Class II div 1
,
Increased overjet
,
Deepbite

Leveling curve of Spee
,
Intrusion
,
Retraction
,
First premolar extraction

Treatment information

  • Age: 33
  • Gender: female
  • Invisalign Treatment Option: Invisalign Full

Diagnostic Summary

  • Class II div 1
  • Increased overjet
  • Deepbite

Use of:

  • Intrusion
  • Leveling Curve of Spee
  • Extraction
  • Retraction
  • First Premolar extraction
  • Optimized rotation attachment (G3) on Buccal 4.4 (LR4), Buccal 3.4 (LL4)
  • Power ridge feature (G3) on Buccal 3.1 (LL1)
  • Optimized root control attachments (G4) on Buccal 4.3 (LR3)
  • Optimized deepbite attachments for anchorage (G5) on Buccal 4.5 (LR5)
  • Precision bite ramp (G5) on Lingual 1.1 (UR1), Lingual 1.2 (UR2), Lingual 2.1 (UL1), Lingual 2.2 (UL2)
  • Optimized retraction attachments (G6) on Buccal 1.3 (UR3), Buccal 2.2 (UL2)
  • First premolar extraction solution for maximum anchorage (G6) on Buccal 1.5 (UR5), Buccal 1.6 (UR6), Buccal 1.7 (UR7), Buccal 2.5 (UL5), Buccal 2.7 (UL7)
Courtesy of Dr. H. Xu 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

  • Functional canine guidance on both sides
  • Normal  overjet and overbite achieved
  • Midlines coincident
  • Proper axial inclination of incisors
  • Curve of Spee leveled
  • Aesthetic smile line was achieved
  • All treatment goals were achieved case
  • Harmonic arches were achieved

Total treatment Time

  • 15 months

Number of aligners

  • Maxillary: 39 + 19 = 58
  • Mandibular: 39 + 19 = 58

Aligner wear time

  • 1-week

Comments

  • The condition of the patient's lower posterior teeth indicated that this patient would benefit from occlusal restoration
  • We divided the orthodontic treatment into three steps:
  • Step 1: The extraction of 1.4,2.4, finishing the buccal occlusion in Class I canine relationship and Class II molar relationship, retracting the anterior teeth and improving lip protrusion.
  • Besides maintaining the height of the upper anterior teeth and intruding the lower anterior, to correct the deep bite of the anterior teeth.
  • Step 2: Establishing a normal overbite with posterior teeth occlusal restoration
  • Step 3: finalizing the treatment
  • Successes during this treatment
  • We closed the extraction spaces with the use of the maximum anchorage attachments utilizing the G6 protocol only, no Class II elastics, no micro-screw implant
  • Lower anterior teeth intrusion achieved which treated the overbite successfully within the initial aligner phase
  • Improvement points
  • There has been a significant loss of torque of the maxillary incisors in the initial aligner phase which we could solve with the use of power ridges in the Additional aligner phase
  • Posterior occlusal restoration could have been done better which resulted in a deeper bite then we planned. The patient lived in another city and this conflicted with the treatment plan.
  • Conclusion
  • This case provided us more confidence in the Invisalign G6 system
  • Overall treatment results are very satisfying

Retention

  • Maxillary: Other clear
  • Mandibular: Other clear