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List of problems

• Facial midline was not straight, the mental region was right shift for 10cm, and the lower 1/3 of the face was long. 
• Severe crowding of maxillary and mandibular teeth. 
• Demineralization of 12, 13, 22 and 23. 
• Caries of 16, 26 and 36, scissors-bite of 17 and 47.
• Gingivitis.
• Nonfunctional jaw.

Treatment Objective

•  Align maxillary and mandibular teeth.
•  Improve overbite and overjet and the midline of anterior teeth. 
•  Correct scissors-bite of 17 and 47.
•  Class I canine teeth relationship.
•  Class I molar relationship.

Orthodontic treatment plan

•  Four first premolars were extracted.
•  Enhanced anchorase for maxilla and mandible.
•  Smartee Clear Aligner.

Comparison before and after correction

Before correction

After correction

Before correction

After correction

Mandibular deviation

Basic situation

Product:Smartee Clear Aligner

Diagnosis:Angle Class I

Doctor:Peng Wenbo

Doctor's summary
1.   High angle mandibular deviation, accompanied with right posterior scissors-bite. The patient was not willing to straighten the jaw, so control over the vertical direction was designed. 
2.   Four first premolars were extracted, with enhanced anchorase for posterior teeth.  
3.   First, TPA was used to correct the right scissors-bite, which took half a year.
4.  Intruded posterior teeth, and increased positive torque of anterior teeth in design of invisible orthodontic treatment.
5.  2 anchorage nails were implanted at zygomatic alveolar ridge for high traction. The sagittal and vertical direction were controlled based on the principle of biomechanics.   
6.  Wore 40 sets of clear aligners. It took one year to enter the retention stage, and 1.5 years of total course of treatment. Stable joints, healthy dental periphery and opened airway were obtained after operation.
Orthodontic treatment steps and cycle

Maxilla:45+40 sets

Mandible:45+40 sets

Cycle:22 months