Invisalign · Hamad S., 20s
Eighteen Months of Quiet Movement
Severe crowding with a deep bite, treated without extractions, in a patient who had been told twice that he needed brackets.
- Treatment
- Invisalign
- Duration
- 18 months
- Appointments
- 14 visits
- Clinician
- Dr. Lina Farouk
Patient Goal
What they came in for.
He was about to start a client-facing role and did not want to spend his first year in it wearing metal. Two previous consultations had told him aligners could not handle his case. He wanted a straight answer about whether that was true.
Initial Condition
What we found.
8.4mm of crowding in the upper arch and 6.1mm in the lower, with both upper laterals displaced palatally and the lower right canine rotated 42 degrees. Overbite of 85%, with the lower incisors contacting the palatal gingiva. Class II division 2 incisor relationship. Good periodontal health and no restorations, which meant the biology was on our side even if the geometry was not.
Final Result
Where it finished.
All 14.5mm of crowding resolved without a single extraction. Overbite reduced from 85% to 22%. The lower canine finished within 2 degrees of the planned position. Total treatment ran eighteen months against a planned sixteen, the difference being a month he spent travelling with inconsistent wear — which he volunteered without being asked.
Patient Experience
In their words.
He said the hardest part was the first three days of every new tray in the first two months, and that after that he stopped noticing. He started the new job in month two and reports that nobody there knew he was in treatment until he mentioned it at the end.
The plan, before anything started.
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Phase 01
Space creation
Arch expansion combined with staged interproximal reduction, avoiding the four premolar extractions previously proposed.
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Phase 02
Bite opening
Anterior intrusion staged over the first nine months using precision bite ramps built into the aligners.
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Phase 03
Rotation control
Optimised rotation attachments on the lower canine, planned for a slow 3-degree-per-tray correction.
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Phase 04
Refinement
A second series planned from the outset rather than presented as a surprise at month fourteen.
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Phase 05
Retention
Fixed bonded retainers on both arches plus clear night retainers, for life.
Treatment process
What actually happened, in order.
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Month 0
Scan, radiographs and a two-hour planning session. Dr. Farouk staged 62 aligners and showed him the simulation before he paid for anything.
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Months 1 — 6
Expansion and initial alignment. Interproximal reduction performed in three small stages as space was needed, never in advance.
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Months 7 — 12
Bite opening phase. Overbite reduced from 85% to 34%. Progress scans at each review overlaid on the plan; tracking held throughout.
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Months 13 — 15
Final rotation of the lower canine and root torque on the upper laterals. The canine was the slowest movement in the case, as expected.
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Months 16 — 18
Refinement series of 11 aligners, then attachment removal, edge polishing and bonded retainers the same day.
The same mouth.
Photographed under identical lighting, 18 months apart
- 14.5mm
- Crowding resolved
- 0
- Teeth extracted
- 62 + 11
- Aligners in the series
Technology used
What it took.
- 3Shape TRIOS 5 scanning
- ClinCheck staging
- Optimised rotation attachments
- Progress scan overlay
- Printed retainer workflow
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