Clear aligner hybrid approach: A case report

Introduction: This case demonstrates that hybrid application of clear aligners can be a rational and efficient approach for treating malocclusions, as compared with a clear aligner therapy alone option in which the magnitude of some movements would require a higher number of aligners and likely further refinement. Treatment plan and progress: After a first successful orthopedic phase face mask + rapid maxillary expansion (FM + RME), a diagnostic digital setup of the second orthodontic treatment phase was performed, opting for an esthetic approach to make the treatment as fast and efficient as possible. After positioning lingual tubes on both arches, digital models were obtained and lingual archwires, passing through the previously positioned tubes, were simulated digitally. Then, a virtual setup comprising 10 steps for both arches was planned. Aligners enveloped fixed partial lingual appliances, improving patient comfort and efficiency of overall treatment. Aligners were changed every 7 days and the second phase of treatment was finished in 10 weeks with good occlusion and alignment in both arches. The entire treatment of the Class III patient was completed in 13 months of active therapy. Conclusion: Combining clear aligner therapy and fixed lingual appliance is an esthetic means of treating malocclusions in a shorter treatment time with low costs and high efficiency.