Class II div 1
,
Increased overjet
,
Narrow arches
,
Mandibular midline deviation
,
Crowding
,
Rotations

Restorative
,
Leveling curve of Spee
,
Extrusion
,
Intrusion
,
Expansion
,
Retraction
,
IPR
,
Implants

Treatment information

  • Age: 69
  • Gender: female
  • Invisalign Treatment Option: Invisalign Full

Diagnostic Summary

  • Class II div 1
  • Increased overjet
  • Narrow arches
  • Mandibular midline deviation
  • Crowding
  • Rotations

Use of:

  • Expansion
  • Extrusion
  • Intrusion
  • Leveling Curve of Spee
  • Retraction
  • IPR
  • Pre-restorative
  • Implants
  • Optimized rotation attachment (G3) on Buccal 1.4 (UR4), Buccal 1.5 (UR5), Buccal 4.4 (LR4), Buccal 3.3 (LL3)
  • Optimized root control attachments (G4) on Buccal 1.2 (UR2), Buccal 1.3 (UR3), Buccal 2.1 (UL1), Buccal 2.2 (UL2), Buccal 2.3 (UL3), Buccal 2.4 (UL4), Buccal 3.4 (LL4)
  • Optimized deepbite attachments for anchorage (G5) on Buccal 4.5 (LR5)
  • Pressure areas (G5) on Lingual 2.1 (UL1), Lingual 4.1 (LR1), Lingual 4.2 (LR2), Lingual 4.3 (LR3), Lingual 3.1 (LL1), Lingual 3.2 (LL2), Lingual 3.3 (LL3)
  • Optimized extrusion attachments for molars (G7+) on Buccal 3.5 (LL5)
Courtesy of Dr R. Loyer 2019

Photos

Click to compare enlarged
upper
Initial
lower
right
front
left
Click to compare enlarged
upper
Final
lower
right
front
left
Click to compare enlarged
upper
Progress
lower
right
front
left

Radiographs

ClinCheck treatment plan

video anterior
video right-left
video upper-lower
Download ADF files
Initial

Treatment summary

Results Achieved

  • Class I relationship maintained
  • Class II relationship maintained
  • Normal¬† overjet and overbite achieved
  • Significant improvement of overjet
  • Proper axial inclination of incisors
  • Curve of Spee leveled
  • Arches aligned and coordinated
  • Arch form improved
  • Aesthetic smile line¬†was achieved
  • All treatment goals were achieved case
  • Harmonic arches were achieved

Total treatment Time

  • 9 months

Number of aligners

  • Maxillary: 19
  • Mandibular: 19

Aligner wear time

  • 2-weeks

Comments

  • This patient was formerly treated for her bruxism with the diagnosis of Cervico-Cranio-Mandibular Disorder
  • The final position of her mandibular bone was stable
  • We did expansion and bimaxillary arch correction
  • We created more lingual torque to superior incisors, vestibular torque to inferior incisors, intruded inferior incisors to improve the curve of Spee
  • We improved the superior and inferior canine interrelationship in order to reconstruct canine cusps in a later stage to obtain canine guidance
  • Our goal was to smoothen the sulcus of the inferior lip and chin and to close the nasal-labial angle to improve the patient's profile.
  • We wanted to obtain a right-side Class I dental relationship, but the patient was satisfied and didn't want to continue with Additional Aligners
  • She decided that for her age and condition, the initial treatment including the posterior canine cusp reconstruction was really good. The treatment surpassed her initial expectations