Class I
,
Mandibular retrognathia
,
Narrow arches
,
Midline shift
,
Crowding
,
Rotations

Elastics: Class II
,
Expansion
,
Retraction
,
Other extraction
,
First premolar extraction
,
IPR
,
Space Closure

Treatment information

  • Age: 16
  • Gender: female
  • Invisalign Treatment Option: Invisalign Full

Diagnostic Summary

  • Class I
  • Mandibular retrognathia
  • Narrow arches
  • Midline shift
  • Crowding
  • Rotations

Use of:

  • Expansion
  • Extraction
  • Retraction
  • Other extraction
  • First Premolar extraction
  • IPR
  • Space Closure
  • Elastics: Class II
  • Class II Elastics in Additional Aligners
  • Optimized rotation attachment (G3) on Buccal 2.3 (UL3), Lingual 2.4 (UL4), Buccal 3.4 (LL4)
  • Optimized root control attachments (G4) on Buccal 1.2 (UR2), Buccal 2.5 (UL5), Buccal 3.5 (LL5)
  • Optimized retraction attachments (G6) on Buccal 1.3 (UR3), Buccal 4.3 (LR3)
  • First premolar extraction solution for maximum anchorage (G6) on Buccal 1.5 (UR5), Buccal 1.6 (UR6), Buccal 1.7 (UR7), Lingual 1.5 (UR5), Lingual 1.6 (UR6), Lingual 1.7 (UR7)
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 achieved
  • Class II relationship maintained
  • Functional canine guidance on both sides
  • Normal¬† overjet and overbite achieved
  • 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

  • 16 months

Number of aligners

  • Maxillary: 35 + 21 + 14 = 70
  • Mandibular: 35 + 21 + 14 = 70

Aligner wear time

  • 1-week

Comments

  • Relief of crowding in both upper and lower arch and correction of the upper dental midline was achieved through extraction of first premolars on the right side
  • The upper left lateral incisor was removed due to severe palatal displacement
  • G6 First Premolar Extraction Solution was incorporated into the Clincheck Plan for maximum anchorage space closure
  • Light Class II elastics were used for arch and midline coordination during space closure
  • IPR was used to adjust any Bolton discrepancy
  • Upon completion of the orthodontic treatment, the crown of the upper left canine was modified with composite in order to mimic the shape of the contralateral incisor

Retention

  • Maxillary: Hawley
  • Mandibular: Hawley