Case overview

Treatment of severe lower crowding, crossbite and discomfort on closing — combining fixed ceramic braces with Clear Aligner therapy.

• Initial situation: The patient came to our orthodontic team because of severe crowding of the lower teeth and concerns about upper-tooth aesthetics. We were also concerned about a right-sided crossbite, and the patient reported an unpleasant discomfort when closing the jaws.
• Treatment plan: We planned the extraction of one lower front tooth to prevent later periodontal disease and relieve the crowding, and at the same time we fitted a fixed appliance. Closing the resulting space and resolving the crowding with an aesthetic ceramic appliance took a total of 8 months. We then changed technique and started upper and lower Clear Aligner (invisible aligner) treatment combined with intermaxillary elastics for a total of 5 months. Combining the two techniques delivered an excellent result.
• Treatment duration: 8+5 months (1 year 1 month in total)
• Result: A functionally and aesthetically excellent outcome that was a huge relief for the patient — especially as extraction-based plans often feel daunting at the start.
• Summary: Patient age: 32 years. Treatment type: fixed braces on the lower arch, Clear Aligner treatment on both arches. Treatment time: 8+5 months, 1 year 1 month in total. Review frequency: every 4 weeks. Case completion: fixed retention wire, removable retainer for night wear.