Align Global Gallery

Invisalign Submission Option: Invisalign First

Year: 2023	Difficulty Level: Intermediate
Age: 7	Treatment Time: 1 year 4 months 5 days
Gender: Female

Dr. Sunyoung Park

11469

Invisalign First

Patient Chief Concern
Due to skeletal Class III malocclusion, the patient had a cross bite. After using face mask, the cross bite was improved, but the guardian wanted to achieve a more stable occlusion and ensure proper alignment of the permanent teeth for an aesthetically pleasing result.

What learning would you share with other Invisalign providers?
I would like to share with other dentists how a patient with a previous cross bite, after skeletal correction, was able to develop a stable occlusion during the growth period using Invisalign First clear aligners. I also hope to discuss the extent to which occlusion can and should be established in such cases.

What contributed most to this treatment being successful?
In a mixed dentition patient, the gentle expansion force of Invisalign's SmartTrack material allowed comfortable and consistent wear without pain. Additionally, the ability to establish proper angulation of the erupting permanent anterior teeth and to create a stable overjet and overbite helped prevent the relapse of a developing cross bite. These factors were key contributors to the success of this treatment.

Clinical Indications

Class I
Crowding
Increased overjet
Narrow arches
Rotations

This treatment is considered highly suitable for preventing relapse by reinforcing a Class I relationship and enhancing overjet and overbite after improving the occlusion of a patient who had a cross bite with a skeletal tendency toward mild Class III.

Modalities

Extrusion
Leveling Curve of Spee
Overtreatment
Phase I treatment / Interceptive

An arch expansion of 2.5 mm per quadrant was applied to both the upper and lower arches to align the permanent anterior teeth. To ensure proper setting of overjet and overbite, the Curve of Spee in the anterior region was flattened, and extrusion of the maxillary anterior teeth was performed. Additionally, overtreatment of the overjet was carried out to prevent relapse of the Class III malocclusion.

Treatment Information

Retainer: Vivera retainer
There is no better appliance than Vivera when it comes to maintaining the arch expansion and guiding the eruption of permanent teeth as primary teeth exfoliate within the secured space.

Submission Process: iTero Scanner Element/5D
In the first set of aligners, the primary focus was on expanding both the upper and lower arches and stabilizing the occlusion through extrusion of the maxillary anterior teeth. In the second additional set, the treatment was completed with a focus on precisely securing space for the eruption of permanent teeth, along with accurate alignment and angulation of the permanent anterior teeth to ensure proper eruption and long-term occlusal stability.

Length of Treatment: 16 months

Additional Aligners: 1

Number of Aligners:

	Initial	Additional	Total
Maxillary	26	12	38
Mandibulary	26	12	38

Aligner Wear Time: 10 days

Images

Initial

Final

Progress

Post

Radiographs

Initial Panorama

Final Panorama

Initial Lateral

Final Lateral

ClinCheck

Summary

Arch expansion and space creation for the permanent teeth were achieved, along with alignment of the permanent anterior teeth and improvement of the occlusion. In addition, overtreatment of the overbite and overjet was performed to prevent the reappearance of genetically influenced malocclusion during the child’s growth.