Clinical Indications

• Anterior crossbite
• Asymmetric arches
• Class III
• Class III relationship
• Crossbite
• Crowding
• Deep bite
• Deepbite
• Facial/dental midline descrepancy
• Mandibular midline deviation
• Maxillary midline deviation
• Midline shift
• Narrow arches
• Overbite
• Posterior crossbite
• Rotations
• Smile line (overbite)
• Smile line (overjet)
• Smile width (narrow arches)
• Underbite

The main clinically issue of this case is the class III malocclusion, anterior crossbite, non-consonant and uneven gingival margin. Clear aligner was indicated and more superior to traditional braces in the deepbite condition as upper braces could not be bonded without opening the bite. And Invisalign is more aesthetically pleasing for a 21 years old female. Excellent vertical control of aligner is utilized in this case for intrusion of upper and lower incisors. Non extraction for this case was indicated as distalisation for lower arch, IPR, proclination of upper incisors and retroclination of lower incisors to relieve crowding, midline correction and improve profile. Lingual posterior crossbite of 17 27 were improved by using elastics. Class III elastics were used to correct the Class III canines and to normalise incisal relationship. Class II elastics to control the upper incisors inclination. Invisalign is more superior in controlling the root and crown torque of individual teeth during correction of class III malocclusion. Symmetrical archform can be designed and better planned in the ClinCheck software. The Smile design software was not available in 2020 during the treatment commerced, it would be an excellent tool to design the smile for this case. • Palatal crown torque on 17 27 to correct buccal flaring of 17 27 • Correction of reverse overbite by proclination of upper incisors with controlled tipping and retroclination of lower incisors • Controlled root tipping movement when correcting midline • After space created from distalisation, move tooth 33 43 roots first before crown

Modalities

• Class III elastics
• Distalization
• Elastics
• Elastics: Class III
• Elastics: Vertical
• Expansion
• Extrusion
• Intrusion
• IPR
• Level the curve of Spee
• Leveling Curve of Spee
• Mesialization
• Palatal Expansion
• Pre-scan IPR
• Proclination

• Palatal crown torque on 17 27 to correct buccal flaring of 17 27 using Smartforce feature and vertical elastics were used. • Correction of reverse overbite by proclination of upper incisors with controlled tipping and retroclination of lower incisors after distalisation with Class III elastics. • Class III elastics were used to correct Class III incisal and canine relationship and vertical elastics were used to correct the vertical posterior occlusion. • Controlled root tipping movement when correcting midline and IPR was prescribed. • After space created from distalisation, move tooth 33 43 roots first before crown

Treatment Information