Clear aligner-based multidisciplinary camouflage treatment for adult skeletal class III malocclusion: A 7-year...

This case report describes non-surgical camouflage treatment of a skeletal Class III malocclusion in a 28-year-old female using clear aligners, integrating orthodontics, restorative dentistry, and implantology. The patient presented with a full Class III molar relationship with borderline cephalometric values (Wits appraisal: -4.92mm; Holdaway angle: 11°), and some functional issues. The orthodontic approach prioritized vertical and sagittal correction, including bite opening through intrusion and retroclination of mandibular incisors and proclination of maxillary incisors. The thickness of the aligner material with attachments on the occlusal surfaces of molars to open the bite, supplemented by Class III elastics contributing to favourable mandibular plane clockwise rotation and occlusal plane counterclockwise flattening. Substantial dental changes resulted, including maxillary incisor proclination (99.17° to 109.74°), mandibular incisor retroclination (96.37° to 88.08°), with roots maintained within basal bone. The soft tissue profile improved (NA-Apo: -5.31° to -2.51°), and normal overjet, overbite, and molar intercuspation were achieved. The multidisciplinary approach also involved restoring a discoloured UL1, initially managed with conservative observation before being extracted and replaced with an implant, along with aesthetic restoration of the anterior teeth. Seven-year follow-up showed stable results, highlighting the effectiveness of carefully planned clear aligner in camouflage treatment treating Class III malocclusions.