Class III
,
Anterior crossbite
,
Edge to edge bite
,
Open bite
,
Asymmetric arches
,
Maxillary midline deviation
,
Mandibular midline deviation
,
Midline shift
,
Crowding
,
Rotations

Elastics: Class III
,
Distalization
,
Leveling Curve of Spee
,
Extrusion
,
Expansion
Courtesy of Dr K. Malekian, 2018
Before picture of treatment

Treatment Summary

Patient Information

  • Age: 17
  • Gender: male
  • Invisalign Treatment Option: Teen

Total Treatment Time

  • 17 months

Number of aligners

  • Maxillary: 32 + 17 = 49
  • Mandibulary: 32 + 17 = 49

Aligner Wear time

  • Progressive Aligner change protocol.( 14 day -10 day-7 day). At Refinement period 7 day change aligner interval.

Results achieved

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

Comments

  • 1.Sequential lower arch distalisation ( tooth by tooth ) is the key factor to go from Class Molar and canine into Class I Molar and Canine.
    2.Esthetic start motivation from stages L1 to L6 prior starting sequential lower distalisation.
    3.Esthetic start motivation goal is to improve the lower anterior crowding in the first stages which patients appreciate and motivates them.
    4.Lingual bevelled attachments at lower incisors allows us extra anchorage during sequential distalisation of lower molars and premolars.
    5.Molar anchorage attachments: Once the second lower molars and first lower molars finish distalisation we place a bevelled attachment at the buccal surface of the molars increasing aligner fitness and anchorage for the upcoming premolars and lower anterior to be distalised.
    6.Upper Maxilla posterior expansion.
    7.***One of the key factor is that with lower arch distalisation we achieve overjet which is crucial in order to improve the lower incisor torque and to retract upper incisors improving esthetic inclination.The goal is to achieve 131 interincisal angle at the end of treatment.
    8.Full time 22 hour per day aligner and class III elastics is requiered.
    9.Vivera Retainer upper and lower arch (night time wear)
    10.Fixed lingual retainer 3-3 .

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 enlarged296
Click to compare enlarged290