Invisalign Lite Instead of Extraction Orthodontics in Your 40s? What Can Be Achieved with 10 Months of Treatment?

Hello.

This is Apgujeong Yonsei Baro Dental Clinic, an orthodontic clinic in Gangnam.

Once people reach their 30s or 40s, orthodontic treatment can feel burdensome to anyone.

It can feel even more daunting when orthodontic treatment requires the extraction of premolars due to protrusion, crowding, or other concerns.

Extraction orthodontics usually takes about two years, and considering the patient’s age, it may take even longer than that.

It can feel particularly burdensome at a time when the gums may feel weaker.

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Today, I would like to show you a case in which the treatment goals were set more modestly when extractions were needed, and the patient received simple treatment with Invisalign Lite within 10 months.

The patient first visited the clinic in February of last year for orthodontic treatment.

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The patient’s main concern was that the left front tooth, from the patient’s perspective, had dropped down and protruded.

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The upper teeth covered the lower teeth extensively, showing a deep bite, or overbite.

The rearmost molar indicated by the blue arrow shows a scissor bite, in which the upper and lower teeth meet in a crossed position.

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The protrusion of the front teeth can be seen from the side.

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The second molar can be seen leaning toward the tongue.

Because of this, it could not properly occlude with the opposing upper second molar, resulting in a scissor bite.

A condition in which the teeth meet in a crossed position like this is called a scissor bite.

Correcting the molar occlusion and protrusion completely would require comprehensive orthodontic treatment, including the extraction of premolars, and would take at least two years.

Because the patient’s only concern was the left front tooth, they did not want to invest that much time and money.

We decided to use Invisalign Lite to improve the front teeth as much as possible within the achievable range, while accepting some limitations, and to address the scissor bite and protrusion as much as possible.

From March through July 2024, the patient continued treatment for four months, changing the first set of 14 aligners sequentially every seven days.

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To achieve a clear improvement in the scissor bite, a miniscrew was placed in the palate.

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Similarly, a miniscrew was placed to properly upright the rearmost molar, which was leaning over.

A total of two miniscrews were placed.

Because Invisalign Lite is originally intended for mild malocclusion, placing miniscrews is not common.

They were placed to achieve the greatest possible effect within the permitted treatment period.

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To correct the remaining areas, additional aligners were fabricated. This image shows the result after wearing a second set of 14 aligners for four months, from August through December 2024.

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During the second set, partial MTA appliances were attached and wire was placed to upright the leaning molar with somewhat greater force.

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This is the result after completing treatment.

The deep bite, in which the front teeth met too deeply, was improved.

The size of the black triangles can be reduced through interproximal reduction, but excessive interproximal reduction should be avoided, so a small amount of black triangle space remained.

Before and after treatment.

Left – before treatment / Right – after treatment

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Improvement in the protruding appearance of the front teeth through interproximal reduction

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The leaning molar was successfully uprighted.

Improvement in the alignment of the lower front teeth through interproximal reduction

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Improvement in the deep bite and dental midline

As the front-tooth protrusion was relieved and the space between the upper and lower teeth decreased, closing the lips became more comfortable.

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Is Invisalign Lite possible even when extraction orthodontics is needed?

It may be possible depending on the case. However, it is important to set the treatment goal toward improving the patient’s main concern rather than achieving perfect occlusion.

Can miniscrews be used with Invisalign Lite?

When necessary, the treatment range can be expanded by using miniscrews together with partial wire orthodontics.

How long did the treatment take?

In this case, treatment continued for approximately 10 months and was completed with additional aligners.

Can a deep bite and scissor bite also be improved?

Depending on the patient’s condition, a deep bite and scissor bite may be improved to a certain extent by using Invisalign Lite together with auxiliary appliances.

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If the patient wears the Invisalign aligners diligently and the treating dentist develops a treatment plan while making various efforts, such as using miniscrews or partially attaching mini-tubes, good results can be achieved with Invisalign Lite in a relatively short period.