Class II div 1
,
Increased overjet
,
Deepbite
,
Narrow arches
,
Asymmetric arches
,
Maxillary midline deviation
,
Mandibular midline deviation
,
Midline shift
,
Crowding
,
Rotations

Elastics: Class II
,
Leveling curve of Spee
,
Extrusion
,
Intrusion
,
Expansion
,
Proclination

Treatment information

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

Diagnostic Summary

  • Class II div 1 relationship
  • Narrow Arches
  • Midline Shift
  • Mandibular midline deviation
  • Maxillary midline deviation
  • Deepbite
  • Increased overjet
  • Crowding
  • Rotations
  • Asymmetric arches

Use of:

  • Elastics: Class II
  • Leveling Curve of Spee
  • Expansion
  • Extrusion
  • Intrusion
  • Proclination
  • Power Ridge Feature on Buccal 1.1 (UR1)
  • Optimized Rotation Attachment (G3) on Buccal 1.5 (UR5), Buccal 2.5 (UL5), Buccal 4.3 (LR3), Buccal 4.4 (LR4), Buccal 4.5 (LR5), Buccal 3.3 (LL3), Buccal 3.4 (LL4), Buccal 3.5 (LL5)
  • Optimized Root Control Attachments (G4) on Buccal 1.3 (UR3), Buccal 1.4 (UR4), Buccal 2.1 (UL1), Buccal 2.2 (UL2), Buccal 2.3 (UL3), Buccal 2.4 (UL4)
  • Conventional Bite Ramp on Lingual 1.3 (UR3), Lingual 2.3 (UL3)
  • Pressure Areas (G5) on Lingual 1.1 (UR1), Lingual 1.2 (UR2), Lingual 2.1 (UL1), Lingual 4.1 (LR1), Lingual 4.2 (LR2), Lingual 3.1 (LL1), Lingual 3.2 (LL2)
Courtesy of Dr M. Pedernera 2018
Award 2019 Peer Review Award

Photos

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

Radiographs

ClinCheck treatment plan

video anterior
video right-left
video upper-lower

Treatment summary

Results Achieved

  • Class I relationship achieved
  • Functional canine guidance on both sides
  • Normal¬† overjet and overbite achieved
  • Midlines coincident
  • Proper axial inclination of incisors
  • Curve of Spee levelled
  • Arches aligned and coordinated
  • Aesthetic smile line¬†was achieved
  • All treatment goals were achieved case
  • Harmonic arches were achieved

Total treatment Time

  • 15 months

Number of aligners

  • Maxillary: 17 + 9 + 10 = 36
  • Mandibular: 18 + 9 + 8 = 35

Aligner wear time

  • The first set of aligners were changed every 2 weeks
  • The Additional Aligners were changed every week

Comments

  • This case was very challenging for me because the patient wanted not only to improve the crowded teeth but to improve his profile.
  • The main issue was to solve the crowding of the lower teeth and performing intrusion of both the upper and lower incisors.
  • In order to correct the Spee curve some extrusion of the lateral sectors was needed and the conventional bite ramps helped.
  • The patient wore his aligners and elastics the right amount of time
  • Class II elastics full time on the left side and only at night on the right side.

Retention

  • Maxillary:
  • Mandibular: