Mandibular retrognathia
,
Class II div 1
,
Increased overjet
,
Deep bite
,
Crowding
,
Rotations

Mandibular advancement
,
Leveling Curve of Spee
,
Intrusion
,
Expansion
,
Proclination
,
Elastics: Class II
Courtesy of Dr B. Glaser, 2018
Before picture of treatment

Treatment Summary

Patient Information

  • Age: 11
  • Gender: male
  • Invisalign Treatment Option: Teen

Total Treatment Time

  • 21 months

Aligner Wear time

  • Initially 2 week wear as part of study protocol. switched to 1 week wear mid-treatment as part of revision to study protocol

Results achieved

  • Class I relationship achieved
  • Functional canine guidance on both sides
  • Normal overjet and overbite achieved
  • Deepbite improved
  • Overjet improved
  • Significant improvement ofoverbite
  • Significant improvement of overjet
  • Midlines coincident
  • Proper axial inclination of incisors
  • Curve of Spee levelled
  • Arches aligned and coordinated
  • Aesthetic smile linewas achieved
  • All treatment goals were achieved case

Comments

  • After 27 aligners in both arches, the patient was Class I canine on the right side and 3 mm Class II
    canine on the left.
  • Aligner wear compliance was good and oral hygiene was
    excellent.
  • The majority of the crowding in both arches was resolved during
    the mandibular advancement phase.
  • The bilateral posterior open bite present
    would be closed by additional leveling of the curve of Spee, along with lingual
    root torque of the upper anterior teeth.
  • By reducing the anterior interference's,
    the mandible would be able to auto rotate into a better Class I relationship.
  • Additional Aligners Phase: One set of Additional Aligners was used, which
    lasted 9 months (19 U/L stages, weekly aligner changes.)
  • Reverse curve of Spee was added to the set-up of the lower arch to correct the deep bite
    and remove any heavy anterior occlusion, in order to close the posterior
    open bite.
  • A 4 oz. Class II elastic was worn on the left side only for just
    6 weeks, from aligner stages 14 to 19 (with Precision Cuts on the upper canine
    and the lower first molar), to complete the sagittal correction to Class I.
  • All remaining rotations were fully resolved during Additional Aligners. The
    total treatment time for this patient was 21 months (11 months for the
    mandibular-advancement phase, 1 month for transitional aligners awaiting
    Additional Aligners, and 9 months for Additional Aligners with standard
    Invisalign treatment), which is well within the expected treatment time for
    this severity of Class II malocclusion.

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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