Align Global Gallery

Invisalign Submission Option: Invisalign Moderate

Year: 2024	Difficulty Level: Initiator
Age: 22	Treatment Time: 2 years 2 days
Gender: Female

Dr. Ching Cheng Hsu

18997

Invisalign Moderate

Patient Chief Concern
My lips look protrusive, and I have difficulty closing them comfortably. I would like to undergo orthodontic treatment, but I do not want to have any teeth extracted.

What learning would you share with other Invisalign providers?
A carefully planned combination of distalization, arch expansion, and IPR, together with adjunctive TADs and interarch elastics, provided sufficient space and anchorage for controlled anterior retraction. This biomechanical approach enabled successful correction of dentoalveolar protrusion with Invisalign aligners while avoiding tooth extraction.

What contributed most to this treatment being successful?
Successful distalization and expansion of both dental arches, together with interproximal reduction (IPR), provided sufficient space for crowding relief and anterior retraction, resulting in improved facial profile and achievement of competent lip closure.

Clinical Indications

Class I
Crowding
Narrow arches
Rotations

This case presented with bimaxillary dento-alveolar protrusion, narrow dental arches, and mild dental crowding.

Modalities

Distalization
Elastics: Class II
Intrusion
IPR
Leveling Curve of Spee
Retraction
TADs

The treatment objective was to retract the maxillary and mandibular anterior dentitions to correct lip incompetence without premolar extraction. Space for anterior retraction was obtained through arch expansion, interproximal reduction, and limited amount of distalization. Bilateral mandibular buccal shelf TADs were placed to provide skeletal anchorage. Retraction of the mandibular anterior dentition was achieved using power chains extending from the mandibular canines to the buccal shelf TADs. In addition, Class II elastics extending from the maxillary canines to the mandibular buccal shelf TADs were used to facilitate retraction of the maxillary dentition.

Treatment Information

Retainer: Other clear

Smartforce: Conventional and Optimized

Submission Process: Intra-oral scan

Length of Treatment: 24 months

Additional Aligners: 2

Number of Aligners:

	Initial	Additional	Total
Maxillary	26	42	68
Mandibular	26	42	68

Aligner Wear Time: 10 days

Images

Initial

Final

Progress

Radiographs

Initial Panorama

Final Panorama

Initial Lateral

Final Lateral

ClinCheck

Summary

TAD-assisted retraction of the maxillary and mandibular incisors resulted in improved lip competence and a harmonious facial profile. Maximum interdigitation was achieved, with stable bilateral Class I canine and molar relationships, as well as ideal overjet and overbite.