Align Global Gallery

Invisalign Submission Option: Invisalign Comprehensive

Year: 2020	Difficulty Level: Advanced
Age: 21	Treatment Time: 2 years 9 months 12 days
Gender: Female

Dr. Keunchul Cho

11240

Invisalign Comprehensive

Patient Chief Concern
Misaligned teeth, protruded maxillary central incisors

What learning would you share with other Invisalign providers?
Invisalign treatment can be enhanced with the assistance of TADs and other orthodontic appliances.

What contributed most to this treatment being successful?
Both the maxilla and mandible exhibited crowding. with maxillary being severe. To resolve the crowding, expansion was treatment planned, along with IPR. Additionally, overall distalization of the teeth was incorporated into the ClinCheck plan. To maximize distalization, TADs were placed in the posterior region, and elastics were used. Furthermore, additional TADs were placed on the palatal side and connected with Sigmoid Parallel Arm by power chain to enhance the distalization effect. Despite being a non-extraction case, proper alignment was achieved without labial inclination of the maxillary anterior teeth. This was likely due to the combination of planned distalization with the Invisalign aligners, IPR, TADs, and auxiliary orthodontic appliances.

Clinical Indications

Class II div 1
Crowding
Increased overjet
Mandibular midline deviation
Narrow arches
Rotations

Severe overjet, Skeletal A-P Relationship: Class II, Upper incisal inclination: labially, severe

Modalities

Distalization
Elastics: Class II
IPR
Leveling Curve of Spee
TADs

To retract the teeth distally, mini-implants were used on the buccal side of #16, 15, and #25, 26. Elastics were used with the aligner's precision hooks to retract the teeth distally. To effectively retract teeth distally, an additional two screws were placed on the palatal side (#16, 17, #26, 27). A SPA (Sigmoid Parallel Arm) was bonded on the palatal side of #16,26, and power chain was adjusted between the SPA's hook and palatal screw.

Treatment Information

Retainer: Wire retainer
Wire retained with bonded fixed retainer

Smartforce: Conventional and Optimized

Submission Process: iTero Scanner Element/5D
Initial : iTero final : PVS impression

Length of Treatment: 33 months

Additional Aligners: 2

Number of Aligners:

	Initial	Additional	Total
Maxillary	56	37	93
Mandibular	56	37	93

Aligner Wear Time: 1 week

Images

Initial

Final

Progress

Radiographs

Initial Panorama

Final Panorama

Initial Lateral

Final Lateral

ClinCheck

Summary

Achieved the following: severely protruded incisors were retracted, Class I relationship, narrow maxillary arch has been widened properly, functional canine guidance on both sides, normal overjet and 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, and aesthetic smile line.