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List of problems

• Facial asymmetry, left deviation of mandible for 2mm.
• Microdontia of 21 and 22, crossbite of 22.
• Supernumerary teeth embedded between root 42 and 43.
• Orthotopic eruption of 18 and 28, mesio-supraversion impaction of 38 and 48.
• Class I molar relationship or mesial molar relationship.
• Misalignment of upper and lower midline, left deviation of upper midline for 3mm, and left deviation of lower midline for 3mm.
• Average angle, the occlusal plane high in left and low in right.

Treatment Objective

• Improve facial shape.
• Align upper and lower teeth, fix crossbite of 22, close maxillary space, and correct mandibular crowding.
• Build Class I canine-molar relationship, and maintain normal overbite and overjet of anterior teeth.
• Align upper and lower midline.

Orthodontic treatment plan

•  Orthodontic anterior periodontal treatment.
•  Extract the embedded supernumerary teeth between Root 42 and 43, and the embedded 18, 28, 38 and 48.
•  Smartee non-extraction invisible orthodontic treatment without brackets.
•  Correct microdontia after orthodontic treatment.

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:Zhou Yueying

Doctor's summary
1.Maxillary lateral incisor of the patient was microdontia. Bolton index discrepancy. The first orthodontic treatment closed the anterior teeth space, but didn’t take functional jaw of the patient into account, and the protruding jaw might cause occlusal interference After the first orthodontic treatment, space between anterior teeth was created, followed by functional facial asymmetric deformity (mandibular deviation, mental region to left).
2.Due to severe enamel demineralization of the patient and microdontia of 22, invisible orthodontic treatment was adopted for the second time. Jaw pillow had obvious advantages over fixation in removing occlusion interference. Crossbite of 22 was corrected with repair space reserved.
3.The patient had a slight overbite and Skeletal Class I. After treatment, Index Post Face Height/Ant Face Height (FHI) was decreased by 2.4°. The mandible rotated backward for 1mm. Overject of anterior teeth was increased. The maxillary central incisor was retracted for 2.7°. Labial inclination of lateral incisors was reduced. The original facial shape was basically maintained.
Orthodontic treatment steps and cycle

Maxilla:20 sets

Mandible:20 sets

Cycle:15 months