Mandibular retrognathia
,
Class II div 1
,
Increased overjet
,
Spacing

Mandibular advancement
,
Elastics: Class II in Additional Aligners
,
Leveling curve of Spee
,
Extrusion

Treatment in the Spotlight

Dr T. Lee
Dr T. Lee

Dr. Quote: "Simultaneous tooth alignment and profile change in Class II teenagers can now be achieved by Invisalign Treatment with Mandibular Advancement Appliance. This case shows that suitable case selection with stepwise clincheck planning, close clinical monitoring together with patient’s compliance are the keys to the success of the treatment. "

Treatment information

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

Diagnostic Summary

  • Class II div 1
  • Increased overjet
  • Mandibular retrognathia
  • Spacing

Use of:

  • Extrusion
  • Leveling Curve of Spee
  • Class II Elastics in Additional Aligners
  • Mandibular advancement
  • Optimized rotation attachment (G3) on Buccal 2.3 (UL3), Buccal 2.4 (UL4), Buccal 4.3 (LR3), Buccal 3.4 (LL4)
  • Optimized multiplane (G4) on Buccal 1.2 (UR2), Buccal 2.2 (UL2)
  • Optimized root control attachments (G4) on Buccal 1.3 (UR3), Buccal 1.4 (UR4)
  • Optimized deepbite attachments for anchorage (G5) on Buccal 4.4 (LR4)
  • Precision wings brackets (MA)
Courtesy of Dr T. Lee 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
Download ADF files
Initial
Additional Aligners

Treatment summary

Results Achieved

  • Class I relationship achieved
  • Functional canine guidance on both sides
  • Overjet improved
  • Significant improvement of overjet
  • Midlines coincident
  • Curve of Spee leveled
  • Arch form improved
  • Aesthetic smile line was achieved
  • All treatment goals were achieved case

Total treatment Time

  • 15 months

Number of aligners

  • Maxillary: 32 + 20 = 52
  • Mandibular: 32 + 20 = 52

Aligner wear time

  • 1-week

Comments

Overjet Reduction from 9mm to 2.5mm by Invisalign Mandibular Advancement Appliance:

  • 1) MA phase with 3 steps advancements - 1st advancement with stage 1-8, 2nd advancement with stage 9-16, 3rd advancement with stage 17-27
  • 2) Transition phase- stage 28-32
  • 3) Additional Aligners for refinement and settle of posterior occlusion with 20 active stage + Class II elastics.

Retention

  • Maxillary:
  • Mandibular: