Class I
,
Increased overjet
,
Deep bite
,
Narrow arches
,
Midline shift
,
Crowding
,
Rotations

Leveling Curve of Spee
,
Intrusion
,
Expansion
,
Proclination
,
IPR
Courtesy of Dr M. Pedernera, 2018
Before picture of treatment

Treatment Summary

Patient Information

  • Age: 27
  • Gender: female
  • Invisalign Treatment Option: Invisalign Full

Total Treatment Time

  • 13 months

Number of aligners

  • Maxillary: 20 + 21 + 17 = 58
  • Mandibulary: 20 + 21 + 17 = 58

Aligner Wear time

  • 1-week

Results achieved

  • Class I relationship maintained
  • Functional canine guidance on both sides
  • Normal overjet and overbite achieved
  • Midlines coincident
  • Curve of Spee levelled
  • Arches aligned and coordinated
  • All treatment goals were achieved case

Comments

  • Treatment plan was to expand both arches to improve the narrow arches
  • I planned an strategic IPR from lower 4 to lower 4 in order to compensate the Bolton discrepancy and be able to end up in a full Class I with centered midlines
  • Lower incisors intrusion was planned together with very mild proclination to correct the deep bite. 
  • One thing to have into account is the amount of IPR that is more than the recommended by align because, I didn't want to procline lower incisors too much in order to avoid anterior contacts, also the periodontal biotype is thin, but mainly because of the Bolton Index discrepancy which says there's an excess of dental material in the lower arch not only in the anterior sector but in the posterior.
  • The patient didn't accept a "lower incisor extraction".

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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