Child Orthodontics, Clear Aligners, Invisalign First Review

Hello,

This is Apgujeong Orthodontic Clinic, where we focus on child orthodontics and Invisalign clear aligner treatment.

I previously posted about the midway progress of a child Invisalign First case,

and since the orthodontic treatment has now been completed, I’m going to summarize it again.

This case also started as pediatric orthodontics and was completed with treatment into adulthood.

The previous post covered the first set of treatment from September 2022 to May 2023.

To summarize the previous treatment, at the initial visit the front four teeth on each side had erupted.

There were still 10 baby teeth remaining, and because the timing of when children lose and erupt teeth differs from person to person, it is difficult to predict exactly.

2022.09

Because the patient is a child actor, we started with Invisalign First clear aligners for children rather than visible wire braces.

He wore the appliance diligently, and this shows the changes from September 2022 to May 2023.

2022.09~2023.05

After the front teeth were aligned like this, a fixed retainer wire was attached, and we entered a resting period while waiting for the canines to erupt.

During the resting period, the last aligner was worn only at night, so the patient could take it easy.

After that, during regular checkups every three months, the canines began to erupt, but it was observed that the space for the canines to come in was slightly narrow.

We decided to remake the aligners once the canines had erupted sufficiently, so we deliberately waited longer and began the remake seven months later, in January 2024.

24.01

24.01

Below, because retention was good and there were no issues, you can see that the upper canine did not have enough space to erupt and came down rotated like a crowded tooth.

Because of situations like this, Invisalign First has an 18-month warranty period.

It is there to correct any unexpected issues.

Any problems discovered within the warranty period can be resolved.

We proceeded with the remake, and for another six months, until July 2024, the patient wore one additional set of aligners.

This is the appearance after wearing the final aligner.

24.07

The canine that had been protruding like a crowded tooth was well aligned, and in the meantime the last four baby molars had fallen out and the permanent premolars were erupting.

The patient had finally entered the permanent dentition stage.

24.07

To help the premolars come down properly and establish a good bite, metal attachments were bonded to the teeth, and elastic rubber bands that can be taken on and off were also prescribed.

After wearing the rubber bands for two months and stabilizing the premolar bite, all treatment was finally completed in September 2024.

24.09

The midline is perfectly aligned,

24.09

and the molar relationship shows a Class I occlusion.

24.09

The alignment is also good.

In the meantime, the second molars that were erupting last are also coming in well.

We started with a pediatric orthodontic appliance, but everything turned out so well that there is no need for orthodontic treatment again as an adult.

This is one of the concerns many people have when they come in for pediatric orthodontic consultations.

I often hear people say, “I heard that if you get braces when you’re young, your teeth will shift again.”

Whether for adults or children, it is important to diligently use the semi-permanent fixed retainer behind the front teeth and the removable retainer that can be taken on and off, and if the retainer is poorly used or not used at all, the teeth will inevitably shift again.

Since the orthodontic treatment has been completed well, if we want to maintain this good condition for a long time, we need to carefully check the retainer during the retention period.

This is why aftercare is important.

The time difference in the photos is 24 months, but if you calculate the intentional waiting periods for permanent teeth to erupt in between, it comes to about 10 months, so the actual treatment period was about 14 months.

Let’s look at the before-and-after comparison photos.

2022.09~2024.09

The midline aligned well, and the deep overbite of the front teeth was also improved.

If you look closely at the blue arrow area, you can see that the shape of the center front tooth changed.

As shown in the photo, the barrel-shaped tooth still appears to have open edges even after the front teeth have been well aligned.

Such tooth-shape issues can be addressed in adults with no-prep laminate veneers, but since the child still has a career and is not yet old enough for no-prep laminate veneers, it would be a shame to leave it as is.

A simple resin treatment can change a child’s smile.

2022.09~2024.09

2022.09~2024.09

The 18-month warranty period provided by Invisalign First can feel short or long depending on how you look at it.

For patients undergoing pediatric orthodontic treatment with Invisalign First, regular checkups are обязательно performed right before the warranty period ends, around the 17th month, with remaking the aligners in mind.

By making good use of the 18 months and arranging active treatment periods and resting periods appropriately, we will do our best to achieve the best possible result.