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How to reduce a large overjet with Invisalign

Initial presentation of upper proclaimed teeth

Not all patients have had the benefit of orthodontic treatment, and as they get older the problem gets worse.

Sometimes teeth have been orthodontically treated but without adequate retention, orthodontic relapse occurs.

The protrusion of upper teeth can be from tongue, thumb or even lower lip forces and this can create an unfavourable profile.

Before treatment

In this young lady we have a normal nasolabial angle but an increased upper E-line measurement, meaning that the upper lip protrudes out. protrusion. This can be from a longer upper jaw or a shorter lower jaw (asymmetric growth) but it can also be from upper teeth protruding outwards.

Sometimes the lower lip gets caught behind the upper front teeth and can cause protrusion.

This case study shows a young lady who did not have orthodontic treatment and she was not happy with dental appearance or the lip profile.

The only way to reduce the overjet was to remove upper premolar teeth. Nothing else would give a better result without also lower jaw surgery, which we normally do not recommend.

We agreed to do Invisalign with 2 upper teeth extractions.

We had 39 upper and 22 lower aligners, and the patient changed her aligners every 10 days.

After about 1 year we carried out a refinement scan for some new aligners; 11 in total.

The large overjet was greatly reduced to within 2mm and the patient was very happy.

We discussed using Invisalign retainers, that are rotated every 4 months, to stop them from stretching.

The upper lip profile has been relaxed and the patient can comfortably close her lips together. A great result with such a simple technique.