Class III
,
Anterior crossbite
,
Deepbite
,
Narrow arches
,
Posterior crossbite
,
Asymmetric arches
,
Maxillary midline deviation
,
Mandibular midline deviation
,
Midline shift
,
Crowding
,
Rotations
,
Spacing
,
Diastema

Elastics: Class III
,
Distalization
,
Mesialization
,
Leveling curve of Spee
,
Intrusion
,
Expansion
,
Retraction
,
Proclination
,
IPR
,
Phase II treatment

Treatment information

  • Age: 31
  • Gender: female
  • Invisalign Treatment Option: Invisalign Full

Diagnostic Summary

  • Class III
  • Anterior crossbite
  • Deepbite
  • Narrow arches
  • Posterior crossbite
  • Asymmetric arches
  • Maxillary midline deviation
  • Mandibular midline deviation
  • Midline shift
  • Crowding
  • Rotations
  • Spacing
  • Diastema

Use of:

  • Distalization
  • Mesialization
  • Expansion
  • Intrusion
  • Leveling Curve of Spee
  • Proclination
  • Retraction
  • IPR
  • Elastics: Class III
  • Phase II treatment
  • Class III Elastics During Additional Aligners.
  • Optimized rotation attachment (G3) on Buccal 1.4 (UR4), Buccal 2.3 (UL3), Buccal 2.4 (UL4), Buccal 3.5 (LL5)
  • Optimized root control attachments (G4) on Buccal 1.3 (UR3), Buccal 1.5 (UR5), Buccal 2.5 (UL5), Buccal 4.3 (LR3), Buccal 4.4 (LR4), Buccal 3.3 (LL3), Buccal 3.4 (LL4)
  • Optimized deepbite attachments for anchorage (G5) on Buccal 4.5 (LR5)
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
  • Anterior crossbite corrected
  • Posterior crossbite corrected
  • Normal  overjet and overbite achieved
  • Deepbite improved
  • Overjet improved
  • Significant improvement of overbite
  • 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

  • 20 months

Number of aligners

  • Maxillary: 62 + 17 = 79
  • Mandibular: 62 + 17 = 79

Aligner wear time

  • Progressive Aligner Change: 14 Days- 10 Days- 7 Days.

Comments

  • Maxilla arch expansion
  • Mesialization of upper arch: molars, premolars, canine
  • Sequential lower arch distalization: molars, premolars, canine & incisors ( total distalization 3.25mm )
  • Full-time class iii elastics wear
  • Full-time aligner wear
  • Sequential attachments at lower molars: at the stage, the lower molars finish distalization a 4mm beveled attachment is placed at the buccal surface of the lower molars to increase anchorage
  • Lingual beveled attachments placed at the lingual surface of lower incisors
  • Retraction and simultaneous lingual root torque of lower incisors during lower arch sequential distalization
  • The lower reversed curve of Spee flattened
  • Multiple rotations were aligned with optimized rotation attachments: ur5, ur4, ul4
  • Spacing and diastema were closed at upper incisors

Retention

  • Maxillary: Vivera retainer
  • Mandibular: Vivera retainer