic Summary

  • Class I relationship
  • Class III relationship
  • Narrow Arches
  • Midline Shift
  • Mandibular midline deviation
  • Maxillary midline deviation
  • Increased overjet
  • Openbite
  • Crowding
  • Rotations

Use of:

  • Distalization
  • Extrusion
  • Levelling Curve of Spee
  • Expansion
  • Elastics: Vertical
  • Retraction
  • Vertical triangular elastics for final adjustment and occlusion of UR3,UL3 (p0lease check the progress photos )
Courtesy of Dr. K. Malekian 2016
Award 2017 Peer Review Award

Photos

Click to compare enlarged
upper
Initial
lower
right
front
left
Click to compare enlarged
upper
Final
lower
right
front
left
Progress
right
front
left

Radiographs

ClinCheck Treatment Plan

video anterior
video right-left
video upper-lower

Treatment Summary

Results Archieved

  • 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 line¬†was achieved
  • All treatment goals were achieved case
  • Harmonic arches were achieved

Total treatment Time

  • 51 months

Number of aligners

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

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.

Retention

  • Maxillary: Vivera
  • Mandibular: Vivera