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

Retraction
,
Space Closure
Courtesy of Dr. R. Lie, 2019
Before picture of treatment

Treatment Summary

Patient Information

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

Total Treatment Time

  • 19 months

Number of aligners

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

Aligner Wear time

  • 1-week

Retention

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

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 linewas achieved
  • All treatment goals were achieved case
  • Harmonic arches were achieved

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’

Images

Initial and final

InitialFinal
Before picture of treatment
After picture of treatment
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upper
lower
right
front
left
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upper
lower
right
front
left

Progress

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upper
lower
right
front
left

Radiographs

Initial Final
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