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Management of overbite with the Invisalign appliance

      Highlights

      • The Invisalign appliance is relatively successful in managing overbite.
      • Our results did not show that posterior teeth intrude significantly with the Invisalign appliance.
      • The Invisalign appliance improved deepbites primarily by proclination of the mandibular incisors.
      • The Invisalign appliance corrected mild to moderate anterior open bites mainly through incisor extrusion.

      Introduction

      Most of the published literature on the management of overbite with the Invisalign appliance (Align Technology, Santa Clara, Calif) consists of case reports and case series.

      Methods

      In this retrospective study of 120 patients, we sought to assess the nature of overbite changes with the Invisalign appliance. Records were collected from 3 practitioners, all experienced with the Invisalign technique. The patients were consecutively treated adults (>18 years old) who underwent orthodontic treatment only with the Invisalign appliance. Patients with major transverse or anteroposterior changes or extraction treatment plans were excluded. The study sample included 68 patients with normal overbites, 40 with deepbites, and 12 with open bites. Their median age was 33 years, and 70% of the patients were women.

      Results

      Cephalometric analyses indicated that the deepbite patients had a median overbite opening of 1.5 mm, whereas the open bite patients had a median deepening of 1.5 mm. The median change for the normal overbite patients was 0.3 mm. Changes in incisor position were responsible for most of the improvements in the deepbite and open bite groups. Minimal changes in molar vertical position and mandibular plane angle were noted.

      Conclusions

      The Invisalign appliance appears to manage the vertical dimension relatively well, and the primary mechanism is via incisor movements.
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