Class II malocclusion correction with Invisalign: Is it possible?

•Significant improvements in the ABO score with Invisalign treatment. •No improvements were seen in anteroposterior correction in Class II group. •No posttreatment occlusions met ABO standards in Class II malocclusion group. Introduction This research aimed to determine whether Class II malocclusion can be treated with clear aligners after completing treatment with the initial set of aligners. Methods A sample of 80 adult patients were divided into Group 1 with Class I molar malocclusions (n = 40 [11 men and 29 women]; 38.70 ± 15.90 years) and Group 2 with Class II molar malocclusions (n = 40 [11 men and 29 women]; 35.25 ± 15.21 years). All patients had finished treatment with the initial set of Invisalign aligners (Align Technology, Santa Jose, Calif) without known centric occlusion–centric relation discrepancies, issues of compliance, or overcorrection. The 7 measurements using the American Board of Orthodontics (ABO) Model Grading System and millimetric measurements for anteroposterior (AP) and vertical dimensions were assessed and compared between the 2 groups at pretreatment, posttreatment ClinCheck (Align Technology) prediction, and posttreatment. Results No improvements were observed in the AP correction. The amount of AP correction in patients with Class II malocclusion was 6.8% of the predicted amount. The amount of overbite correction achieved was 28.8% and 38.9% of the predicted amounts in patients with Class I and Class II malocclusion, respectively. Significant improvements in alignment and interproximal contact scores were observed, with only slight improvements in total ABO scores. An increase in mean occlusal contacts score was observed after treatment. No patient with Class II malocclusions would meet the ABO standards after Invisalign treatment. Conclusions The Invisalign system successfully achieves certain tooth movements but fails to achieve other movements predictably. No significant Class II correction or overjet reduction was observed with elastics for an average of 7-month duration in the adult population. Additional refinements may be necessary to address problems created during treatment, as evidenced by a posterior open bite incidence.