Align Global Gallery

Invisalign Submission Option: Invisalign Comprehensive

Year: 2023	Difficulty Level: Advanced
Age: 23	Treatment Time: 2 years 6 months 1 day
Gender: Female

Dr. Eui seon Baek

15425

Invisalign Comprehensive

Patient Chief Concern
Dental midline deviation by impaction of 2.4, spacing, protrusion.

What learning would you share with other Invisalign providers?
When the impacted tooth was positioned too deeply for surgical extraction, it was necessary to induce orthodontic tooth movement without affecting the impacted tooth. In this case, the precise and strategically designed tooth movement plan provided by the Invisalign system played a crucial role.

What contributed most to this treatment being successful?
CBCT-integrated ClinCheck treatment planning was performed to avoid interference with the impacted 2.4 during orthodontic movement with Invisalign aligners.

Clinical Indications

Asymmetric arches
Class II div 1
Facial/dental midline descrepancy
Impacted canines
Increased overjet
Maxillary midline deviation
Open bite (Post/Ant)
Rotations
Spacing

In cases where surgical extraction of the impacted tooth is not feasible, precise ClinCheck planning based on CBCT-integrated iTero scans is essential to achieve smooth and controlled tooth movement.

Modalities

Elastics: Class III
Elastics: Vertical
Extraction
First Premolar extraction
IPR
Overtreatment
Retraction
Space Closure
TADs

By using TADs to establish absolute anchorage where needed and performing unilateral extraction to balance the number of teeth, the deviated dental midline was successfully aligned with the facial midline.

Treatment Information

Retainer: Wire retainer
fixed wire retainer with Vivera

Smartforce: Conventional and Optimized

Submission Process: iTero Scanner Element/5D

Length of Treatment: 30 months

Additional Aligners: 2

Number of Aligners:

	Initial	Additional	Total
Maxillary	32	52	84
Mandibular	32	52	84

Aligner Wear Time: 1 week

Images

Initial

Final

Progress

Radiographs

Initial Panorama

Final Panorama

Initial Lateral

Final Lateral

ClinCheck

Summary

A perfect outcome was achieved, with not only a stable and tight Class I molar relationship but also ideal dental midline alignment. The unilateral premolar defect caused the maxillary dental midline to shift toward the left side of the face. Following Invisalign treatment, the midline discrepancy was resolved, and the maxillary dental midline is now aligned with the patient’s facial midline. The retraction of the anterior teeth resulted in an improvement of the protrusive profile.