Class II div 1
,
Increased overjet
,
Mandibular retrognathia
,
Openbite
,
Narrow arches
,
Posterior crossbite
,
Asymmetric arches
,
Maxillary midline deviation
,
Mandibular midline deviation
,
Midline shift
,
Crowding
,
Rotations
,
Spacing
,
Diastema

Elastics: Class II
,
Elastics: Class II in Additional Aligners
,
Leveling curve of Spee
,
Extrusion
,
Intrusion
,
Expansion
,
Retraction
,
IPR
,
Space Closure
,
Phase II treatment

Treatment information

  • Age: 30
  • Gender: female
  • Invisalign Treatment Option: Invisalign Full

Diagnostic Summary

  • Class II div 1
  • Increased overjet
  • Mandibular retrognathia
  • Openbite
  • Narrow arches
  • Posterior crossbite
  • Asymmetric arches
  • Maxillary midline deviation
  • Mandibular midline deviation
  • Midline shift
  • Crowding
  • Rotations
  • Spacing
  • Diastema

Use of:

  • Expansion
  • Extrusion
  • Intrusion
  • Leveling Curve of Spee
  • Retraction
  • IPR
  • Space Closure
  • Elastics: Class II
  • Class II Elastics in Additional Aligners
  • Phase II treatment
  • Optimized rotation attachment (G3) on Buccal 1.4 (UR4)
  • Optimized extrusion attachment (G3) on Buccal 1.1 (UR1), Buccal 1.2 (UR2), Buccal 1.3 (UR3), Buccal 2.1 (UL1), Buccal 2.2 (UL2), Buccal 2.3 (UL3), Buccal 4.1 (LR1), Buccal 4.2 (LR2), Buccal 4.3 (LR3), Buccal 3.1 (LL1), Buccal 3.2 (LL2), Buccal 3.3 (LL3)
  • Optimized multiplane (G4) on Buccal 2.6 (UL6)
  • Optimized root control attachments (G4) on Buccal 4.4 (LR4)
  • Optimized retraction attachments (G6) on Buccal 2.4 (UL4), Buccal 3.4 (LL4)
Courtesy of Dr. K. Malekian 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
  • Class I relationship maintained
  • Functional canine guidance on both sides
  • Posterior crossbite corrected
  • Normal¬† overjet and overbite achieved
  • Overjet improved
  • Significant improvement of overjet
  • 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

  • 14 months

Number of aligners

  • Maxillary: 42 + 18 = 60
  • Mandibular: 42 + 19 = 61

Aligner wear time

  • Progressive Aligner Change Interval: 1 4 Days- 10 Days- 7 Days.

Comments

  • Upper incisor and canine Alignment
  • Lower incisor spacing closure
  • Retraction of upper and lower incisors and canine
  • Posterior expansion of upper and lower arch.
  • IPR upper arch: 0.5mm at upper molars, premolars, canines, incisors
  • IPR lower arch: 0.3mm at lower premolars, canine and incisors
  • Lingual root torque of upper and lower premolars and canines: individual tooth lingual torque was planned with the ClinCheck Pro feature
  • Relative extrusion of upper and lower incisors and canines was provided by retraction of upper and lower incisors and canine.
  • Extrusion of upper and lower incisors and canines was programmed to treat and correct the upper and lower reversed curve of Spee
  • Passive intrusion ( 1-2 mm ) of upper and lower molars and premolars with aligner wear
  • Full-time aligner wear and Class II elastics

Retention

  • Maxillary: Vivera retainer
  • Mandibular: Vivera retainer