Class III
,
Anterior crossbite
,
Openbite
,
Narrow arches
,
Posterior crossbite
,
Asymmetric arches
,
Mandibular midline deviation
,
Midline shift
,
Crowding
,
Rotations
,
Spacing
,
Pre-restorative

Elastics: Class III
,
Distalization
,
Leveling curve of Spee
,
Extrusion
,
Expansion
,
Retraction
,
Proclination
,
Space Closure

Treatment information

  • Age: 21
  • Gender: female
  • Invisalign Treatment Option: Invisalign Full

Diagnostic Summary

  • Class III
  • Anterior crossbite
  • Openbite
  • Narrow arches
  • Posterior crossbite
  • Asymmetric arches
  • Mandibular midline deviation
  • Midline shift
  • Crowding
  • Rotations
  • Spacing
  • Pre-restorative

Use of:

  • Distalization
  • Expansion
  • Extrusion
  • Leveling Curve of Spee
  • Proclination
  • Retraction
  • Space Closure
  • Elastics: Class III
  • Optimized rotation attachment (G3) on Buccal 1.5 (UR5), Buccal 2.5 (UL5), Buccal 4.5 (LR5), Buccal 3.5 (LL5)
  • Multi-tooth extrusion attachments (G4) on Buccal 1.1 (UR1), Buccal 1.2 (UR2), Buccal 2.1 (UL1), Buccal 2.2 (UL2)
  • Pressure areas (G5) on Lingual 4.3 (LR3), Lingual 3.3 (LL3)
Courtesy of Dr. S. Chieh Lin 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

Treatment summary

Results Achieved

  • Class I relationship achieved
  • Functional canine guidance on both sides
  • Anterior crossbite corrected
  • Posterior crossbite corrected
  • Normal  overjet and overbite achieved
  • 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

  • 21 months

Number of aligners

  • Maxillary: 45 + 10 + 8 = 63
  • Mandibular: 45 + 17 + 12 = 74

Aligner wear time

  • 1-week

Comments

  • This is a skeletal Class III mandibular prognathism with anterior crossbite case.
  • Although the patient is missing two congenital lower incisors, she also has a larger size 4.3
  • The Treatment plan was to retract the lower teeth by space closure and proline upper teeth to correct the anterior  crossbite and open bite
  • Rotational 3.5 and the posterior crossbite were also corrected at the end of the treatment
  • This patient had severe decalcification from the beginning this is a very good indication to prefer Invisalign treatment instead of conventional treatment as oral hygiene is difficult to maintain during conventional treatment

Retention

  • Maxillary: Hawley
  • Mandibular: Hawley