Correction of Deep Bite in Adults Using the Invisalign System

full correction. 1 The amount of incisor exposure in smiling is an important consideration in deep-bite cases. When the maxillary incisor display is correct, maxillary incisor intrusion is unnecessary; treatment should involve intrusion and leveling of the mandibular anterior teeth to avoid flattening of the smile arc. 2 Any maxillary incisor intrusion or mandibular leveling should be carefully monitored during treatment to maintain proper incisor exposure while effectively correcting the deep bite. After the development of thermoformed appliances that could be used for minor tooth movements, 3-7 the Invisalign* system was introduced for treatment of moderate malocclusions. 8-13 In 2004, Wheeler reported that Invisalign could be used in patients with anterior and posterior crossbites, deep bites, anterior open bites or shallow overbites, and periodontal problems. 14 The present article describes the use of Invisalign appliances for the correction of deep bite in adult patients with normal skeletal patterns. Case 1 A 23-year-old female presented with a Class I malocclusion, a deep bite, and mild crowding in both arches (Fig. 1). Treatment involved 23 upper and 29 lower aligners. After 15 months of initial treatment, another six months of Case Refinement was needed to finish the lower alignment (Figs. 2,3). The upper and lower crowding was corrected with interproximal reduction. The deep bite was opened by leveling the mandibular arch, using controlled proclination of the mandibular incisors and only slight intrusion of the maxillary incisors, thus maintaining the smile arc. The patient’s good posterior occlusal relationship was preserved.