Invisalign Comprehensive

Patient Chief Concern
Protruded maxillary anterior teeth

What learning would you share with other Invisalign providers?
To achieve proper occlusal settling, buttons can be bonded to the teeth and vertical elastics can be applied.

What contributed most to this treatment being successful?
The patient presented with severe rotation of the maxillary anterior teeth. The central incisors were protruded, and the canines were significantly buccally inclined. The maxillary first molars were notably displaced from the arch. Both the maxillary and mandibular arches showed crowding. In the mandible, the second premolars were severely rotated, and the first molars were lingually inclined. Arch expansion was performed in both arches to relieve the crowding and correct the tooth rotations. In particular, tooth #13 was extruded while applying lingual torque. To address the Class II molar relationship, Class II elastics were used during the primary order. A progress image was taken during the patient’s visit while wearing the final aligner of the first order. As seen in the image, Class III molar relationship was seen, so in the additional aligners, both Class III and vertical elastics were used to further stabilize the occlusion.