Align Global Gallery

Invisalign Submission Option: Invisalign First

Year: 2023	Difficulty Level: Advanced
Age: 7	Treatment Time: 2 years 13 days
Gender: Female

Dr. Sunyoung Park

12807

Invisalign First

Patient Chief Concern
The upper front teeth are colliding with the lower teeth, and the teeth are unable to erupt due to insufficient space. The upper and lower midlines are gradually becoming misaligned.

What learning would you share with other Invisalign providers?
What process is used to correct occlusion while expanding, the process of correcting tooth axis angles when there are malformed teeth, when primary canines are lost prematurely the midline becomes severely deviated - I want to share the process of correcting the midline. Also, I want to share ClinCheck planning methods for treating while properly maintaining primary teeth in Invisalign First treatments.

What contributed most to this treatment being successful?
Invisalign system's inherent expansion capability, the ability to encompass all teeth to control tooth position and correct tooth axis.

Clinical Indications

Anterior crossbite
Class I
Crowding
Edge to edge bite
Mandibular midline deviation
Midline shift
Narrow arches

Due to family history, the maxillary anterior teeth are positioned posteriorly, showing crossbite of tooth 1.1 and edge-to-edge bite of tooth 2.1. There is space deficiency for the maxillary left and right lateral incisors, and early loss of tooth 8.3 has resulted in space deficiency for tooth 4.3 and mandibular midline deviation.

Modalities

Extrusion
Palatal Expansion
Phase I treatment / Interceptive
Proclination

Primary preliminary orthodontic treatment involved maxillary and mandibular arch expansion to secure space for the maxillary lateral incisors and improve the midline. Proclination of the maxillary anterior teeth was performed to improve the angulation of the maxillary front teeth and correct the cross bite. Due to early loss of tooth 8.3, space was re-acquired for tooth 4.3, and simultaneously, Class III elastics were used on the left side to improve the maxillary and mandibular midlines.

Treatment Information

Retainer: Vivera retainer
After Invisalign First treatment, Vivera retainer is the best appliance for maintaining arch expansion and guiding permanent tooth eruption while preserving space for permanent teeth.

Submission Process: iTero Scanner Element/5D
For the initial Invisalign treatment scan and additional appliance scans, iTero 5D Element was used, and after orthodontic completion, iTero Lumina was used for scanning. The iTero scanner is being effectively utilized for Invisalign treatment and treatment progress evaluation.

Length of Treatment: 24 months

Additional Aligners: 1

Number of Aligners:

	Initial	Additional	Total
Maxillary	30	21	51
Mandibular	30	21	51

Aligner Wear Time: 10days

Images

Initial

Final

Progress

Post

Radiographs

Initial Panorama

Final Panorama

Initial Lateral

Final Lateral

ClinCheck

Summary

Expansion was achieved for permanent tooth eruption in both the maxilla and mandible, resulting in midline improvement and normal anterior overjet and overbite. Most importantly, the harmonious aesthetics between the teeth and face was improved.