Class II div 2
,
Increased overjet
,
Mandibular retrognathia
,
Deepbite
,
Narrow arches
,
Asymmetric arches
,
Mandibular midline deviation
,
Crowding
,
Rotations

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

Treatment information

  • Age: 18
  • Gender: female
  • Invisalign Treatment Option: Invisalign Full

Diagnostic Summary

  • Class II div 2
  • Increased overjet
  • Mandibular retrognathia
  • Deepbite
  • Narrow arches
  • Asymmetric arches
  • Mandibular midline deviation
  • Crowding
  • Rotations

Use of:

  • Distalization
  • Expansion
  • Leveling Curve of Spee
  • Retraction
  • IPR
  • Elastics: Class II
  • Optimized rotation attachment (G3) on Buccal 1.3 (UR3), Buccal 1.4 (UR4), Buccal 3.3 (LL3)
  • Power ridge feature (G3) on Buccal 2.2 (UL2), Buccal 4.2 (LR2)
  • Optimized root control attachments (G4) on Buccal 2.3 (UL3), Buccal 2.4 (UL4), Buccal 2.5 (UL5), Buccal 4.4 (LR4)
  • Optimized deepbite attachments for anchorage (G5) on Buccal 1.5 (UR5), Buccal 3.4 (LL4)
  • Pressure areas (G5) on Lingual 1.1 (UR1), Lingual 1.2 (UR2), Lingual 2.1 (UL1), Lingual 4.1 (LR1), Lingual 4.2 (LR2), Lingual 4.3 (LR3), Lingual 3.1 (LL1), Lingual 3.2 (LL2), Lingual 3.3 (LL3)
Courtesy of Dr M. Simonetta 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
  • Significant improvement of overbite
  • Significant improvement of overjet
  • Midlines coincident
  • Proper axial inclination of incisors
  • Curve of Spee leveled
  • 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

  • 21 months

Number of aligners

  • Maxillary: 33 + 22 + 16 = 71
  • Mandibular: 18 + 15 + 16 = 49

Aligner wear time

  • Initial 10 days, refinements 7 days

Comments

  • Although the patient had a severe class II and was at the end of her growth, she refused to extract or perform surgery
  • All treatment was performed to eliminate occlusal interference, such as deep bite and contraction of the upper arch, then opening the bite and expanding the upper arch.