Class II div 1
,
Increased overjet
,
Openbite
,
Narrow arches
,
Posterior crossbite
,
Maxillary midline deviation
,
Midline shift
,
Crowding
,
Rotations

Mandibular advancement
,
Expansion
,
Proclination
,
Phase I treatment / Interceptive

Treatment information

  • Age: 9
  • Gender: female
  • Invisalign Treatment Option: Invisalign Teen with MA

Diagnostic Summary

  • Class II div 1
  • Increased overjet
  • Openbite
  • Narrow arches
  • Posterior crossbite
  • Maxillary midline deviation
  • Midline shift
  • Crowding
  • Rotations

Use of:

  • Expansion
  • Proclination
  • Mandibular advancement
  • Optimized rotation attachment (G3) on Buccal 1.3 (UR3)
  • Optimized extrusion attachment (G3) on Buccal 1.1 (UR1), Buccal 2.1 (UL1), Buccal 2.2 (UL2)
  • Power ridge feature (G3) on Buccal 4.1 (LR1), Buccal 4.2 (LR2), Buccal 3.1 (LL1)
  • Precision wings (MA) on Buccal 1.6 (UR6), Buccal 2.6 (UL6), Buccal 4.6 (LR6), Buccal 3.6 (LL6)
Courtesy of Dr F. Garino 2019

Photos

Click to compare enlarged
upper
Initial
lower
right
front
left
Click to compare enlarged
upper
Final of Phase I
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
  • Posterior crossbite corrected
  • NormalĀ  overjet and overbite achieved
  • Significant improvement of overjet
  • Midlines coincident
  • Arches aligned and coordinated
  • Alignment of both arches through derotation
  • Arch form improved
  • All treatment goals were achieved case
  • Harmonic arches were achieved

Total treatment Time

  • 17 months

Number of aligners

  • Maxillary: 40 + 18 = 58
  • Mandibular: 40 + 11 = 51

Aligner wear time

  • 1-week

Comments

  • Expansion in the upper arch as needed to obtain space for 1.2 and increase intercanine width in combination with the use of MA Precion wings to allow class II correction
  • In the lower arch the crowding was corrected through expansion and proclination
  • Additional aligners were used to extrude 1.2 once space was created
  • The patient ended his phase 1 of treatment with Class II corrected into an almost a Class I molar relationship considering that lee way space will be used since still in mixed dentition
  • The case will be evaluated in the next 1-2 years and if needed a short phase II to correct minor tooth movements of permanent canines and bicuspids will be done
  • I shared this case to show how important the use of a phase I treatment for a growing patient with the use of not only tooth movement but also a functional treatment can be

Retention

  • Maxillary:
  • Mandibular: