Align Global Gallery

Invisalign Submission Option: Invisalign Comprehensive

Year: 2022	Difficulty Level: Advanced
Age: 25	Treatment Time: 1 year 2 months 23 days
Gender: Female

Dr. Keunchul Cho

11232

Invisalign Comprehensive

Patient Chief Concern
Relapse of openbite

What learning would you share with other Invisalign providers?
By designing ghost attachments, molar intrusion can be successfully achieved with Invisalign aligners. With molar intrusion and anterior tooth extrusion, open bite can be effectively treated. Therefore, open bite treatment can be successfully achieved with Invisalign aligners.

What contributed most to this treatment being successful?
The extrusion of the anterior teeth and the intrusion of the posterior teeth were important. To intrude the molars, ghost attachments were designed on the occlusal surfaces. For the anterior teeth, optimized multi-tooth extrusion attachments were used. To correct Angle Class III malocclusion on the left side, Class III elastics were used only on the left side.

Clinical Indications

Mandibular midline deviation
Open bite (Post/Ant)

This patent had severe anterior open bite, therefore extrusion of anterior teeth with posterior intrusive force was designed. Ghost attachment was used on occlusal surface of mandibular molar teeth (#36,37,46,47).

Modalities

Elastics: Class III
Elastics: Vertical
Intrusion
IPR
Leveling Curve of Spee

Approximately 18 days before removing attachments, the vertical elastics were used to settle the occlusion (triangular: upper 4, lower 4-5. inverted triangular: upper 5-6, lower 6).

Treatment Information

Retainer: Other clear
Clear retainer with bonded fixed retainer

Smartforce: Conventional and Optimized

Submission Process: iTero Scanner Element/5D

Length of Treatment: 15 months

Additional Aligners: 1

Number of Aligners:

	Initial	Additional	Total
Maxillary	30	12	42
Mandibulary	33	12	45

Aligner Wear Time: 1 week

Images

Initial

Final

Progress

Radiographs

Initial Panorama

Final Panorama

Initial Lateral

Final Lateral

ClinCheck

Summary

Achieved results include the following: severe open bite correction, Class I relationship, functional canine guidance on both sides, normal overjet and overbite, proper axial inclination of incisors, curve of Spee leveled, arches aligned and coordinated, alignment of both arches through derotation, arch form improved, and an aesthetic smile line.