This clinical case demonstrates how Elencia Aligners successfully corrected dental crowding by gradually moving misaligned teeth into their ideal positions.
Adult orthodontic treatment often requires balancing ideal treatment objectives with the patient’s preferences. This case demonstrates how Elencia Aligners successfully managed proclined maxillary anterior teeth and lip incompetence using an extraction-based treatment approach, resulting in improved dental alignment, facial harmony, and smile aesthetics while respecting the patient’s treatment goals.
A 34-year-old female presented with proclined maxillary anterior teeth, an end-on molar relationship, and a Class II Division 1 malocclusion. Clinical examination also revealed lip incompetence, affecting facial aesthetics and smile harmony. The patient desired an aesthetic orthodontic treatment with Elencia Aligners and did not wish to undergo comprehensive correction of the molar relationship.
A customized digital treatment plan was developed using Elencia Aligners.
Considering the patient’s chief complaint and treatment expectations, an extraction-based treatment approach was selected to facilitate anterior retraction and improve facial soft tissue balance. Since the patient did not desire comprehensive correction of the molar relationship, treatment focused on reducing maxillary incisor proclination, improving lip competence, and enhancing smile aesthetics while maintaining functional occlusion.
Treatment was completed over 19 months using 74 customized clear aligners.
Elencia Aligners Case Overview
| Case Type | Adult Orthodontic Correction |
| Treatment Duration | 19 Months |
| Total Aligners | 74 Aligners |
| Upper Arch | 38 Aligners |
| Lower Arch | 36 Aligners |
| Extractions | Yes (Extractions Case) |
| Treatment Modality | Clear Aligners |
Following completion of treatment, the patient achieved:
The treatment successfully addressed the patient’s primary concerns while respecting her treatment preferences and delivering a balanced, natural-looking smile.
This case demonstrates the flexibility of Elencia Aligners in delivering patient-centered orthodontic care. Rather than pursuing ideal occlusal correction alone, treatment was customized to address the patient’s primary concerns—proclined anterior teeth, excessive overjet, and lip incompetence. Through orthodontist-led digital treatment planning and precise aligner biomechanics, a significant improvement in facial profile and smile aesthetics was achieved while fully respecting the patient’s treatment goals.
A clinical case treated using Elencia Aligners
Bimaxillary protrusion can affect not only dental alignment but also lip competence, facial aesthetics, and a patient’s confidence while smiling.
This case involved a 36-year-old female presenting with bimaxillary protrusion and lip incompetence. Despite having Class I molar and Class I canine relationships, the prominent anterior teeth and associated lip incompetence were a major aesthetic concern.
The case was managed using an all four premolar extraction approach with Elencia Aligners.
The patient was concerned about the prominence of her teeth and her overall smile appearance.
She was hesitant to smile and avoided getting her photographs clicked, reflecting the significant impact of her dental appearance on her confidence.
A customized extraction-based clear aligner treatment plan was developed using Elencia Aligners.
To create the space required for controlled anterior retraction, all four premolars were extracted as part of the orthodontic treatment plan.
The treatment focused on controlled space closure and progressive retraction of the anterior teeth while maintaining the existing Class I molar and canine relationships.
Sequential clear aligners were digitally planned to guide tooth movement throughout the treatment.
Clear Aligner Case Overview
| Case Type | Bimaxillary Protrusion |
| Treatment Duration | 20 Months |
| Total Aligners | 76 Aligners |
| Upper Arch | 40 Aligners |
| Lower Arch | 36 Aligners |
| Extractions | All Four Premolar Extraction |
| Treatment Modality | Elencia Aligners |
The before-and-after transformation demonstrates how a carefully planned extraction approach can help manage bimaxillary protrusion while improving both dental aesthetics and the patient’s confidence.
Bimaxillary protrusion cases require more than simply aligning crowded teeth.
With Elencia Aligners, treatment can be digitally customized to plan controlled space closure and anterior retraction according to the specific clinical objectives of the case.
In this case, the extraction of all four premolars created the required space for planned tooth movement, allowing improvement in dental protrusion and lip competence while maintaining the existing Class I molar and canine relationships.
