The 12-year-old patient presented for orthodontic evaluation with chief concerns of a chipped tooth and habitual lip biting. Initial records demonstrated a class I molar relationship on the right side and class II molar relationship on the left. The maxillary midline was coincident with the facial midline, while the mandibular midline was deviated 2 mm to the left. Overjet was 4 mm, and overbite was 90%. Arch length analysis revealed moderate to severe lack of space, with a mandibular discrepancy of -7 mm and a maxillary discrepancy of -5 mm. No upper leeway space was present, while the lower arch showed 2 mm of leeway space bilaterally. Clinical findings included anterior crossbite involving teeth Nos. 10 and 22, a moderate curve of Spee, large buccal corridors, and mixed dentition. Treatment was carried out using ClearCorrect® clear aligners (Straumann, clearcorrect.com) with unilateral leftside class II elastics. Four refinement phases were needed. Active treatment time was 19 months (excluding a 4-month eruption monitoring period; total treatment duration: 25 months). Meeting the treatment objectives, including correction of deepbite, leveling of the curve of Spee, resolution of lower anterior crowding, space management for eruption of permanent canines, and correction of the class II occlusion on the left side, resulted in improved occlusion and function.
KEY TAKEAWAYS
- Engineered for precision, comfort, and esthetics, ClearCorrect clear aligners combine proprietary ClearQuartz™ tri-layer material, Performance Trimline, and scientifically proven ClearControl™ clinical features to support providers in achieving their orthodontic goals.
- Patients may be easily evaluated for ClearCorrect aligners with the use of an intraoral scanner to tailor treatment precisely with specialized features to meet the individual patient’s needs.
- Notable elements of this case included deepbite correction, leveling of the curve of Spee, managing space for eruption of adult canines, correction of crowding on the lower anterior teeth, and correction of class II occlusion on the left side.
Figure 1
Pretreatment, full facial view. Among the patient’s concerns was that she was, “always biting my lip.”
Figure 2
Intraoral scan, right lateral view.
Figure 3
Intraoral scan, left lateral view.
Figure 4
Initial panoramic radiograph. A cephalometric analysis was also done and revealed: skeletal class II with a mild hyperdivergent facial pattern; class II molar relationship; mild lower lip retrusion.
Figure 5
Initial delivery of aligners (March 15, 2024), right lateral view. Active aligners 1 through 16 were delivered. Horizontal attachments were placed on 6s to increase retention. Horizontal beveled attachments were placed on the upper laterals to help with extrusion movements.
Figure 6
Revision check 1 (July 2, 2024). Goals for refinement included increasing space for erupting teeth Nos. 6, 11, and 28.
Figure 7
Three months after delivery of aligners 17 through 28, revision check 2 was performed (December 6, 2024). Attachments were removed and teeth scanned to see if permanent teeth had erupted further. Follow-up was planned for 4 months.
Figure 8
At the follow-up (May 16, 2025), the teeth were scanned and it was decided to continue toward the previous treatment plan and close all remaining spaces.
Figure 9
At the follow-up (May 16, 2025), the teeth were scanned and it was decided to continue toward the previous treatment plan and close all remaining spaces.
Figure 10
Two-and-a-half months after delivery of aligners 29 through 43, a revision check was performed (November 28, 2025). Goals for refinement included: intrude the lower incisors; close spaces mesial of teeth Nos. 3, 23, 26, and 28 through 30; achieve class I canine using class II elastics lingual-sided; align the midlines; and mesial out rotation on tooth No. 20.
Figure 11
Two-and-a-half months after delivery of aligners 29 through 43, a revision check was performed (November 28, 2025). Goals for refinement included: intrude the lower incisors; close spaces mesial of teeth Nos. 3, 23, 26, and 28 through 30; achieve class I canine using class II elastics lingual-sided; align the midlines; and mesial out rotation on tooth No. 20.
Figure 12
Delivery of aligners 43 through 51 (February 20, 2026). Engager was bonded on tooth No. 20 and Caplin hook for elastics on tooth No. 19. Elastics instruction: class II, 3.5-oz force, 3/16-in diameter, nighttime only, left side.
Figure 13
End of treatment, full facial view (April 17, 2026).
Figure 14
Final outcome, intraoral view.
Figure 15
Final panoramic radiograph.
Mostafa Altalibi, DMD, MSc D. Ortho
Private Practice in Orthodontics, Montreal, Quebec, Canada
Zahra Turki, DDS
Private Practice in Orthodontics, Montreal, Quebec, Canada