Class II div 2
,
Mandibular retrognathia
,
Narrow arches
,
Asymmetric arches
,
Crowding

Mandibular advancement
,
Distalization
,
Mesialization
,
Leveling curve of Spee
,
Extrusion
,
Intrusion
,
Expansion
,
Proclination
,
IPR

Treatment in the Spotlight

Dr. J. L. Lagunilla Ruiz
Dr. J. L. Lagunilla Ruiz

We would like to congratulate Dr. Lagunilla Ruiz with winning the Scientific Symposium 2019 Peer review awards!

Dr. Quote: “I wanted to show with this treatment that a class II case which many classical orthodontists would have solved with extractions of 1.4 and 2.4, can be solved using Invisalign, performing the  alignment and the mandibular advancement simultaneously, in a short period of time and without the need for extractions, with a good treatment planning and thanks to patient's collaboration”.

 

Treatment information

  • Age: 13
  • Gender: female
  • Invisalign Treatment Option: Invisalign Teen with MA

Diagnostic Summary

  • Class II div 2
  • Mandibular retrognathia
  • Narrow arches
  • Asymmetric arches
  • Crowding

Use of:

  • Distalization
  • Mesialization
  • Expansion
  • Extrusion
  • Intrusion
  • Leveling Curve of Spee
  • Proclination
  • IPR
  • Mandibular advancement
  • Optimized rotation attachment (G3) on Buccal 1.3 (UR3), Buccal 1.5 (UR5), Buccal 2.3 (UL3), Buccal 4.3 (LR3), Buccal 4.4 (LR4), Buccal 4.5 (LR5), Lingual 3.4 (LL4), Lingual 3.5 (LL5)
  • Optimized extrusion attachment (G3) on Buccal 1.2 (UR2), Buccal 2.1 (UL1), Buccal 2.2 (UL2)
  • Precision wings (MA)
Courtesy of Dr. J. L. Lagunilla Ruiz 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
  • Normal  overjet and overbite achieved
  • Deepbite improved
  • Overjet improved
  • 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

  • 17 months

Number of aligners

  • Maxillary: 46 + 16 + 15 = 77
  • Mandibular: 46 + 13 + 9 = 68

Aligner wear time

  • 1-week

Comments

  • Our plan was to expand the arches this helped to solve the crowding and created space to align the teeth and extrude the 1.3 and the 2.3
  • All treatment goals were achieved