Radiographs

Initial Panorama

Final Panorama

Initial Lateral

Final Lateral

Summary

Results achieved

• Class I relationship maintained
• Functional canine guidance on both sides
• Normal  overjet and overbite achieved
• 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

Comments

1. This case is a re-orthodontic case where the teeth were in labioversion, and the contacts had loosened, causing the teeth to spread and the gingiva to weaken. Specifically, #1.3 had insufficient alveolar bone, resulting in very poor gingival condition, making traditional bracket orthodontics challenging. Using Invisalign's SmartTrack and optimized attachments, which provide gentle yet precise force, treatment focused on expanding the premolar area and applying IPR to the anterior teeth to address the labioversion as much as possible. Despite #13 and #14 having abnormal roots that made tooth movement difficult, the gentle force allowed the teeth and roots to be repositioned within the alveolar bone's range into the arch.
2. For this patient in their 20s, aesthetics were also extremely important. The gentle force of IPR and the optimized expansion support attachments for the premolars allowed for smooth expansion, improving the angle of the maxillary and mandibular anterior teeth by about 10 degrees. This achieved the aesthetic goals with just one set of Invisalign Express. Particularly, Invisalign's gentle and precise teeth movements were very useful in this re-orthodontic case, where the gingiva and roots were weakened.
3. I believe that the precise ClinCheck by the dentist, combined with Invisalign, can enable safe teeth movement in a short time with minimal appliances. This case had many areas for improvement, including expansion of the premolar area, improvement of the anterior angle, and extrusion of the impacted tooth. Despite these challenges, significant improvements were achieved with just one set of Invisalign Express, without the need for additional appliances. The choice of Vivera retainers helped maintain the perfect retention. Although there was more teeth movement than expected, the precise ClinCheck with minimal appliances resulted in successful outcomes. I can confidently say that this case was of high difficulty.