A new functional approach to Class II treatment with clear aligners in growing patients

In this edition of the Aligner Corner, the authors present two case reports using the F22* aligner system with a mandibular-advancement feature referred to as the “advancement block.” This is a protuberance of plastic placed behind the upper incisors that causes the patient to posture forward, thus imparting functional-appliance forces to the aligners. In the first case, a 10-year-old male wore the advancement aligner for 10 months and achieved a correction to Class I. The second phase, which occurred two years later, consisted of six months of treatment with aligners and a fixed sectional appliance using lingual buttons on the lower left lateral incisor, canine, and first premolar. In the second case, the female patient had already undergone 12 months of rapid palatal expansion at age 6, during the mixed dentition. Her aligner and mandibular-advancement phase commenced at age 12 and involved nine sets of aligners, with the advancement block added only to the last tray. As in the first case, the mandibular advancement occurred first (10 months), followed by refinement (three months), resulting in a still-impressive 13-month treatment time. As always, there are many ways to reach the same objectives, but these authors did achieve excellent results.