The proclination of mandibular incisors in non-extraction crowded Invisalign cases
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OBJECTIVES: Investigate changes in mandibular incisor position resulting from Invisalign correction of the crowded dentition. MATERIALS AND METHODS: A retrospective chart review was undertaken on 61 adult Caucasian patients. Subjects were categorized into 3 groups based on the value of pre-treatment crowding of the lower dentition; 20 mild (2.0-3.9mm), 22 moderate (4.0-5.9mm) and 19 severe (>6.0mm). Cephalometric radiographs were measured to determine lower incisor changes. Interproximal reduction (IPR) and changes in arch width were also measured. Statistical evaluation of T0 and T1 values using paired t-tests and ANCOVA were applied to evaluate mean value changes. RESULTS: Lower incisor position and angulation changes were statistically significant in the severe crowding group. There were no statistically significant differences in lower incisor position between the mild and moderate crowding groups. There was a statistically significant increase in buccal expansion in each of the 3 groups. CONCLUSIONS: Invisalign® treatment can successfully resolve mandibular arch crowding using a combination of buccal arch expansion, interproximal reduction and lower incisor proclination. When there is <6mm of crowding, lower incisor position remained relatively stable. In more severely crowded dentitions (>6mm), the lower incisors proclined and protruded to allow for arch alignment.