Treatment of a challenging Class III malocclusion case using Invisalign clear aligners and micro-osteoperforation: a case report

Class III malocclusion cases can be some of the most difficult cases to treat, especially in non-growing patients. Many patients prefer to avoid surgical treatment if possible, and are interested in more conservative treatment options if available. In this case report, a Class III malocclusion was treated using the Invisalign appliance in combination with auxiliary devices as well as micro-osteoperforation to facilitate first molar space closure. The challenges of this Class III case include skeletal mandibular unilateral prognathism, missing mandibular left first molar, chin deviation, as well as lateral functional shift. Detailed diagnosis including cone beam computed tomography and clinical examination, as well as alternative treatments, are discussed. The results showed improvement in the patient's profile and occlusion as well as closure of the space of the mandibular left first molar. Limitations and criticism of the treatment outcome are also discussed. Palabras clave: chin deviation, Class III skeletal, clear aligners, functional shift, malocclusion, micro-osteoperforation