Assessment of dental, skeletal, and soft tissue changes following mandibular advancement with Invisalign in skeletal Class II

Objective: This study evaluated the dentoskeletal and soft tissue changes for Class II malocclusion patients treated with Invisalign clear aligners with mandibular wings (IAMW).

Methods: This retrospective study included 50 skeletal Class II patients treated with Invisalign clear aligner with mandibular wings. Records of 20 subjects were collected from the AAOF Legacy Collection (The Case Western Bolton Brush Growth Study) and were used as a control. The dental, skeletal, and facial soft tissue changes were assessed by digitizing and analyzing lateral cephalograms using Dolphin Imaging software (version 11.95 Premium; Dolphin Imaging & Management Solutions, Chatsworth, Calif). Paired t-tests and independent t-tests were used to assess the changes before and after and to compare between the IAMW and control groups.

Results: The different measurements of the maxilla have shown that IAMW effect on the maxilla included minimal, non-significant retraction compared to the control group. The SNB and mandibular base position increased by 1.17° (±2.63) and 3.79 (±8.13), respectively. The mandible advanced significantly in the treatment group compared to the control group. Dentally, the lower incisors tipped slightly buccally, but the change was not significant (p > 0.05). The facial convexity angle decreased by 1.16° (±4.36).

Conclusion: Invisalign clear aligner with mandibular advancer wings was able to correct the Class II malocclusion. This correction was mainly skeletal with some dental changes. This device can be used to address the growth modification problem in Class II malocclusion at the same time as addressing the other occlusal problems.