Class III correction and enhanced periodontal health with aligner treatment in a 53-year-old patient

In this case report, we describe the successful camouflage treatment of a 53-year-old female with dental and skeletal Class III malocclusion combined with anterior crossbite, gingival recession, and mobility of the lower incisors, using clear aligners. The treatment involved periodontal debridement followed by orthodontic treatment. The mandibular posterior teeth were distalized to correct the anterior crossbite and to establish Class I molar relationships. During treatment, the mandibular incisors were intruded, and the mandibular occlusal plane underwent a clockwise rotation due to slight extrusion of the maxillary buccal segments and distalization of the mandibular posterior teeth. Following treatment, all objectives were achieved, including resolution of the anterior crossbite, significant reduction of gingival recession and tooth mobility, and improved functional occlusion. The dental and skeletal Class III malocclusion was corrected, and the marginal alveolar bone dehiscence was significantly reduced. The results remained stable over a 3-year retention period, with enhanced molar intercuspation and gingival growth progression. This case adds to the evidence supporting the adaptability and effectiveness of clear aligners in treating orthodontic patients with compromised periodontium. The treatment outcomes support that orthodontic treatment using clear aligners, combined with periodontal monitoring, can assist in managing alveolar bone defects, gingival recession, and tooth mobility.