Adult orthodontic treatment should be planned not only according to the clinical diagnosis but also according to the patient’s individual treatment goals.
This case involved a 35-year-old male patient with a Class II Division 2 malocclusion who was primarily concerned about the alignment of his anterior teeth.
The patient did not wish to undergo comprehensive correction of his existing molar relationship and preferred a relatively quick treatment focused on improving anterior alignment. A customised non-extraction clear aligner approach was therefore planned around these specific treatment goals.
The patient was concerned about the irregular alignment of his anterior teeth and wanted to improve the appearance of his smile.
Being an adult patient, he preferred a focused and relatively efficient treatment approach rather than comprehensive orthodontic correction.
The patient specifically did not wish to undergo treatment aimed at correcting the existing molar relationship.
A customised non-extraction treatment plan using Elencia Aligners was developed with the primary focus on anterior alignment.
As the patient did not wish to undergo comprehensive correction of the existing molar relationship, treatment was planned specifically around his aesthetic concerns and expectations.
The clear aligner treatment focused on progressive alignment of the anterior teeth and improvement of smile aesthetics, without pursuing correction of the posterior molar relationship.
Clear Aligner Case Overview
| Case Type | Adult Orthodontics |
| Treatment Duration | 13 Months |
| Total Aligners | 46 Aligners |
| Upper Arch | 26 Aligners |
| Lower Arch | 20 Aligners |
| Extractions | Non-Extraction |
| Treatment Modality | Elencia Aligners |
The existing molar relationship was not targeted for correction, in accordance with the patient’s treatment preference.
Not every adult orthodontic patient seeks comprehensive correction of every occlusal discrepancy.
With Elencia Aligners, digital treatment planning allows clinicians to customise treatment objectives according to the individual clinical situation and the patient’s informed treatment preferences.
In this case, the treatment focused specifically on improving anterior alignment and smile aesthetics while respecting the patient’s decision not to pursue correction of the existing molar relationship.
This case involved a doctor with Class I malocclusion and dental crowding who was uncomfortable with the appearance of her teeth and felt it affected her confidence while interacting with patients.
Although she wanted to improve her smile, she did not want conventional braces and specifically preferred an invisible orthodontic solution.
Clear aligner therapy offered an aesthetic and removable alternative, allowing her to undergo orthodontic treatment while maintaining her professional appearance and continuing routine oral hygiene.
Her primary requirement was a discreet orthodontic treatment that would not interfere with her professional appearance.
A customised treatment plan was developed using Elencia Aligners.
Clear aligners were selected because they provided a discreet orthodontic option while allowing the patient to remove the aligners for routine oral hygiene and eating.
Clear Aligner Case Overview
| Case Type | Dental Crowding |
| Treatment Duration | 20 Months |
| Total Aligners | 75 Aligners |
| Upper Arch | 41 Aligners |
| Lower Arch | 34 Aligners |
| Extractions | Extraction |
| Treatment Modality | Elencia Aligners |
In this case, the patient specifically wanted to avoid conventional braces and preferred an invisible orthodontic solution.
This case involved a 15-year-old boy presenting with dental crowding and a Class I malocclusion, along with crossbite involving the maxillary lateral incisors (12 and 22).
A non-extraction clear aligner approach was planned, incorporating posterior bite blocks in the form of rectangular occlusal attachments to assist with bite opening and facilitate correction of the anterior crossbite.
A customised non-extraction treatment plan using Elencia Aligners was developed.
To facilitate correction of the anterior crossbite, posterior bite blocks were incorporated into the aligners in the form of rectangular occlusal attachments.
These bite blocks were used to provide posterior disclusion and assist in creating the vertical clearance required for controlled correction of the anterior crossbite.
Clear Aligner Case Overview
| Case Type | Teen Crowding & Crossbite Correction |
| Treatment Duration | 13 Months |
| Total Aligners | 39 Aligners |
| Upper Arch | 25 Aligners |
| Lower Arch | 14 Aligners |
| Extractions | Non-Extraction |
| Treatment Modality | Elencia Aligners |
The case demonstrates the use of a customised clear aligner design with posterior bite blocks to assist in managing anterior crossbite alongside dental crowding.
