Clear aligners for Class III malocclusion and severe open bite camouflage: A case report

Objective: The aim of the study was to describe a clinical case of a Class III malocclusion and severe open bite approached with clear aligners (CAs) and intermaxillary elastics. Case Presentation: A 21-year-old male patient showed to the dental clinic asking for orthodontic treatment. His chief complaint was an unpleasant smile esthetics. The patient showed an oval face with increased length of the lower third of the face, slight mandibular asymmetry, and concave profile. On intraoral evaluation, a bilateral canine and molar Class III with reduced overbite could be seen. Pre-treatment panoramic radiograph showed good root parallelism and presence of all dental elements. Cephalometric values confirmed skeletal Class III (Wits Appraisal = −6.5 mm), increased vertical dimension (FMA = 34.3°), correctly inclined upper incisors and retroclined lower incisors. After discussing the treatment options with the patient, CAs (F22, Sweden and Martina, Due Carrare, Padova, Italy) were chosen to approach this malocclusion together with intermaxillary elastics. After 9 months of active treatment involving 18 sets of aligners, the patient showed correct overbite, bilateral canine e molar Class I, leveled and aligned dental arches, and no signs of radicular or bone resorption. Cephalometric parameters show control of vertical dimension (FMA = 34.4°), upper incisor flaring and lower incisor retroclination, and signs of a dentoalveolar compensation. Conclusion: Careful diagnosis, treatment planning, and clinical management of CAs and intermaxillary elastics led to a successful dentoalveolar compensation featured by good occlusal results, bilateral Class I relationship, and normal overbite which remained stable after 1 year from the end of treatment.