Class III
,
Posterior crossbite
,
Anterior crossbite
,
Edge to edge bite
,
Deep bite
,
Narrow arches
,
Asymmetric arches
,
Maxillary midline deviation
,
Mandibular midline deviation
,
Midline shift
,
Crowding
,
Rotations

Distalization
,
Leveling curve of Spee
,
Extrusion
,
Intrusion
,
Expansion
,
Proclination
,
IPR
,
Elastics: Class III
Courtesy of Dr K. Malekian, 2018
Award 2019 Peer Review Award
Before picture of treatment

Treatment Summary

Patient Information

  • Age: 30
  • Gender: male
  • Invisalign Treatment Option: Invisalign Full

Total Treatment Time

  • 21 months

Number of aligners

  • Maxillary: 32 + 33 + 20 = 85
  • Mandibulary: 32 + 33 + 20 = 85

Aligner Wear time

  • 10 day aligner change for treatment aligner. Refinement aligner change range between 7-5 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
  • 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
  • Alignment of both arches through derotation
  • Arch form improved
  • Aesthetic smile linewas achieved
  • All treatment goals were achieved case
  • Harmonic arches were achieved

Comments

  • Determine space selection was the key factor to resolve the severe crowding in the upper and lower arch
  • Staging was also a key factor: We started with high expansion of upper molars and premolars and when gained enough space we continued with arch development and retraction to extrude upper canines
  • IPR was planned at upper and lower premolars
  • Carefull IPR tracking with distalization movement of upper and lower premolars allowed space in order to align high angle rotation of canines 2.3,3.3 and 4.3 .
  • Conventional bite ramps at the buccal surface of lower four incisors were used in order to correct the deepbite
  • Class III elastics were used in order to improve the anterior/posterior relationship and turn Class III canine and molar into full class I molar and canine.
  • Proclination of upper laterals 1.2 and 2.2 in order to correct the anterior crossbite.
  • Arch coordination tool at clincheck Pro was very helpfull.
  • The maxilla and mandible arch form at stage U0-L0 were very asymmetric and required arch form coordination.
  • Lower incisor proclination and simultaneously lower canines were retracted and distalized

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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