Align Global Gallery

Invisalign Submission Option: Invisalign Comprehensive

Year: 2024	Difficulty Level: Advanced
Age: 24	Treatment Time: 1 year 10 months 15 days
Gender: Female

Dr. Takao Minamidate

10528

Invisalign Comprehensive

Patient Chief Concern
Crowding, Lip protrusion,

What learning would you share with other Invisalign providers?
In cases with severe crowding and protrusion of the lips, extraction of premolars can be an effective method for orthodontic treatment.

What contributed most to this treatment being successful?
Selection of extraction sites for premolars and setting treatment goals. Adjustment of intermaxillary elastics settings during the treatment process.

Clinical Indications

Class III
Crowding
Mandibular midline deviation
Open bite (Post/Ant)
Rotations

The skeletal Class I, Angle Class III. There was severe crowding, and the canines on both sides were mesially tipped in both the upper and lower, resulting in partial open bite. Labial inclination of the anterior teeth and lip protrusion were also observed.

Modalities

Elastics: Class II
Elastics: Class III
Extraction
First Premolar extraction
IPR
Leveling Curve of Spee
Mesialization
Other extraction
Space Closure

To improve crowding and reduce lip protrusion, the maxillary second premolars and mandibular first premolars on both sides were extracted. Staging was performed simultaneously. Initially, Class III elastics were used, but adjustments with Class II and vertical elastics were made during treatment as needed.

Treatment Information

Retainer: Other clear
A lingual bonded retainer with fixed wire in the lower anterior teeth, a wrap-around retainer in the lower, and a clear retainer in the upper.

Smartforce: Conventional and Optimized

Submission Process: Intra-oral scan

Length of Treatment: 22 months

Additional Aligners: 1

Number of Aligners:

	Initial	Additional	Total
Maxillary	47	7	54
Mandibulary	43	8	51

Aligner Wear Time: 10days

Images

Initial

Final

Progress

Radiographs

Initial Panorama

Final Panorama

Initial Lateral

Final Lateral

ClinCheck

Summary

Improvement of crowding, alignment of upper and lower midlines with the facial midline, appropriate overjet and overbite, functional occlusion, lip protrusion, improvement of the lateral profile.