Accelerated Invisalign treatment of patients with a skeletal Class III

IMG_2833In skeletal Class III patients, severe disharmony of the maxilla
and mandible is corrected surgically. However, there is a
wide variety of criteria for this surgery and practitioners
must often select a non-surgical treatment if requested by
the patient. In such a situation, in patients where anterior
crowding is accompanied by anterior crossbite, a common
treatment involves improvement through mandibular
pre-molar extraction and lingual inclination of the mandibular
incisors1. In addition, expansion of the maxillary dental
arch is an effective technique. However, from an aesthetic
point of view, patients occasionally choose a multi-bracket
appliance, even on the lingual side, in favour of a removable
device. Just a few years ago, when compared with multi-
bracket treatments, aligners usually required longer treatment
times and the lack of precise control of axial movement
led some to suggest that cases treated with aligners must be
chosen carefully2.
Since 2010, when Schupp et al presented a successful treatment
of class II relationship using the Invisalign system with
non-extraction, but molar distalization3, more and more
practices have begun to treat patients previously believed to
need extraction with a non-extraction distalization approach4-
6. Compared with case reports on the distalization
of maxillary molars, the number of mandibular-molar distalization
case reports is lower7, and clear data (molar distalization
distance limits) have not yet been presented.
This article reports two patient examples. In the first, we
used the Invisalign technique only, changing the aligners
every 7 days. The second patient example shows a non-surgical
treatment of a severe skeletal Class III using a combination
of aligners with temporary anchorage advices (TADs)8
and AcceleDent9-11 (OrthoAccel Technologies, Inc, 6575 West
Loop South, USA) obtaining more effective and faster mandibular
molar distalization.

Werner Schupp, Julia Haubrich, Kenji Ojima, Chisato Dan, Yuriko Kumagai, Sumimasa Otsuka

Journal of Aligner Orthodontics 2017;1(1):37–57

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