Retrospective Evaluation of Invisalign® Mandibular Advancement in Growing Patients: Cephalometric, PAR and 3D Molar Displacement Outcomes.

Background

Class II malocclusion is one of the most prevalent dentoskeletal disorders, usually caused by mandibular retrusion. The Invisalign® Mandibular Advancement System is an aesthetic, comfortable alternative to conventional braces for growing patients allowing mandibular projection and dental alignment. This retrospective study assessed the effectiveness of the Invisalign® Mandibular Advancement (MA) System in growing patients with mandibular retrognathia.

Methods

At treatment onset, seventeen patients were divided into the following two groups according to the aligner system used and cervical vertebral maturation stage: the Invisalign® First group (CVM2), and the Invisalign® Teen group (CVM3, some transitioning to CVM4), all treated with the Comprehensive Package. Treatment efficacy was evaluated through cephalometric analysis, occlusal classification, and three-dimensional tooth movement assessment. Cephalometric evaluations were performed pre-(T0) and post-treatment (TF). In addition, a clinical follow-up during the retention period was conducted to assess post-treatment stability.

Results

Significant dentoalveolar and skeletal changes were observed in both groups. The Teen group showed greater mesial movement of the lower molars (3.57 ± 1.26 mm) compared to the First group (1.34 ± 0.48 mm; p < 0.001). Conversely, the First group showed greater distal movement of the upper molars (2.24 ± 0.64 mm) compared to the Teen group (1.35 ± 0.69 mm; p = 0.002). The PAR index showed significant reductions in both groups (p < 0.001), and although the Teen group achieved greater improvements, the First group demonstrated a clinically relevant reduction (23.60 vs. 19.43 points), despite two severe cases that did not achieve full Class II correction.

Conclusions

Both the Invisalign® First and Comprehensive Package for teens systems improved occlusion and skeletal patterns. These findings support the MA System as an effective option for correcting Class II malocclusion during growth.