Hello.

This is a Gangnam orthodontic clinic specializing in Invisalign treatment for children.

I previously posted about this child’s intermediate treatment process with Invisalign First, and since the orthodontic treatment was recently completed, I am organizing the case again.

This is another case that began with pediatric orthodontic treatment and was completed without the need for adult orthodontic treatment.

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

To summarize the previous treatment, four upper and four lower incisors had erupted at the initial examination.

Although 10 baby teeth were still present, it is difficult to predict precisely because the rate at which children lose and develop teeth varies from person to person.

22.09

Because the child is a young actor, treatment was started with Invisalign First clear aligners for children instead of visible braces with wires.

The aligners were worn diligently, and the following images show the changes from September 2022 to May 2023.

2022.09~2023.05

After the front teeth were aligned, a fixed wire retainer was bonded, and we took a break while waiting for the canines to erupt.

During this break, the last aligner worn was used only while sleeping, allowing the child to continue comfortably.

The canines were monitored through regular examinations at three-month intervals, and they eventually began to erupt. However, it was observed that the space available for the canines was somewhat limited.

We decided to remake the aligners once the canines had erupted sufficiently. We intentionally waited longer and began remaking them seven months later, in January 2024.

24.01

24.01

The alignment below was well maintained and presented no problems. However, there was insufficient space for the upper canines to erupt, and they could be seen descending in a rotated position, like overlapping teeth.

This is one reason Invisalign First provides an 18-month warranty period.

It allows issues that deviate from expectations to be corrected.

Problems identified during the warranty period can be addressed as needed.

The aligners were remade, and one additional set was worn for six months, through July 2024.

This is how the teeth looked after the final aligner was worn.

24.07

The canines that had erupted like overlapping teeth were aligned well. Meanwhile, the four remaining baby molars had fallen out, and the permanent premolars were in the process of erupting.

24.07

Metal buttons were bonded to the teeth, and removable elastics were prescribed so that the premolars could erupt properly and establish occlusion.

After wearing the elastics for two months to stabilize the premolar occlusion, all treatment was finally completed in September 2024.

24.09

The midline is properly aligned.

24.09

The molar occlusion shows a Class I relationship.

24.09

The alignment is also good.

During this time, even the second molars, which erupt last, have been coming in well.

Although treatment began with pediatric orthodontic appliances, the result is good enough that there should be no need to undergo orthodontic treatment again as an adult.

This is one of the concerns often expressed by people who come in for a pediatric orthodontic consultation:

“I heard that teeth can become misaligned again if orthodontic treatment is done at a young age.”

Whether the patient is an adult or a child, it is necessary to diligently use both the wire retainer bonded semi-permanently behind the front teeth and the removable retainer. If the retainers are defective or not used, the teeth may become misaligned again.

The orthodontic treatment has been completed successfully, so the retainers must be checked carefully during the retention period to maintain this good condition for a long time.

This is why follow-up care is important.

The photographs span 24 months, but after accounting for the periods intentionally spent waiting for the permanent teeth to erupt, the total waiting time was approximately 10 months.

In other words, the actual treatment period was approximately 14 months.

Let’s look at the before-and-after photographs.

2022.09~2024.09

The midline is well aligned, and the deep overbite, in which the front teeth bite too deeply, has also improved.

If you look closely at the area indicated by the blue arrow, you can see that the shape of the central incisors has changed.

As can also be seen in the photographs, barrel-shaped teeth may still appear to have flared edges even after the front teeth have been properly aligned.

Problems with this type of tooth shape can be addressed in adults with no-prep veneers. However, it would be unfortunate to simply leave them as they are while waiting until the child reaches an age at which no-prep veneers are possible, especially when the child has an active career.

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

2022.09~2024.09

2022.09~2024.09

The 18-month warranty period provided with Invisalign First may seem short or long, depending on how it is viewed.

For patients undergoing pediatric orthodontic treatment with Invisalign First, regular examinations are always performed at month 17, just before the warranty period ends, with possible remaking of the aligners in mind.

We will make the best use of the 18-month period, appropriately arranging active treatment and breaks to achieve the best possible result.

For pediatric orthodontics, “how it is managed” is more important than “when it ends”

Children’s orthodontic treatment is not simply about straightening the teeth.

It is most important to continuously monitor how the permanent teeth erupt during growth and to continue appropriate treatment when necessary.

Apgujeong Yonsei Baro Dental Clinic makes active use of the Invisalign First warranty period and does its best to maintain stable orthodontic results over the long term through customized treatment tailored to each child’s growth and systematic follow-up care.