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Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners

Yonsei Baro Dental Clinic · 치과미슐랭 · January 5, 2026

Hello. This is a dental clinic specializing in children’s clear aligner treatment in Apgujeong. Today, I’m writing this post to help answer questions about the clear aligner treatm...

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This page is an English translation of a Korean Naver Blog archive entry. For exact wording and source context, verify against the Korean archive original and the original Naver post.

Clinic: Yonsei Baro Dental Clinic

Original post date: January 5, 2026

Translated at: April 20, 2026 at 8:20 AM

Medical note: This translation does not guarantee medical accuracy or suitability for treatment decisions.

Hello.

This is a dental clinic specializing in children’s clear aligner treatment in Apgujeong.

Today, I’m writing this post to help answer questions about the clear aligner treatment process for children.

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 1

23.11~25.08

In particular, I hope this post will be helpful for parents who are feeling anxious after hearing at a pediatric dental clinic that their child has no permanent teeth or no posterior teeth, and who are urgently looking into orthodontic treatment for children.

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 2

23.11

This is a 10-year-old child who came for orthodontic treatment two years ago.

There is one upper front tooth that is lifted, and there is a deep bite.

A midline mismatch is also visible.

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 3

The upper front teeth protrusion is clearly visible from the side.

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 4

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 5

The space for the permanent teeth is relatively good.

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 6

The premolar that should be in the blue arrow position is congenitally missing.

In cases like this, treatment is performed by preserving and using the retained primary tooth for as long as possible, since there is no successor permanent tooth.

If you decide to preserve and use the retained primary tooth for a long time, you must be especially careful during orthodontic treatment so that unnecessary tooth movement does not cause the retained primary tooth root to resorb and become shorter.

Primary teeth do not move as easily as permanent teeth when orthodontic force is applied, and since their roots are already weaker than those of permanent teeth, if root resorption occurs, it creates an awkward situation in which the tooth may need to be extracted.

If a primary tooth is kept in place instead of a permanent tooth, you may be wondering how many more years it can last.

If the bite is stable, many people use them until their 40s or 50s.

After that, if it falls out, an implant will be needed.

Invisalign First treatment began, and by April 2024, the patient had worn all 21 aligners in the first set.

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 7

24.04

Improvement in the deep bite

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 8

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 9

Improvement in alignment

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 10

It is now the time when the remaining primary teeth are just falling out and the permanent teeth are coming in, so we take a strategic break.

This is a time of waiting for the permanent teeth to erupt while wearing the 21st aligner only at night.

We waited six months, until October 2024, for the remaining permanent teeth to erupt.

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 11

24.10

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 12

In the meantime, the remaining primary teeth were dealt with and quite a few permanent teeth had erupted. It was time to remake the aligners.

From December 2024 to August 2025, treatment was completed after wearing all the additional aligners.

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 13

25.08

During that time, all remaining primary teeth fell out, and the dentition has now become a complete permanent dentition.

The reason the midline is still off is

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 14

because the retained primary tooth at the blue arrow is 1.5 times larger than a normal permanent tooth.

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 15

However, the molar bite achieved a Class I occlusal relationship.

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 16

Since the treatment result is comparable to that of adult orthodontic treatment, the retainer is made in the same way as for adults.

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 17

However, to prevent recurrence of the deep bite, it is safer to add an ABP bite plate to the retainer.

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 18

If the deep bite does not recur, this child will likely not need orthodontic treatment again as an adult.

Now let’s look at the before-and-after comparison of the children’s orthodontic treatment.

The total treatment period was 1 year and 9 months. Excluding the 6 months in the middle spent waiting for permanent teeth to erupt, the active aligner-wearing period was 1 year and 3 months.

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 19

23.11-25.08

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 20

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 21

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 22

23.11~25.08

The gap between the upper and lower teeth has decreased, making it easier to close the mouth.

If children in this age group develop the habit of sleeping with their mouths open because of protruding front teeth, various side effects caused by mouth breathing can occur.

A longer facial growth pattern, bad breath, a higher risk of cavities, and so on.

Rather than thinking, “I’ll wait until I’m an adult, then have teeth extracted and get orthodontic treatment for protruding mouth,” it is better to treat it early.

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 23

23.11~25.08

The child’s smile has changed,

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 24

23.11~25.08

and their confidence has changed.

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 25

23.11~25.08

The mouth, which had not closed easily because of the protruding and flared front teeth, now closes comfortably.

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 26

23.11~25.08

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 27

23.11~25.08

The retained primary tooth at the blue arrow has been well preserved without root resorption compared to the initial visit.

There is no root resorption in the other permanent teeth, and root parallelism is good.

Even in cases of congenital missing teeth, if treatment is done properly, orthodontic treatment can be completed without any major problems.

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 28

Treatment Period for Congenital Missing Teeth, Retained Primary Teeth, Deep Bite, and Protrusive Mouth with Invisalign First Children’s Clear Aligners image 29