Improving Crowding and Rotated Upper Teeth with Invisalign
A 15-year-old patient attended Lancashire Smiles Dental Practice in Kirkham with concerns about rotated upper lateral incisors and crowding affecting both the upper and lower teeth.
After a detailed assessment, Dr Arnold Gangaidzo developed a personalised Invisalign treatment plan designed to improve the alignment of both arches, address the rotated upper teeth and create a more balanced bite.
The patient was highly motivated throughout treatment, attended all scheduled appointments and followed the recommended aligner wear instructions closely, helping to achieve the planned result. Invisalign Case Study Treating …
The Patient's Concerns
The patient's main concerns were:
- Rotated upper lateral incisors
- Moderate crowding of the upper teeth
- Moderate crowding of the lower teeth
- The overall alignment and appearance of the smile
The clinical assessment also identified a Class II Division 2 bite, with the upper lateral incisors rotated and positioned higher than ideal. Invisalign Case Study Treating …
Planning Invisalign Treatment
Dr Arnold Gangaidzo carried out a comprehensive assessment before treatment began, including clinical photographs, X-rays and a digital intraoral scan using the iTero scanner.
The digital scan allowed the proposed tooth movements to be planned virtually using Invisalign's ClinCheck treatment planning system. The patient could also see a simulation of the anticipated outcome, helping her understand how the teeth were expected to move throughout treatment.
The treatment objectives were to:
- Improve the alignment of the upper and lower arches
- Reduce the existing crowding
- Correct the rotation and position of the upper lateral incisors
- Improve the relationship between the upper and lower teeth
- Establish a more stable and balanced bite
Because every Invisalign case is different, the treatment plan was tailored specifically to the patient's teeth and bite rather than following a standardised approach. Invisalign Case Study Treating …
The Invisalign Treatment Approach
The treatment involved a combination of carefully planned tooth movements to create space, improve alignment and correct the position of the upper front teeth.
Upper interproximal reduction (IPR) was incorporated into the treatment plan to create additional space where required. Class II elastics were also used alongside the Invisalign aligners to help improve the relationship between the upper and lower teeth.
The treatment plan included:
- Alignment of the upper and lower arches
- Controlled movement and rotation of the upper lateral incisors
- Space creation using upper IPR
- Retraction of the upper front teeth
- Posterior tooth movements to help achieve the desired bite
- Class II elastics using metal buttons
- Carefully controlled rotations to improve tooth positioning
The patient's progress was monitored throughout treatment, with the iTero scanner also being used at review appointments to demonstrate the changes achieved. Invisalign Case Study Treating …
Refinement and Additional Aligners
Following the first stage of Invisalign treatment, further refinement was carried out to make additional adjustments and fine-tune the final result.
Additional aligners allowed Dr Gangaidzo to make further controlled tooth movements and optimise the alignment achieved during the initial phase of treatment.
This refinement stage is an important part of many Invisalign treatments. Teeth do not always move exactly as predicted, and additional aligners can be used where necessary to make further adjustments and achieve the best possible result. Invisalign Case Study Treating …
The Result
At the end of treatment, the upper and lower arches were significantly better aligned, with improvements to the crowding and positioning of the upper lateral incisors.
The final result was compared with the original Invisalign ClinCheck plan to assess the outcome of treatment.
The case demonstrates how Invisalign can be used to address more than straightforward cosmetic alignment. With careful treatment planning, clear aligners can be used to manage tooth rotations, crowding and aspects of bite correction in appropriately selected patients. Invisalign Case Study Treating …
Before and after Invisalign
Before and after digital scans
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Retention: Maintaining the Result
Once active Invisalign treatment was complete, a retention plan was put in place to help maintain the new position of the teeth.
The patient was provided with both upper and lower bonded retainers, helping to reduce the risk of the teeth moving back towards their original positions.
Vivera retainers were also prescribed, with the wearing schedule gradually reducing from full-time wear during the first month to overnight wear from the third month onwards.
Retention is an important part of orthodontic treatment. Teeth can naturally move over time, so wearing retainers as instructed helps protect the results achieved through Invisalign treatment. Invisalign Case Study Treating …
Invisalign at Lancashire Smiles
This case was treated by Dr Arnold Gangaidzo, owner of Lancashire Smiles Dental Practice in Kirkham.
Dr Gangaidzo graduated from the University of Lancashire in 2017 and has a particular interest in orthodontic treatment. He holds a postgraduate diploma in clear aligner therapy and also mentors other clear aligner providers.
His work in orthodontics has been recognised through several professional accolades, including being voted Best Young Dentist in the North West in 2020 and being named in the Dentistry Top 50 in 2025.
At Lancashire Smiles, Invisalign treatment is planned around each patient's individual teeth, bite and treatment goals, with digital scanning and treatment planning helping patients understand their proposed treatment before they begin. Invisalign Case Study Treating …
Considering Invisalign?
If you're unhappy with crowded, rotated or misaligned teeth, Invisalign may be an option for you.
Book a consultation or contact the team at Lancashire Smiles Dental Practice in Kirkham to find out whether clear aligner treatment could be suitable for your smile.
Book an Invisalign consultation Invisalign Case Study Treating …
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