Mid-term

After creating a space for alignment while resolving anterior crowding, #12/#22 I made the teeth jump. Afterwards, the central incisor that protruded anteriorly was aligned while retraction, and the setup was completed with overall retraction.

: 11 : approx. 22 weeks : maxillary lateral incisor cross bite

Treatment

Steps Treatment period Analysis

Long-term

Because the treatment is quite complex, we did not design all the steps at once, but several new impressions and model scans. We first setup to eliminate crowding through IPR and expansion. During the maxillary expansion, the mandibular intrusion and + torque were performed to avoid occlusal interference with the goal of lateral incisor jumping. During retraction, #12/#22 extrusion was performed to avoid open bite.

: 17 : approx. 34 weeks : anterior cross bite

Treatment

Steps Treatment period Analysis

Mid-term

To secure space, IPR and expansion setup of the mandibular anterior region were performed. After securing space, aligned it while adjusting the rotation and tip. In the last retraction step, we made some overcorrection and completed the setup.

: 12 : approx. 24 weeks : anterior crowding

Treatment

Steps Treatment period Analysis

Long-term

In the case of very severe crowding and close occlusal relationship, we performed expansion setup and IPR together. We mainly aligned central incisor axis adjustment and #22 rotation for the maxillary, and #31 rotation and #32/42 labial movement for the mandibular. We performed IPR once more due to severe crowding, and the setup was completed after retraction.

: 23 : approx. 46 weeks : severe crowding at Mx / Md

Treatment

Steps Treatment period Analysis

Mid-term

To secure space, IPR and expansion setup were performed. In order for the maxillary and mandibular anterior teeth to act as an undercut, + torque was applied to the labial surface to tilt it, and then the setup was made to position it on the occlusal surface. In the retraction layer, - torque was applied to increase the amount of overbite.

: 12 : approx. 24 weeks : lateral incisor open bite

Treatment

Steps Treatment period Analysis

Long-term

Aligned after securing space by an expansion setup for the maxilla, and anterior IPR before treatment for the mandible. Extrusion was induced by proceeding with the both jaws torque and extrusion setup. For extrusion, we attach attachments for the fifth step aligner. We reduced the burden of tooth movement distance by distributing the amount of movement across multiple layers. After adjusting the amount of overjet and overbite along with overall retraction, the setup was finished.

: 19 : approx. 38 weeks : severe anterior open bite

Treatment

Steps Treatment period Analysis

Mid-term

Secured a space with IPR, the setup was performed by focusing - torque and intrusion in the maxillary anterior region. An intrusion setup was added to prevent extrusion during retraction. To increase success rate of intrusion setup, it is efficient to attach attachments to the anterior region.

: 10 : approx. 20 weeks : anterior protrusion

Treatment

Steps Treatment period Analysis

Long-term

Because the treatment is quite complex, we did not design all the steps at once, but several new impressions and model scans. Due to the lack of space for the maxillary, IPR was performed on the premolars, and the whole dental arch from the premolars to the premolars was expanded and moved to make the arch from V to U shape, reducing the protrusion of the central incisors. After creating a space for the central incisors to move, the intrusion was given along with retraction to prevent overbite. IPR was performed on the mandibular premolars and the arch was expanded to create an environment for improving the long axis of the anterior teeth. At the same time, after adjusting + torque, intrusion, and tip to the anterior teeth, retraction was performed to significantly lower the overbite and create a condition for rearward movement of the maxillary incisors.

: 20 : approx. 40 weeks : maxillary anterior protrusion including severe protrusion of central incisors

Treatment

Steps Treatment period Analysis

Short-term

The central incisor tip in both Mn/Mx is not good, and there is space. Make an ideal arch line by adjusting rotation and tip, and retraction, and finally setup to resolve space. Since the amount of overjet is larger than the normal occlusal, we adjusted the - torque.

: 4 : approx. 8 weeks : minor anterior spacing

Treatment

Steps Treatment period Analysis

Mid-term

The axis of the maxillary central incisor is - tipping, so the axis is corrected by + tipping and the space is uniformed. Using the remaining space, the mandibular was aligned through tip adjustment and slight torque adjustment. Since it is a case where the maxillary overbite is insufficient, a little intrusion was added when retraction.

: 12 : approx. 24 weeks : anterior spacing

Treatment

Steps Treatment period Analysis

Long-term

We setup without IPR because there is enough space. Since this patient has a poor periodontal disease, we divided the steps as finely as possible to reduce the amount of movement per device. After alignment by applying rotation, we perform retraction over three layers, and slowly close space.

: 17 : approx. 34 weeks : big space of anterior

Treatment

Steps Treatment period Analysis

Short-term

For the maxillary, crowding was eliminated with just an expansion setup, and aligned. For the mandibular, a retraction space was needed to avoid occlusal interference, so we setup an expansion with IPR. After crowding was resolved, ideal alignment was achieved through rotation leveling, and finally space closing and setup were completed by retraction.

: 7 : approx. 14 weeks : minor anterior crowding

Treatment

Steps Treatment period Analysis