Class III
,
Openbite
,
Midline shift
,
Crowding
,
Rotations

Elastics: Class III
,
Mesialization
,
Extrusion
,
Intrusion
,
Expansion
,
IPR

Treatment information

  • Age: 26
  • Gender: female
  • Invisalign Treatment Option: Invisalign Full

Diagnostic Summary

  • Class III
  • Openbite
  • Midline shift
  • Crowding
  • Rotations

Use of:

  • Mesialization
  • Expansion
  • Extrusion
  • Intrusion
  • IPR
  • Elastics: Class III
  • Optimized rotation attachment (G3) on Buccal 1.3 (UR3), Buccal 1.4 (UR4), Buccal 2.3 (UL3), Buccal 2.5 (UL5), Buccal 4.3 (LR3), Buccal 4.5 (LR5), Buccal 3.3 (LL3), Buccal 3.4 (LL4), Buccal 3.5 (LL5)
  • Optimized extrusion attachment (G3) on Buccal 4.1 (LR1), Buccal 4.2 (LR2), Buccal 3.1 (LL1), Buccal 3.2 (LL2)
  • Optimized multiplane (G4) on Buccal 1.2 (UR2)
  • Optimized root control attachments (G4) on Buccal 1.1 (UR1), Buccal 1.5 (UR5), Buccal 2.4 (UL4), Buccal 4.4 (LR4)
  • Pressure areas (G5) on Lingual 1.1 (UR1), Lingual 2.1 (UL1), Lingual 2.2 (UL2)
Courtesy of Dr M. Pedernera 2019

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
  • Functional canine guidance on both sides
  • Normal¬† overjet and overbite achieved
  • Midlines coincident
  • Proper axial inclination of incisors
  • Arches aligned and coordinated
  • Aesthetic smile line¬†was achieved
  • All treatment goals were achieved case

Total treatment Time

  • 20 months

Number of aligners

  • Maxillary: 28 + 17 + 17 = 62
  • Mandibular: 28 + 17 + 17 = 62

Aligner wear time

  • 1-week

Comments

  • The chief concern was that it the patient was not able to bite properly (through food) with the anterior teeth.
  • The patient didn't accept the use of TAD's so she challenged me and asked me to try with anterior extrusion and posterior intrusion with the help of chewies
  • The patient moved to another country during treatment.
  • My treatment plan was to expand both arches to improve the narrow arch situation
  • In the first Clincheck I asked to close the anterior open bite through Anterior Extrusion, combined with posterior intrusion and it worked just perfect.
  • I ordered the extraction of all wisdom teeth, and that has reduced the open bite significantly, allowing the premolars and anterior teeth to contact for the first time in her life
  • Once we arrived in the final stage of additional aligners (last 4 aligners), there was an issue with 1.2 and 2.2 not fitting well
  • I've managed to force eruption with buttons and elastics as you can see in the intermediate pictures
  • The orthodontic treatment was combined with a lingual reeducation working hand to hand with a Speech Therapist
  • We finalized the treatment with fixed retainers from cuspid to cuspid and Vivera retainers on top and bottom.

Retention

  • Maxillary:
  • Mandibular: