Class III
,
Anterior crossbite
,
Posterior crossbite
,
Asymmetric arches
,
Mandibular midline deviation
,
Midline shift
,
Crowding
,
Pre-restorative

Elastics: Class II
,
Elastics: Class III
,
Leveling curve of Spee
,
Extrusion
,
Intrusion
,
Expansion
,
Proclination
,
IPR
,
Restorative

Treatment information

  • Age: 48
  • Gender: female
  • Invisalign Treatment Option: Invisalign Full

Diagnostic Summary

  • Class III
  • Anterior crossbite
  • Posterior crossbite
  • Asymmetric arches
  • Mandibular midline deviation
  • Midline shift
  • Crowding
  • Pre-restorative

Use of:

  • Expansion
  • Extrusion
  • Intrusion
  • Leveling Curve of Spee
  • Proclination
  • IPR
  • Elastics: Class II
  • Elastics: Class III
  • Pre-restorative
  • Anterior Cross and Posterior Triangle
  • Optimized rotation attachment (G3)
  • Optimized extrusion attachment (G3)
  • Power ridge feature (G3)
  • Optimized root control attachments (G4)
  • Multi-tooth extrusion attachments (G4)
Courtesy of Dr L. Ching Fan Li 2019

Photos

Click to compare enlarged
upper
Initial
lower
right
front
left
Click to compare enlarged
upper
Final
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
  • Anterior crossbite corrected
  • Posterior crossbite corrected
  • Normal¬† overjet and overbite achieved
  • Proper axial inclination of incisors
  • Curve of Spee leveled
  • Arches aligned and coordinated
  • Alignment of both arches through derotation
  • Aesthetic smile line¬†was achieved
  • All treatment goals were achieved case
  • Harmonic arches were achieved

Total treatment Time

  • 20 months

Number of aligners

  • Maxillary: 46 + 17 + 22 = 85
  • Mandibular: 46 + 17 + 22 = 85

Aligner wear time

  • Initially every 10 days, weekly from MCC

Comments

  • The premature contact between anterior teeth leading mandibular displacement was corrected by proclination of upper anterior teeth and upper and lower arch expansion
  • Different patterns of elastics were used throughout the treatment to help arch coordination
  • Extrusion with attachments worked great with leveling of curve of Spee and settling the bite
  • Periodontal condition was maintained
  • Root canal treatment was completed on the upper left canine (23).
  • Prior to final refinement we did composite build up of upper anterior teeth after correction of the anterior crossbite