Orthodontics
Two-phase Treatment with a Growth Regulator and Clear Aligner Therapy of a Class II Adolescent Patient Anderson T. Huang, D.D.S.; Darren Huang, D.D.S.
ABSTRACT Technological developments in clear aligner therapy have allowed for the expansion of its application to the treatment of children and adolescents. Notably, in 2019, Align introduced “Invisalign First” to function as a modality for phase I therapy. However, few studies have assessed the efficacy of clear aligner therapy for the treatment of children and adolescents. To address this lack of evidence, we report in this case study the two-phase treatment of a Class II adolescent patient with a growth regulator, high-pull headgear, during phase I treatment and clear aligner therapy with Invisalign during phase II treatment. We describe the successful improvement to the patient’s dental, skeletal and soft tissues through both phases. We also detail the patterns of thinking and biomechanics involved in this novel approach towards two-phase clear aligner treatment for a Class II adolescent patient. 14 NOVEMBER 2021 The New York State Dental Journal ●
Since the early 1990s, the number of teenage patients seeking orthodontic treatment has grown rapidly. The American Association of Orthodontists (AAO) reports that nearly 4.3 million patients 17 years old and younger were treated in North America in 2016, an increase of 66% since 1989.[1] The last decade has also seen increasing demand among teens for more esthetic alternatives to traditional fixed appliances. [2] Align Technology reported an increase in product sales, from 100,000 to over 235,000 between 2013 and 2017. In the last two years, the company’s volume of teenage patients grew faster than that of adults. Invisalign Teen, a modification of the original appliance, was introduced in 2008 as a means of expanding the capabilities of clear aligner therapy to the adolescent population.[3] The features of the appliance included eruption compensation, compliance indicators and, more recently, precision wings for mandibular advancement in Class II treatment. In July 2019, Align introduced “Invisalign First,” another modification of its clear aligners, to function as phase I interceptive treatment for patients ages 6 to 10. The efficacy of clear aligner therapy has been widely evaluated in adult populations, but few studies have considered its use in growing adolescents and those performed have been limited to assessments of the compliance indicators.[4,5,6] A recent sys-
