Class II div 1
,
Increased overjet
,
Mandibular retrognathia
,
Deepbite
,
Posterior crossbite
,
Asymmetric arches
,
Maxillary midline deviation
,
Mandibular midline deviation
,
Crowding
,
Rotations

Mandibular advancement
,
Elastics: Class II in Additional Aligners
,
Distalization
,
Leveling curve of Spee
,
Intrusion
,
Expansion

Teen case of the month

Dr. J. Brabant
Dr. J. Brabant

We would like to congratulate Dr. Brabant with the results of this great Mandibular Advancement case and the 900th case published to the Global Invisalign Gallery!

Dr. Quote: “Invisalign with Mandibular Advancement helps not only the AP correction but also alignment and transverse correction at the same time.” 

 

Treatment information

  • Age: 14
  • Gender: male
  • Invisalign Treatment Option: Invisalign Teen with MA

Diagnostic Summary

  • Class II div 1
  • Increased overjet
  • Mandibular retrognathia
  • Deepbite
  • Posterior crossbite
  • Asymmetric arches
  • Maxillary midline deviation
  • Mandibular midline deviation
  • Crowding
  • Rotations

Use of:

  • Mandibular advancement
  • Distalization
  • Expansion
  • Intrusion
  • Leveling Curve of Spee
  • Class II Elastics in Additional Aligners
  • Optimized rotation attachment (G3) on Buccal 1.4 (UR4), Buccal 4.3 (LR3), Buccal 3.3 (LL3)
  • Power ridge feature (G3) on Buccal 2.1 (UL1)
  • Optimized root control attachments (G4) on Buccal 1.1 (UR1), Buccal 1.3 (UR3), Buccal 2.4 (UL4), Buccal 4.4 (LR4)
  • Optimized deepbite attachments for anchorage (G5) on Buccal 3.4 (LL4)
  • Optimized support attachment on upper laterals (G7) on Buccal 1.2 (UR2)
  • Precision wings brackets (MA) on Buccal 1.6 (UR6), Buccal 2.6 (UL6), Buccal 4.5 (LR5), Buccal 3.5 (LL5)
Courtesy of Dr. J. Brabant 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
  • 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
  • Arch form improved
  • Aesthetic smile line was achieved
  • All treatment goals were achieved case

Total treatment Time

  • 20 months

Number of aligners

  • Maxillary: 32 + 46 + 12 = 90
  • Mandibular: 32 + 46 + 12 = 90

Aligner wear time

  • 1-week

Comments

  • Invisalign with mandibular advancement was used to perform a number of functions simultaneously
  • AP correction, expansion, alignment, levelling the Curve of Spee were significantly corrected with the first set of aligners
  • Additional aligners used for unilateral upper posterior distalization to correct to Class I molar and canine relationship and to correct midline deviation
  • Class II elastics aided this correction
  • Further levelling the Curve of Spee and posterior extrusion closed lateral open bites
  • Additional aligners without attachments and worn at night were used as retainers as well as fine-tuning the posteriors occlusion

Retention

  • Maxillary: Invisalign aligner
  • Mandibular: Invisalign aligner