Radiographs

Initial Panorama

Final Panorama

Initial Lateral

Final Lateral

Summary

Results achieved

• Class I relationship achieved
• Normal  overjet and overbite achieved
• Deepbite improved
• Overjet improved
• Significant improvement of overjet
• Midlines coincident
• Proper axial inclination of incisors
• Curve of Spee leveled
• Arches aligned and coordinated
• Arch form improved
• Aesthetic smile line was achieved 
• All treatment goals were achieved case

Comments

• A patient with insufficient space for eruption of the permanent teeth and Class II malocclusion performed excellent treatment results with Invisalign First therapy including arch expansion and the alignment was performed simultaneously with upper and lower anterior teeth axis improvement with proper overjet and overbite.
• Phase I orthodontic treatment including arch expansion, molar distalization, and decrowding with dental axis improvement was requested, as alignment and prevention of gingival recession for periodontal health.
• If a general arch expansion device were used, gingival recession in the lower anterior teeth would have been more severe because a fixed appliance had to be attached after arch expansion, not simultaneously, as Invisalign clear aligners. However, since the Invisalign treatment was performed, the arch expansion and the tooth alignment were achieved while improving the axis of the upper and lower anterior teeth at the same time, so more severe gingival recession could be prevented.
• In addition, the deep bite was improved by using the conventional bite ramp function on the lingual side, and better treatment results could be made through the efficient function of the power ridge feature to improve the lingual angulation of lower incisors.
• The arch expansion was performed perfectly as in the initial treatment plan due to the efficient use of the optimized expansion attachment with the patient's good wearing coordination.
• For posterior stable occlusion, it was promoted using optimized extrusion attachment.
• This was a phase I treatment which will be continued with a phase II in the future with permanent dentition.