Class II subdivision correction with clear aligners using intermaxilary elastics

Abstract

BackgroundTo describe an esthetic orthodontic treatment using aligners in an adult patient with class II subdivision associated with crowding and dental crossbite. An 18-year-old hyperdivergent male patient with skeletal class II from mandibular retrusion presented for an orthodontic treatment. Occlusally, the patient presents class II subdivision, crossbite at tooth 4.4, an upper midline deviated towards the left with respect to the lower and facial midlines, and slight crowding in both arches. The patient refused conventional fixed multibracket treatment in favor of aligners. Pre- and post-treatment records as well as 1-year follow-up records are presented.FindingsTreatment objectives were achieved in 12 months, and the patient was satisfied with the functional and esthetic outcomes, which were stable at 1 year.ConclusionCombining aligners with appropriate auxiliaries is an efficacious means of resolving orthodontic issues such as class II, dental crossbite, and crowding in a time-frame comparable to that of conventional fixed orthodontics. Furthermore, this system is associated with optimal oral hygiene and excellent esthetics.

Analysis of the Changes in Occlusal Plane Inclination in a Class II Deep Bite “Teen” Patient Treated with Clear Aligners: A Case Report

“…This study reported the results of a comprehensive treatment with clear aligners of a Class II division 1 malocclusion in a “teen” patient. Although definitive recommendations must be withheld until longer follow-up is available, the combination between clear aligners and Class II elastics may help to address sagittal growth development together with a good vertical control of occlusal plane inclination [ 13 , 14 , 15 ].…”

Clear Aligners: Between Evolution and Efficiency—A Scoping Review

“…Other studies evaluate the behavior of the clear aligner after oral exposure and with aging [ 58 , 59 ]. A clinical study has been published on the efficiency of the use of this clear aligners’ system with elastics in class II malocclusions [ 15 ]. A recent study evaluates the progress of the therapies with this clear aligner and other brands during the last pandemic [ 35 ].…”

“…Not all systems on the market include the use of these integrated devices. Intermaxillary elastics are used, with good movement control and allowing the maintenance of adequate oral hygiene, mainly for class II corrections and dental cross bites by making cuts on the aligners that allow the bonding of orthodontic buttons or by making changes on the aligner itself, which can act as a direct anchor for the elastic bands [ 15 ]. A recent study states “no significant Class II correction or overjet reduction was observed with elastics” and “additional refinements may be necessary to address problems created during treatment, as evidenced by a posterior open bite incidence” [ 52 ].…”

“…The entire resolution of a case in which aesthetic needs can also be associated with functional ones can be often successfully treated with the so-called “hybrid” therapies, where clear aligners’ action is joined to auxiliary tools (mini-screws, elastics, sectional wires, rapid palatal expanders, etc.) [ 15 , 16 , 17 , 18 , 19 ]. The quality of the orthodontic digital workflow, also extended to other specialized fields [ 20 , 21 , 22 ], has made it possible to better evaluate the fit of the aligners and their overall design for better case management [ 23 , 24 , 25 ].…”

3D Printed Orthodontic Distalizer with Individual Base for Tooth-Borne Hybrid Approach in Class II Unilateral Malocclusions Treatment

“…Class II treatments with CAT require mean treatment times of approximately 20 months during which class II elastics need to be used all day from treatment beginning until class I canine relationship has been achieved [19,28].…”