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CC BY 4.0 · Eur J Dent
DOI: 10.1055/s-0045-1808255
Original Article

Deep Bite Correction with the Invisalign System: A Case-Series Study

Trey Spillers III
1   Department of Orthodontics, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama, United States
,
David Alexandre Cruz Walma
2   Department of Orthodontics, Harvard School of Dental Medicine, Boston, Massachusetts, United States
,
Jerry Don Spillers Jr.
1   Department of Orthodontics, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama, United States
,
Chung How Kau 
1   Department of Orthodontics, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama, United States
,
Terpsithea Christou
1   Department of Orthodontics, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama, United States
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Abstract

Objective

This article assesses the dental and skeletal changes resulting from correction of a deep bite using Invisalign clear aligner therapy (Align Technology, Santa Clara, California, United States).

Materials and Methods

This is a retrospective case series study that analyzed pre- and posttreatment cephalograms for 37 adult deep bite patients. Each patient was treated by one experienced clinician using the same treatment protocol. Ten linear and 9 angular variables were evaluated pre- and posttreatment. The Wilcoxon analysis was used to determine if there was a significant difference in the 19 variables pre- and posttreatment.

Results

Statistically significant differences (p < 0.05) were observed for 14 of 19 variables. These included a decrease in overjet (–1.0 mm), decrease in overbite (–4.1 mm), extrusion of the upper first molar (+0.5 mm), intrusion of the upper incisor (–0.6 mm), extrusion of the lower second molar (+1.0 mm), lower first molar (+1.2 mm), lower second premolar (+1.70 mm), and lower first premolar (+1.7 mm), intrusion of the lower incisor (–1.8 mm), proclination of lower incisor (+4.1 degrees), and an increase in sella-nasion- mandibular plane (+0.6 mm). A decrease in anterior occlusal plane was also significant.

Conclusion

Invisalign is an effective treatment modality for correcting dental deep bites through posterior extrusion and anterior intrusion. Minimal skeletal changes are seen when correcting deep bites with Invisalign. Results of this study enhance our understanding of the dental and skeletal changes that can be expected when attempting to correct deep bites with clear aligner therapy.

Keywords

deep bite - Invisalign - clear aligner therapy - anterior tooth intrusion - posterior tooth extrusion

Data Availability Statement

The data sets used and/or analyzed during the current study are available from the corresponding author on reasonable request.


Authors' Contributions

T.S. conceived the idea, processed the experimental data, designed figures/tables, and wrote significant portion of the manuscript. J.D.S. treated the patients and provided the patient's data. C.H.K. contributed to the implementation of research and the final version of the manuscript. D.A.C.W. created all illustrative items and wrote a significant portion of the manuscript. T.C. designed the study, processed the experimental data, interpreted the statistical analysis, and wrote significant portion of the manuscript.


Ethical Approval

This study was approved by the Institutional Review Board (IRB) of the University of Alabama at Birmingham (UAB), Birmingham, Alabama, USA, and the study's protocol identifications is Protocol No. IRB#300010568.


Supplementary Material



Publication History

Article published online:
24 June 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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