Class II div 2
,
Mandibular retrognathia
,
Deepbite
,
Narrow arches
,
Crowding

Mandibular advancement
,
Elastics: Class II in Additional Aligners
,
Intrusion
,
Expansion
,
IPR

Teen case of the month

Dr. M. Makino
Dr. M. Makino

We would like to thank Dr. Makino for submitting this Mandibular Advancement case that shows a well thought out treatment planning with an excellent result.

Dr. Quote: " With the Invisalign system  I find that patient's life management is the most important. I am grateful for the patients who always use their aligners in good compliance."

Treatment information

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

Diagnostic Summary

  • Class II div 2
  • Mandibular retrognathia
  • Deepbite
  • Narrow arches
  • Crowding

Use of:

  • Expansion
  • Intrusion
  • IPR
  • Class II Elastics in Additional Aligners
  • Mandibular advancement
  • Optimized extrusion attachment (G3) on Buccal 2.2 (UL2)
  • Power ridge feature (G3) on Buccal 1.1 (UR1)
  • Optimized root control attachments (G4) on Buccal 3.4 (LL4)
  • Precision bite ramp (G5) on Lingual 1.1 (UR1), Lingual 1.2 (UR2), Lingual 2.2 (UL2)
  • Precision wings (MA) on Buccal 1.5 (UR5), Buccal 1.6 (UR6), Buccal 2.6 (UL6), Buccal 2.7 (UL7), Buccal 4.5 (LR5), Buccal 4.6 (LR6), Buccal 3.5 (LL5), Buccal 3.6 (LL6)
Courtesy of Dr. M. Makino 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
Download ADF files
Initial
Additional Aligners

Treatment summary

Results Achieved

  • Class I relationship achieved
  • Functional canine guidance on both sides
  • Posterior crossbite corrected
  • Normal  overjet and overbite achieved
  • Deepbite improved
  • Overjet improved
  • 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
  • Harmonic arches were achieved

Total treatment Time

  • 16 months

Number of aligners

  • Maxillary: 42 + 24 = 66
  • Mandibular: 42 + 24 = 66

Aligner wear time

  • 1-week

Comments

  • Sufficient mandibular forward propulsion achieved
  • After the MA phase, we used vertical elastics to achieve a good posterior occlusal

Retention

  • Maxillary: Hawley
  • Mandibular: Fixed/Bonded