Asymmetric arches
,
Crowding
,
Increased overjet
,
Narrow arches
,
Openbite
,
Rotations

Elastics: Class II
,
Leveling curve of Spee
,
Extrusion
,
Expansion
,
Retraction
,
IPR

Treatment information

  • Age: 12
  • Gender: female
  • Invisalign Treatment Option: Invisalign Teen

Diagnostic Summary

  • Class II
  • Narrow arches
  • Increased overjet
  • Openbite
  • Crowding
  • Rotations
  • Asymmetric arches

Use of:

  • Expansion
  • Extrusion
  • Leveling Curve of Spee
  • Retraction
  • IPR
  • Elastics: Class II
  • Optimized rotation attachment (G3) on Buccal 1.5 (UR5), Buccal 2.4 (UL4), Buccal 4.3 (LR3), Buccal 4.4 (LR4), Buccal 3.3 (LL3), Buccal 3.4 (LL4)
  • Optimized extrusion attachment (G3) on Buccal 1.1 (UR1), Buccal 1.2 (UR2), Buccal 1.3 (UR3), Buccal 2.1 (UL1), Buccal 2.2 (UL2), Buccal 2.3 (UL3), Buccal 4.1 (LR1), Buccal 4.2 (LR2), Buccal 4.3 (LR3), Buccal 3.1 (LL1), Buccal 3.2 (LL2), Buccal 3.3 (LL3)
  • Optimized root control attachments (G4) on Buccal 2.5 (UL5), Buccal 3.5 (LL5)
  • Multi-tooth extrusion attachments (G4) on Buccal 1.1 (UR1), Buccal 1.2 (UR2), Buccal 1.3 (UR3), Buccal 2.1 (UL1), Buccal 2.2 (UL2), Buccal 2.3 (UL3), Buccal 4.1 (LR1), Buccal 4.2 (LR2), Buccal 4.3 (LR3), Buccal 3.1 (LL1), Buccal 3.2 (LL2), Buccal 3.3 (LL3)
  • Pressure areas (G5) on Buccal 3.5 (LL5)
Courtesy of Dr K. Malekian 2018

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
  • Class I relationship maintained
  • Functional canine guidance on both sides
  • Normal  overjet and overbite achieved
  • Overjet improved
  • Significant improvement of overbite
  • 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 line was achieved
  • All treatment goals were achieved case
  • Harmonic arches were achieved

Total treatment Time

  • 27 months

Number of aligners

  • Maxillary: 42 + 33 + 17 = 92
  • Mandibular: 42 + 27 + 17 = 86

Aligner wear time

  • We started with 2 weeks, while treatment progressed we adjusted the wear time from 14 days to 10, then 7 and we ended with 5 day wear time.

Comments

  • Upper incisor retraction : Reduce anterior over jet
  • Relative anterior extrusion was achieved with upper anterior retraction.
  • Canine extrusion 1.3,2.3: Optimized extrusion attachments
  • Lower canine retraction and rotation
  • IPR ClinCheck personification
  • Class II elastics full time in order to achieve class I molar and canine
  • Extrusion of upper and lower anterior incisors and canines : Optimized extrusion attachments