Invisalign Extraction Treatment for Crowding and Open Bite in a Patient in Their 30s

Hello,

Let me introduce orthodontic treatment with Invisalign in Apgujeong.

Today, I’ll talk again about Invisalign extraction treatment.

23.10~26.01

Even now, when I see orthodontic consultation patients,

there are still quite a few who come in saying they were told that root movement is not possible with Invisalign, or that extraction treatment will cause the molars to tip over.

I hope that patients who want Invisalign treatment in a situation where extraction is needed do not miss the chance to proceed with Invisalign because of some incorrect views.

23.10

This is a patient in their 30s who came in for orthodontic treatment in October 2023.

There is about a 2 mm midline discrepancy and crowding.

There is also an open bite,

and a small premolar that could not fully erupt because there was no space for 30 years.

Because the crowding was so severe, extraction of four premolars was unavoidable.

23.10

At the initial facial examination, slight lip protrusion was observed.

However, because the chin is fairly prominent, the treatment should avoid moving the mouth too far inward and should only improve the slightly sullen appearance.

The patient chose Invisalign treatment.

The first set had 56 aligners, and each aligner was changed every 7 days.

24.03

To prevent the molars from tipping, screws were placed and elastics were attached.

However, because of personal circumstances during treatment, there was a period when the patient could wear the aligners for only 15 hours a day, and some molars tipped during that time.

When molars tip, the aligners begin to lift off some teeth.

In my case, rather than remaking them each time, I usually take steps to prevent further worsening, encourage the patient, and keep moving forward with treatment.

Of course, each doctor may have a different treatment approach in situations like this.

There was also a period when the aligners were changed every 10 days because of insufficient wear time, but after 1 year and 2 months, the patient finally wore all 56 aligners.

24.12

The midline is well aligned, but there is a step in the height of the front teeth.

The molar bite is slightly open.

The crowding has mostly been corrected,

24.12

As shown on the X-ray, some of the already tipped molars were uprighted,

and to close the remaining tiny extraction spaces and stabilize the bite, a remake was started.

After wearing 32 additional aligners from January to October 2025, here is the result.

25.10

The midline and the height of the front teeth are perfect.

25.10

The tipped molar areas were uprighted again with the additional aligners, so the root parallelism is good.

There is still enough extraction space for dental floss to fit loosely, and to further improve the posterior occlusion, a second remake was started.

After wearing all 10 additional aligners from November 2025 to January 2026, treatment was finally completed.

26.01

The midline matches,

and the molar bite shows a tight Class I occlusal relationship.

Now, let me show you the before-and-after comparison.

There were a total of 2 remakes,

and the total treatment period was 2 years and 3 months.

23.10~26.01

23.10~26.01

The open bite has been resolved, and the teeth now bite properly.

Now it is possible to bite through noodles easily.

The midline discrepancy has been corrected.

23.10~26.01

The bite is good.

23.10~26.01

The smile line is harmonious because it is parallel to the lower lip.

23.10~26.01

To avoid pushing the front teeth too far back, the treatment should be carefully planned.

23.10~26.01

The facial profile is completed well so that the chin does not become overly prominent and only the sullen impression is removed.

23.10~26.01

During the 2 years and 3 months of treatment, there was no root resorption, and root parallelism was good.

I hope this post helps those who are considering Invisalign extraction treatment.