In this case, posterior bite blocks were incorporated as rectangular occlusal attachments to provide posterior disclusion and facilitate correction of the anterior crossbite involving 12 and 22.
This combination of customised aligner design and sequential tooth movement allowed the crowding and crossbite to be addressed through a non-extraction approach.
This case involved a 35-year-old female patient presenting with dental spacing and increased proclination.
A non-extraction clear aligner approach was planned. Interproximal reduction (IPR) was performed in both the maxillary and mandibular arches to create the required space for controlled alignment and reduce dental proclination.
The patient presented with spacing between the teeth associated with dental proclination, affecting the overall appearance and harmony of the smile.
A customised treatment plan was developed using Elencia Aligners.
The treatment focused on controlled movement of the teeth to close the existing spaces while improving the inclination of the anterior teeth.
Interproximal reduction (IPR) was strategically performed in both the maxillary and mandibular arches to create the space required for controlled tooth movement and to assist in reducing proclination.
The combination of clear aligner therapy and carefully planned IPR allowed the spaces to be managed through a non-extraction approach.
Clear Aligner Case Overview
| Case Type | Adult Spacing Correction |
| Treatment Duration | 8 Months |
| Total Aligners | 26 Aligners |
| Upper Arch | 16 Aligners |
| Lower Arch | 10 Aligners |
| Extractions | Non-Extraction |
| Treatment Modality | Elencia Aligners |
In this case, Elencia Aligners were used to progressively close the spaces while improving the inclination of the teeth.
Strategically planned IPR in both arches provided additional space-management control and supported the objective of reducing proclination without extraction.
Anterior open bite is a malocclusion in which the upper and lower front teeth do not achieve the desired vertical overlap when the posterior teeth are together. It can affect smile aesthetics, anterior tooth function and the overall balance of the bite.
This case involved a patient presenting with an open bite and an unaesthetic smile. A non-extraction treatment approach was selected using Elencia Aligners, with box elastics and button cutouts incorporated to assist with the planned bite correction.
Button cutouts were provided in the aligners for the specified teeth to facilitate elastic wear. The combination of customized aligners and interarch elastics helped deliver the planned orthodontic mechanics throughout treatment.
The case was completed in 10 months using 38 aligners, with a visible improvement in the patient’s smile.
The patient presented with an open bite that affected the appearance of the smile and the relationship between the upper and lower front teeth.
The treatment objective was to improve the anterior bite relationship, achieve better dental coordination and create a more harmonious smile without extractions.
The button cutouts were provided at:
The effectiveness of elastic mechanics depends on the individual diagnosis, treatment plan, appliance design and patient compliance.
Clear Aligner Case Overview
| Case Type | Open Bite Correction |
| Treatment Duration | 10 Months |
| Total Aligners | 38 Aligners |
| Upper Arch | 20 Aligners |
| Lower Arch | 18 Aligners |
| Extractions | Non-Extraction |
| Treatment Modality | Elencia Aligners |
Following treatment, the before-and-after records demonstrate a visible improvement in the patient’s smile and anterior tooth relationship.
The treatment outcome included:
The case was managed using a non-extraction approach, with box elastics and button cutouts incorporated into the aligner mechanics to support the planned correction.
The treatment was completed in 10 months with 38 aligners — 20 maxillary and 18 mandibular aligners.
The most striking aspect of the case was the visible change in the patient’s smile, demonstrating the role that carefully planned orthodontic treatment can play in improving dental aesthetics.
Open bite correction may require more than aligner movement alone. Depending on the diagnosis and treatment objectives, auxiliaries such as elastics can be incorporated to support the planned tooth movements.
In this case, button cutouts were designed into the aligners at selected upper and lower teeth to facilitate box elastic wear.
This combination allowed the treating clinician to integrate auxiliary mechanics into a removable aligner treatment plan while pursuing the desired bite correction.
The case highlights the importance of individualized treatment planning, appropriate auxiliary selection and patient compliance in managing open bite cases with clear aligners.
Explore the Elencia Aligners Treatment Process:
https://elenciaaligners.com/aligners-treatment-process/
