Align Global Gallery

Invisalign Submission Option: Invisalign Comprehensive

Year: 2023	Difficulty Level: Advanced
Age: 24	Treatment Time: 1 year 11 months 2 days
Gender: Female

Dr. Keunchul Cho

11371

Invisalign Comprehensive

Patient Chief Concern
Protrusion

What learning would you share with other Invisalign providers?
By intentionally applying overcorrection to create an anterior open bite, it is possible to maintain control over the torque for the protruded anterior teeth while stabilizing posterior occlusal settling. With the appropriate use of TADs and elastics, sufficient retraction can be achieved with Invisalign treatment, effectively addressing protrusion.

What contributed most to this treatment being successful?
The success factors of this case can be divided into two main aspects. First, in the primary order, overcorrection was used intentionally so the patient would have an anterior open bite at the final stage. This overcorrection allowed for better control of torque on the anterior teeth while stabilizing the posterior occlusal settling, leading to a more controlled treatment outcome. Second, skeletal anchorages (TADs) were inserted near the maxillary and mandibular first molars (total 4 TADs were placed). By using elastics between the precision hook and TADs, the protrusion was effectively resolved.

Clinical Indications

Crowding
Increased overjet
Mandibular midline deviation
Narrow arches
Rotations

The patient had protrusion of the anterior teeth, a large overjet, and a V-shaped arch.

Modalities

Distalization
Extraction
Mesialization
Retraction
TADs

The 2nd premolar-2nd molar were designed to move mesially, and anterior teeth were designed to be retracted distally to close the extraction space of 1st premolars (maxillary and mandibular, total four 1st premolars were extracted). Four TADs were placed near the four 1st molars and elastics were used between the precision hook and the TADs to retract the anterior teeth.

Treatment Information

Retainer: Wire retainer
Wire retainer with bonded fixed retainer

Smartforce: Conventional and Optimized

Submission Process: iTero Scanner Element/5D

Length of Treatment: 23 months

Additional Aligners: 1

Number of Aligners:

	Initial	Additional	Total
Maxillary	49	33	82
Mandibular	49	33	82

Aligner Wear Time: 10 days

Images

Initial

Final

Radiographs

Initial Panorama

Final Panorama

Initial Lateral

Final Lateral

ClinCheck

Summary

Severely protruded incisors were retracted successfully through 1st premolar extraction and distal retraction (with TADs). Achieved proper torque of anterior teeth, Class I relationship, functional canine guidance on both sides, normal overjet and overbite, significant improvement of overjet. midline coincidence. proper axial inclination of incisors, curve of Spee leveled, arches aligned and coordinated, alignment of both arches through de-rotation, arch form improved, aesthetic smile line, and harmonic arches.