Class II div 1
,
Mandibular retrognathia
,
Asymmetric arches
,
Mandibular midline deviation

Leveling Curve of Spee
,
Intrusion
Courtesy of Dr G. Thiesen, 2019
Before picture of treatment

Treatment Summary

Patient Information

  • Age: 17
  • Gender: female
  • Invisalign Treatment Option: Invisalign Full

Total Treatment Time

  • 6 months

Number of aligners

  • Maxillary: 27
  • Mandibulary: 27

Aligner Wear time

  • 1-week

Results achieved

  • Class I relationship achieved
  • Functional canine guidance on both sides
  • Normal overjet and overbite achieved
  • Significant improvement of overjet
  • Midlines coincident
  • All treatment goals were achieved case
  • Harmonic arches were achieved

Comments

  • Surgery-first approach: orthognathic surgery was done right after IPR and bonding all the attachments, a surgical splint was maintained in place for 14 days after surgery
  • After removing the surgical splint, the aligners were changed on a 5/day frequency and after 3 months on a weekly basis
  • The total treatment time was 6 months
  • During the orthodontic treatment the maxillary and mandibular dental arches were better aligned, and maxillary and mandibular incisor inclinations were improved
  • Ideal overbite was obtained by intruding the mandibular and maxillary anterior teeth which were moved asymmetrically to help to correct the cant in the occlusal plane (partially corrected by the orthognatic surgery)
  • Ideal overjet was obtained by the surgical mandibular advance, associated with the use of Class II elastics after that

Images

Initial and final

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Progress

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InitialFinal
Before picture of treatment
After picture of treatment
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Radiographs

Initial Final
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