Protrusive Mouth, Non-Extraction Orthodontics for Children, Lip Incompetence, Dimpled Chin Wrinkles, Chin Dimples, Buck Teeth, Invisalign First

Hello.

This is an orthodontic clinic in Apgujeong.

Apgujeong pediatric orthodontics

I’ll be talking about pediatric treatment for protrusive mouths.

24.04~25.11

In adults, correcting a protrusive mouth usually requires extraction of premolars or wisdom teeth, but in children, if space is used well, some degree of protrusion can be improved without extraction.

24.04

The front teeth are especially large and positioned low.

From the side, they are flared forward and protruding.

Because there were still five primary teeth remaining in total on the upper and lower jaws, we recommended Invisalign First pediatric orthodontics.

If the patient had come a little later and there were no primary teeth left, an Invisalign program for teenagers or adults would have been necessary.

24.04

From the facial profile, the protruding front teeth made it hard to close the lips properly, and lip incompetence and dimpled chin wrinkles (orange-peel chin) were observed.

Fortunately, the remaining primary teeth were larger than the permanent teeth that would erupt later, and after considering several factors, we expected that the upper front teeth could be moved backward by 3 mm without extracting any permanent teeth.

Of course, even with Invisalign First, the orthodontic program for children, if a child already has severe protrusion, premolar extraction may be performed first.

However, for this child, treatment began with the goal of improving the protrusion by about 3 mm without additional extraction.

24.09

This is the result after wearing all 20 aligners from the first set over six months until September 2024.

It could be described as the end of the first half.

24.09

The two central incisors, which had been positioned lower, moved upward and their heights were aligned.

24.09

The protrusion of the front teeth improved.

Meanwhile, the remaining primary teeth fell out and the permanent teeth are erupting well.

24.09

The alignment is good.

It would be fine to finish treatment like this, but

24.09

We waited a little longer for the remaining maxillary primary teeth and the premolars that had not yet fully descended.

If treatment ends after entering the complete permanent dentition and finishing the bite, the retainer can also be fitted more perfectly.

Rather than using the limitations of pediatric orthodontics as an excuse, we work hard to achieve results as complete as adult orthodontics, even though it is pediatric treatment.

After that, we paused treatment for about seven months, wearing the final aligner only at night for retention.

This was the waiting period for the remaining primary teeth to fall out and the permanent teeth to erupt.

25.04

At last, all of the remaining primary teeth have fallen out.

To further improve the protrusion, we started making the second set of aligners.

We decided to reduce the size of the large front teeth with a small amount of interproximal reduction and to further improve the angle of the front teeth.

The second set consisted of 15 aligners, and after diligently wearing them for six months until November 2025, treatment was finally completed.

25.11

The midline is well aligned, and the arrangement is good.

In the meantime, all permanent teeth, including the last premolars, have erupted and the bite has been completed.

It shows a Class I, tight occlusal relationship.

Now let’s look at the before-and-after comparison.

The total treatment period was 1 year and 6 months, including a 7-month break while waiting for the permanent teeth to erupt, and about 11 months of actively wearing the aligners diligently.

There was one re-fabrication in total.

24.04~25.11

24.04~25.11

Since the result is comparable to adult orthodontics, the retainer is also planned at a level comparable to adult treatment.

We decided to use a Vivera retainer.

24.04~25.11

The goal of Apgujeong Orthodontic Clinic in pediatric orthodontics is to help children avoid needing orthodontic treatment again when they become adults.

24.04~25.11

Now, let’s see how much the facial profile changed.

24.04~25.11

Because we treated the protrusion and the difference in height of the front teeth, and added a small amount of interproximal reduction, the front teeth no longer look like oversized rabbit teeth.

24.04~25.11

24.04~25.11

The uneven dimpled chin wrinkles caused by the protrusion have disappeared, and a smooth chin line has been restored.

24.04~25.11

As the protrusive mouth was resolved, the lips look more beautiful.

25.11

There was no root resorption during treatment, and root parallelism is good.

The improvement in the protruding front teeth and lip profile is noticeable.

We will continue to make every effort so that the child and parents do not have to go through the trouble of orthodontics twice by needing treatment again as an adult.

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I hope this post was helpful for those considering pediatric orthodontic treatment.