The use of intermaxillary cross elastics to bonded buttons assisted with complicated and unpredictable, teeth movement, such as maxillary expansion, was necessary, especially in this non-growing patient.
The use of cross elastics allowed good tracking of the treatment throughout the planned tooth movements.
Full occlusal coverage of all erupted teeth allowed excellent control of the vertical dimension in this patient with a vertical growth pattern.
The ‘end-on-end’ right buccal segment relationship was due in part to mesial migration of the upper right buccal segment, an asymmetric upper arch, Bolton’s discrepancy with relative mandibular excess, and small teeth 12 and 22.
The patient wanted to avoid restorative veneer build-ups of teeth 12 and 22. Additionally, distalization in the upper right quadrant was not advisable due to the underlying Class III skeletal pattern.
This treatment decision to not fully correct the right buccal segment relationship was independent of the Invisalign System.
An aesthetic and functional occlusion was achieved despite us not attempting to fully correct the right buccal segment relationship.
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