Class III Malocclusion Treated Non-Surgically with Invisalign, Mandibular Fixed Appliances and Mandibular TADs

Clinical findings Clinical findings revealed neither signs nor symptoms of temporomandibular joint dysfunction. The maxillary dental midline was coincident to the facial midline, and the mandibular midline was deviated 2mm to the left due to a functional shift. The lower facial third was increased. The clinical intraoral exam revealed the patient had a Class III malocclusion with 0mm to 2mm overjet, 0mm to -2mm overbite, and a crossbite extending from the maxillary lateral incisors to the premolars. Due to the crossbite of the maxillary right lateral, interarch contact was limited to the lateral and second molars only. There was 7mm of crowding in the maxillary arch, with a marked mid-arch constriction. There was minimal crowding (3mm) in the mandibular arch. Dental measurements revealed no significant Bolton discrepancy (77.9 percent). The patient had received previous dental treatment (one crown, and a few occlusal restorations) and had regular dental visits. Although there was no gingival display when the patient was smiling, about 70 percent of the maxillary incisors were displayed. About eight maxillary teeth were shown with buccal corridors within normal limits (Fig. 1).