Management of overbite with clear aligners

Roozbeh Khosravi

Purpose: Most of the published literature on the management of overbite with the Invisalign® appliance consists of case reports or case-series. This retrospective study of 120 patients sought to assess the nature of overbite changes with the Invisalign® appliance.

Methods: Records were collected from three practitioners, all experienced with the Invisalign® technique. The patients were consecutively treated adults (>18-years-old) who underwent orthodontic treatment only with the Invisalign® appliance. Patients with major transverse or antero-posterior changes or extraction treatment plans were excluded. The study sample included 68 normal overbites, 40 deepbites, and 12 openbites. The median age was 33 years and 70% of the patients were female.

Results: Cephalometric analyses indicated that the deepbite patients had a median overbite opening of 1.5 mm, while the openbite patients had a median deepening of 1.5 mm. The median change for the normal overbite patients was 0.3 mm. Changes in incisor position were responsible for most of the improvement in the deepbite and openbite groups. Minimal changes in molar vertical position and mandibular plane angle were noted.

Conclusion: The Invisalign® appliance appears to manage the vertical dimension relatively well, and the primary mechanism is via incisor movements.