Align Global Gallery

Invisalign Submission Option: Invisalign Comprehensive

Year: 2023	Difficulty Level: Advanced
Age: 30	Treatment Time: 1 year 4 months 26 days
Gender: Male

Dr. Keunchul Cho

11225

Invisalign Comprehensive

Patient Chief Concern
Openbite, Facial asymmetry

What learning would you share with other Invisalign providers?
For patients with amelogenesis imperfecta and defective prostheses, orthodontic treatment with brackets is difficult. Therefore, Invisalign treatment can be an ideal tool for these patients.

What contributed most to this treatment being successful?
This case required surgery. Before the surgery, enlarging the intercanine width was important. Due to this expansion, occlusal settlement was stable immediately after the surgery. Before completing the treatment, crowns on #26 and #27 were replaced with new zirconia crowns. After replacing the crowns, the Invisalign aligners were cut out in the molar area to further stabilize the occlusion.

Clinical Indications

Class II div 1
Facial/dental midline descrepancy
Mandibular midline deviation
Maxillary midline deviation
Narrow arches
Open bite (Post/Ant)
Rotations

The patient had attrition on molars and amelogenesis imperfecta. The prostheses occlusion was initially not perfect and VD of them was also low. It would be very difficult to bond brackets.

Modalities

Distalization
Elastics: Vertical
Extraction
Leveling Curve of Spee
Mesialization
Palatal Expansion
Pre-surgical
Restorative

Before treatment, #38 was extracted. After extraction, pre-surgical orthodontic treatment was completed. After pre-surgical orthodontic treatment, 'two-jaw surgery with genioplasty' was performed. After the surgery, vertical elastics (3-3, 5-5) were used for occlusal settling.

Treatment Information

Retainer: Wire retainer
Wire retainer with bonded fixed retainer

Smartforce: Conventional and Optimized

Submission Process: iTero Scanner Element/5D

Length of Treatment: 17 months

Additional Aligners: 2

Number of Aligners:

	Initial	Additional	Total
Maxillary	21	19	40
Mandibular	21	19	40

Aligner Wear Time: 1 week

Images

Initial

Final

Progress

Radiographs

Initial Panorama

Final Panorama

Initial Lateral

Final Lateral

ClinCheck

Summary

Achieved results include severe open bite was resolved, Class I relationship, functional canine guidance on both sides, normal overjet and overbite, midlines coincident, occlusion settled, proper axial inclination of incisors, curve of Spee leveled, arches aligned and coordinated, alignment of both arches through de-rotation, arch form improved, and aesthetic smile line.