Class I
,
Edge to edge bite
,
Rotations
,
Spacing
,
Diastema

Retraction
,
Space Closure

Treatment information

  • Age: 35
  • Gender: male
  • Invisalign Treatment Option: Invisalign Full

Diagnostic Summary

  • Class I
  • Edge to edge bite
  • Rotations
  • Spacing
  • Diastema

Use of:

  • Retraction
  • Space Closure
  • Optimized rotation attachment (G3) on Buccal 1.4 (UR4), Buccal 2.4 (UL4), Buccal 2.5 (UL5), Buccal 4.3 (LR3), Buccal 3.3 (LL3)
  • Optimized multiplane (G4) on Buccal 1.2 (UR2), Buccal 2.2 (UL2)
  • Optimized root control attachments (G4) on Buccal 1.5 (UR5), Buccal 4.5 (LR5)
  • Optimized deepbite attachments for anchorage (G5) on Buccal 4.4 (LR4), Buccal 3.4 (LL4)
  • Optimized retraction attachments (G6) on Buccal 1.6 (UR6), Buccal 2.6 (UL6)
Courtesy of Dr. R. Lie 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 maintained
  • Functional canine guidance on both sides
  • Normal  overjet and overbite achieved
  • Midlines coincident
  • Proper axial inclination of incisors
  • 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

  • 19 months

Number of aligners

  • Maxillary: 40 + 12 + 10 = 62
  • Mandibular: 40 + 18 + 19 = 77

Aligner wear time

  • 1-week

Comments

  • The treatment goals were to retract the upper incisors concomitant with the closure of the excess spaces and midline diastema
  • The space closure in the upper arch was achieved through simultaneous retraction and closure of all the spaces between the incisors
  • In the lower arch, in view of the large diastema, sequential tooth movement was planned with the movement of the lower central incisors first, in order to create space on either side of the central incisors
  • Once sufficient space was created, all the spaces were simultaneously closed together with retraction of the incisors
  • The case was monitored for the need for elastics wear, although there were not required as a result of favorable space approximation and retraction of the incisors
  • the spaces at the final outcome were not entirely closed, though the Clincheck does point towards full closure of all the spaces
  • One of the main reasons that the spaces could not be closed was that the initial tooth-size/arch length discrepancy was too significant as can be observed by the initial large gaps in the anterior segments
  • Complete closure would have produced an excellent outcome for this case but the present outcome is still highly satisfactorily considering the initial position of the teeth
  • I submitted this case, in order to illustrate that with the proper staging of tooth movement, good control of tooth positions can be achieved with the Invisalign aligner system and closure of large spaces can be done
  • The gingival response was excellent as once the lower incisors were in their proper position, the gingiva seemed ’to grow back’

Retention

  • Maxillary: Fixed/Bonded
  • Mandibular: Fixed/Bonded