Radiographs

Initial Panorama

Final Panorama

Initial Lateral

Final Lateral

Summary

Results achieved

• Class I relationship achieved
• Class I relationship maintained
• Functional canine guidance on both sides
• Posterior crossbite corrected
• Normal  overjet and overbite achieved
• Overjet improved
• Significant improvement of overbite
• Significant improvement of overjet
• Midlines coincident
• Proper axial inclination of incisors
• Curve of Spee leveled
• Arches aligned and coordinated
• Alignment of both arches through derotation
• Arch form improved
• Aesthetic smile line was achieved 
• All treatment goals were achieved case
• Harmonic arches were achieved

Comments

• Maxillary expansion with upper teeth alignment and arch development was performed.
• The upper first molar crossbite was corrected with maxillary expansion.
• Upper incisor retraction was planned during upper arch expansion to correct the excessively proclined upper incisors.
• During upper incisor retraction, lingual root torque of the upper incisors was performed.
• Posterior IPR was planned for the lower premolars and canines to achieve space for retraction of severely rotated and mesially tipped lower canines.
• Lower arch IPR at lower incisors, canines, and premolars permitted space to retract lower incisors to achieve overjet.
• G4 multitooth extrusion attachments were planned to extrude upper incisors and canines to close the anterior open bite.
• Full-time wear of aligners (22 hours) with Class III elastics was used to correct the class III molar and canine and achieve class I molar and canine.
• G3 optimized rotation attachments helped to correct the severe rotation of lower canines.
• Tipping of lower central incisors was planned.
• Power ridges at lower incisors helped to correct lingual root control direction.