Class II div 2
,
Increased overjet
,
Openbite
,
Asymmetric arches
,
Mandibular midline deviation
,
Midline shift
,
Crowding
,
Rotations

Distalization
,
Elastics: Class III
,
Elastics: vertical
,
Extrusion
,
Expansion

Treatment information

  • Age: 22
  • Gender: female
  • Invisalign Treatment Option: Full

Diagnostic Summary

  • Class II div 2
  • Increased overjet
  • Openbite
  • Asymmetric arches
  • Mandibular midline deviation
  • Midline shift
  • Crowding
  • Rotations

Use of:

  • Distalization
  • Expansion
  • Extrusion
  • Elastics: Vertical
  • Elastics: Class II
  • Class II Elastics in Additional Aligners
  • Optimized rotation attachment (G3) on Buccal 1.5 (UR5), Buccal 4.3 (LR3)
  • Optimized root control attachments (G4) on Buccal 2.4 (UL4)
  • Multi-tooth extrusion attachments (G4) on Buccal 1.1 (UR1), Buccal 2.1 (UL1), Buccal 4.1 (LR1), Buccal 4.2 (LR2), Buccal 3.1 (LL1), Buccal 3.2 (LL2)
  • Optimized support attachment on upper laterals (G7) on Buccal 1.2 (UR2), Buccal 2.2 (UL2)
Courtesy of Dr. S. Okano 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
Additional Aligners

Treatment summary

Results Achieved

  • Class I relationship achieved
  • Functional canine guidance on both sides
  • Normal  overjet and overbite achieved
  • Overjet improved
  • Significant improvement of overbite
  • Significant improvement of overjet
  • Midlines coincident
  • Proper axial inclination of incisors
  • 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

  • 18 months

Number of aligners

  • Maxillary: 23+51=74
  • Mandibular: 23+51=74

Aligner wear time

  • 1-week

Comments

  • Aligned and coordinated the arches which proved to be very effective to improve open bite
  • The initial treatment plan aimed at mandibular advancement to improve Class II by rotation removing the occlusal interference
  • In the additional aligners, sequential distalization was performed to further improve Class II
  • Class II elastics (3/16 inch, 4.5 or 6.5 OZ) continued using from stage 1 in the additional aligners