Non-Extraction Invisalign Treatment for Protrusive Mouth, Fixing Scissor Bite and Midline Alignment

Hello,

This is Apgujeong Invisalign Dental Clinic.

Let’s talk about Invisalign treatment for a protrusive mouth.

This was a non-extraction treatment.

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This patient in their 30s came for orthodontic treatment two years ago. The blue arrows show the molars protruding toward the cheek side.

Midline discrepancy is also visible.

The patient wanted to correct two things:

Protruding front teeth

Difficulty chewing due to the scissor bite

There is protrusion caused by the front teeth sticking out.

On the left side, there are two scissor-bite areas in total: one in the premolar and one in the molar.

Since half of the molars responsible for occlusion are in a scissor-bite state, it is difficult to chew on the left side.

If you keep chewing only on the right side, it can strain the teeth and gums, and the facial muscles on the side used most often can develop more, making the face look asymmetrical.

The lower molars are tipped inward.

23.08

There is a slight lip incompetence due to the protruding front teeth, but it is not so severe that closing the mouth is difficult. The patient also preferred a non-extraction plan.

The treatment plan was to extract all wisdom teeth and push the molars backward into the wisdom tooth spaces to relieve the protrusion, using a non-extraction approach for protrusive mouth correction.

The patient chose Invisalign, and treatment began.

After wearing all 48 aligners in the first set for one year until August 2024, this is the result.

24.08

A small amount of midline discrepancy remains, but all scissor bites have been resolved.

The protrusion of the front teeth has improved, and the molar occlusion is also good.

The lower molars that had been tipped toward the tongue side also stood up well.

Everything was good, but in order to further improve the protrusive appearance of the front teeth, we decided to do one more set of posterior movement of the entire dentition using the wisdom tooth spaces.

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The second set consisted of a total of 33 aligners, and it was worn from September 2024 to April 2025.

Additional orthodontic screws were placed, and elastics that had to be taken out and put back in were also prescribed.

In April 2025, after wearing all the aligners from the second set, this is the result.

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Because the slight midline discrepancy was still a concern, we proceeded with one final remake.

After wearing all 23 additional aligners from May to November 2025, treatment was completed.

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A midline that had been precisely corrected through two remakes

The molar occlusion shows a tight Class I relationship.

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

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The total treatment period was 2 years and 3 months, with two remakes.

The patient is now maintaining the result by wearing Vivera only while sleeping every day.

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When the balance of the bite is corrected, you can finally chew 50:50 on both sides.

Many people mistakenly think orthodontic treatment is purely cosmetic, but in fact it is a treatment with significant functional benefits.

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Now let’s look at the facial comparison.

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The improvement in the protruding front teeth created a cleaner smile.

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The protrusive mouth was moderately improved without being excessive through non-extraction treatment.

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There was no root resorption, and root parallelism was good.

I hope this helps those who are considering non-extraction protrusive mouth correction, and I’ll end this long post here.