Radiographs

Initial Panorama

Final Panorama

Initial Lateral

Final Lateral

Summary

Results achieved

• Class I relationship achieved
• Functional canine guidance on both sides
• Normal  overjet and overbite achieved
• Midlines coincident
• Curve of Spee leveled
• Arches aligned and coordinated
• Arch form improved
• Aesthetic smile line was achieved 
• All treatment goals were achieved case
• Harmonic arches were achieved

Comments

• Leveling and alignment were completed after 4 months.
• The patient's compliance was good, so the aligners were replaced every 5 days.
• Growth stage analysis was performed at the time of applying MA using the Skeletal mutuality index by hand wrist X-rays (just before step 20).
• Consequently, the MA was not performed because the ANB value was within the normal range at that moment.
• This patient is currently undergoing periodic check-ups after aligner #19, and I plan to evaluate the futural necessity for MA.
• A total of 2 refinements were performed.
• The last refinement was performed after all permanent teeth (except 2nd molars) erupted.
• After 20 months of treatment, the alignment was almost perfect.