Class I
,
Class III
,
Narrow arches
,
Mandibular midline deviation
,
Midline shift
,
Crowding
,
Rotations

Distalization
,
Mesialization
,
Leveling Curve of Spee
,
Extrusion
,
Intrusion
,
Expansion
,
Proclination
,
Elastics: Class II
Courtesy of Dr M. Pedernera, 2018
Before picture of treatment

Treatment Summary

Patient Information

  • Age: 13
  • Gender: female
  • Invisalign Treatment Option: Invisalign Teen

Total Treatment Time

  • 28 months

Number of aligners

  • Maxillary: 50 + 16 + 21 = 87
  • Mandibulary: 50 + 16 + 21 = 87

Aligner Wear time

  • Every 2 weeks the first set of aligners and every week in the Additional Aligners

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
  • Alignment of both arches through derotation
  • Arch form improved
  • Aesthetic smile linewas achieved
  • All treatment goals were achieved case
  • Harmonic arches were achieved

Comments

  • To create space for a future implant in the zone of 4.5 I planned on distalizing 4.6 and 4.7
  • Mesialization on 4.4, 4.3 created the opportunity tocorrect the lower midline and upright the tipped lower incisors
  • The space for the eruption of 3.5 was bigger than needed therefor we distalized 3.4 and 3.3 in order to create a more organic space
  • To solve the deep bite I planned intrusion of lower anterior teeth and intrusion on 3.7 and 4.7, with mild extrusion of lower premolars and first molars.
  • To help with the intrusion we used precision bite ramps in palatal of 1.2, 1.1, 2.1 and 2.2.
  • Upper jaw sequenced expansion by 1/2 protocol and expansion of the posterior teeth
  • De-rotation of 1.6 and 2.6 before aligning the anterior teeth and retruding them
  • The cooperation of the patient during the hole treatment was absolutely fantastic

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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