Class II div 1
,
Posterior crossbite
,
Anterior crossbite
,
Edge to edge bite
,
Increased overjet
,
Narrow arches
,
Asymmetric arches
,
Mandibular midline deviation
,
Midline shift
,
Crowding
,
Rotations
,
Pre-restorative

Phase II treatment
,
Distalization
,
Leveling Curve of Spee
,
Extrusion
,
Expansion
,
Proclination
,
IPR
,
Implants
,
Elastics: Class II
Courtesy of Dr K. Malekian, 2018
Before picture of treatment

Treatment Summary

Patient Information

  • Age: 46
  • Gender: female
  • Invisalign Treatment Option: Full

Total Treatment Time

  • 23 months

Number of aligners

  • Maxillary: 41 + 19 + 18 = 78
  • Mandibulary: 41 + 19 + 18 = 78

Aligner Wear time

  • Progressive Interval Aligner change 14 days- 10 days- 7 days. At refinement Aligner interval change is 7 days.

Results achieved

  • Class I relationship achieved
  • Class I relationship maintained
  • Functional canine guidance on both sides
  • Anterior crossbite corrected
  • Posterior crossbite corrected
  • Normal overjet and overbite achieved
  • 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
  • All treatment goals were achieved case
  • Harmonic arches were achieved

Comments

  • 1. Clincheck Planning strategy for high canine 23 : Due to anatomic high buccal position with severe lack of space we planned to move lingually canine 23 as soon as we achieved space with Maxilla posterior area expansion.2. Posterior Expansion of upper premolar and molar area in order to correct the posterior cross bite on the right side.3. Canine 43 with severe rotation and trapped between adjacent teeth 32 and 43 : Clincheck planning was based on distalization of adjacent premolars 44,45 distally with IPR control Clincheck protocol and tracking in order to achieve the necessary space in order to allow canine 43 to rotate and align.

    4. Tracking of severe rotations of teeth 31 and 43 was one of the key points.

    5. Open Bite closure : Once we achieved developed arch form and alignment and leveling of upper and lower anterior teeth we placed Multi- Tooth Extrusion attachment (G4) at upper incisors and canines.

     

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

Initial Final
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