Abstract
Objective:
This paper aims to present the case of a young boy in late mixed dentition without space for aligning all permanent teeth. He was treated using clear aligners that stimulated facial growth and developed the dental arches gaining space to align his teeth.
Background:
The most frequent malocclusions, that come to the dental office, are Angle class I or norm occlusion malocclusions, with crowding.
Treatment objectives depend on the facial type, the cephalometric discrepancy, the patient's age, arch dimensions, and professional ability.
Early treatment can reduce the requirements for premolar extractions to respect arch dimensions and cephalometric measurements, gaining space to align teeth.
It is possible to stimulate bone growth during the growth period if space is necessary for dental alignment.
This stimulus can be done by dental orthopedic devices. We treated this case using clear aligners.
Method:
The patient was scanned using ITEROTM. He used 75 INVISALIGNTM clear aligners, divided into four virtual treatment plans (clinchecksTM).
Results:
Clear aligners increased intermolar and inter-premolar dimensions and gained space to align all teeth. CBTC after treatment proved that despite the huge buccal expansion of the dental arches, there is a 0.33mm to 2.53mm buccal cortical plate.
Conclusion:
Clear aligners can develop orthodontic and orthopedic movements during growth spread, increasing bone and arch dimensions. Moreover, patient compliance reduced as treatment time advanced.
References
Silva RG, Kang DS. Prevalence of malocclusion among Latino adolescents. American Journal of Orthodontics and Dentofacial Orthopedics. 2001 Mar;119(3):313–5.
Arnett GW, Bergman RT. Facial keys to orthodontic diagnosis and treatment planning. Part I. American Journal of Orthodontics and Dentofacial Orthopedics. 1993 Apr;103(4):299–312.
Cho M-Y, Choi J-H, Lee S-P, Baek S-H. Three-dimensional analysis of the tooth movement and arch dimension changes in Class I malocclusions treated with first premolar extractions: A guideline for virtual treatment planning. American Journal of Orthodontics and Dentofacial Orthopedics. 2010 Dec;138(6):747–57.
Proffit WR. The timing of early treatment: An overview. American Journal of Orthodontics and Dentofacial Orthopedics. 2006 Apr;129(4):S47–9.
Cavalcanti MFXB. Classe I com apinhamentos: relato de caso clínico. Orthodontic Science and Practice. 2012;5(18):214–20.
Meikle MC. Remodeling the Dentofacial Skeleton: The Biological Basis of Orthodontics and Dentofacial Orthopedics. Journal of Dental Research. 2007 Jan;86(1):12–24.
Fleming, P. S. "Timing orthodontic treatment: early or late?." Australian Dental Journal 62 (2017): 11-19.
Zhou, Chenchen, et al. "Expert consensus on pediatric orthodontic therapies of malocclusions in children." International Journal of Oral Science 16.1 (2024): 32.
Franchi L, Baccetti T, McNamara JA Jr. Mandibular growth as related to cervical vertebral maturation and body height. American Journal of Orthodontics and Dentofacial Orthopedics. 2000 Sep;118(3):335–40.
Ricketts R.M. Cephalometric synthesis – An exercise in statin objectives and planning treatment with tracings of the head roentgenogram. Am. J. Orthod., 1960, 46: 647-673.
Ricketts R.M. Bioprogressive Therapy as an answer to orthodontic needs part I and part II, Am. J. Orthod., 1976, 70: 241-267, 70: 359-397.
Simões W.A. Ortopedia Funcional dos Maxilares através da Reabilitação Neuro oclusal, São Paulo, editora Artes Médicas 2003.
Walter, Andre, et al. "Adult maxillary expansion: CBCT evaluation of skeletal changes and determining an efficiency factor between force-controlled polycyclic slow activation and continuous rapid activation for mini-screw-assisted palatal expansion-MASPE vs. MARPE." Head & Face Medicine 20.1 (2024): 70.
Cavalcanti, Marcos Fernando Xisto Braga, et al. "Direct Dental Tracks by Marcos Cavalcanti." International Journal of Orthodontics (Milwaukee, Wis.) 27.4 (2016): 31-36.

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