Relative positional change of a dental implant in the esthetic zone after 12 years: a case report.

Although the biological process of osseointegration is similar in adults and adolescents, implant placement is contraindicated in young patients until bone growth is complete. However, even in adults, significant craniofacial changes may occur over an individual's lifetime, as a result of discrete and continuous dental eruption, vertical soft tissue augmentation, or facial bone growth. After such changes, implants may be in infraocclusion. The present case report describes the long-term follow-up of a dental implant located in the esthetic zone. The implant, placed when the patient was 20 years old, demonstrated a relative positional change 12 years postinsertion. The possible reasons for the movement and the long-term clinical implications of this type of case are discussed.

Mini-implants as provisional anchorage for the replacement of missing anterior teeth: a clinical report.

This clinical report describes an adult patient referred for orthodontic treatment with mini-implants as anchorage to correct the root angulation of maxillary lateral incisors. The purpose of this report was to demonstrate the versatility of mini-implants placed in a vertical direction in esthetic areas. During orthodontic treatment, some aspects must be observed to preserve the interim restoration against the occlusal loads to avoid screw fracture. A fixed appliance was placed to correct the position of the maxillary anterior teeth and to complete the treatment. Acceptable esthetics and function were achieved.

Miniscrew insertion sites of infrazygomatic crest and mandibular buccal shelf in different vertical craniofacial patterns: A cone-beam computed tomography study.

OBJECTIVE: To identify optimal areas for the insertion of extra-alveolar miniscrews into the infrazygomatic crest (IZC) and mandibular buccal shelf (MBS), using cone beam computed tomography (CBCT) imaging in patients with different craniofacial patterns. METHODS: CBCT reconstructions of untreated individuals were used to evaluate the IZC and MBS areas. The participants were divided into three groups, based on the craniofacial pattern, namely, brachyfacial (n = 15; mean age, 23.3 years), mesofacial (n = 15; mean age, 19.24 years), and dolichofacial (n = 15; mean age, 17.79 years). In the IZC, the evaluated areas were at 11, 13, and 15 mm above the buccal cusp tips of the right and left first molars. In the MBS, the evaluated areas were at the projections of the first molars' distal roots and second molars' mesial and distal roots, at a 4- and 8-mm distance from the cementoenamel junction. Intergroup comparisons were performed with analysis of variance and the Tukey test. RESULTS: There was no statistically significant difference in the IZC bone thickness among the groups. For MBS bone availability, some comparisons revealed no difference; meanwhile, other comparisons revealed increased MBS bone thickness in the brachyfacial (first molars distal roots) and dolichofacial (second molars mesial and distal roots) patterns. CONCLUSIONS: There was no significant difference in the IZC bone thickness among the groups. The facial skeletal pattern may affect the availability of ideal bone thickness for the insertion of extra-alveolar miniscrews in the MBS region; however, this variability is unlikely to be clinically meaningful.

Treatment of maxillary canine transposition.

Transposition of maxillary teeth is an eruptive disturbance occurring in approximately 1 of every 300 orthodontic patients. Such cases are frequently very challenging in terms of treatment planning and orthodontic management. The canine is one of the most commonly transposed teeth, ectopically positioned with either the lateral incisor or the first premolar. This case report illustrates unique orthodontic treatment, describes treatment procedures, and presents the final outcome of bilateral maxillary canine-lateral incisor complete transpositions in which the involved teeth were moved to their clinically normal position in the dental arch without extracting premolars.

Periodontal response to orthodontic tooth movement in diabetes-induced rats with or without periodontal disease.

BACKGROUND: Systemic conditions can influence orthodontic tooth movement. This study evaluates histologic periodontal responses to orthodontic tooth movement in diabetes-induced rats with or without periodontal disease. METHODS: Forty Wistar rats were divided according their systemic condition (SC) into diabetic (D) and non-diabetic (ND) groups. Each group was subdivided into control (C), orthodontic tooth movement (OM), ligature-induced periodontitis (P) and ligature-induced periodontitis with orthodontic movement (P+OM) groups. Diabetes mellitus (DM) was induced with alloxan monohydrate, and after 30 days, the P group received a cotton ligature around their first lower molar crown. An orthodontic device was placed in OM and P+OM groups for 7 days, and the animals were then euthanized. RESULTS: Differences in OM between D and ND groups were not significant (6.87± 3.55 mm and 6.81 ± 3.28 mm, respectively), but intragroup analysis revealed statistically significant differences between the P+OM groups for both SCs. Bone loss was greater in the D group (0.16 ± 0.07 mm2 ) than in the ND group (0.10 ± 0.03 mm2 ). In intragroup analysis of the D condition, the P+OM group differed statistically from the other groups, while in the ND condition, the P+OM group was different from the C and OM groups. There was a statistically significant difference in bone density between D and ND conditions (18.03 ± 8.09% and 22.53 ± 7.72%) in the C, P, and P+OM groups. CONCLUSION: DM has deleterious effects on bone density and bone loss in the furcation region. These effects are maximized when associated with ligature-induced periodontitis with orthodontic movement.

Multidisciplinary action in a patient with cleft lip and palate: esthetic-functional dentofacial treatment for more than two decades / Atuação multidisciplinar em paciente com fissura lábio palatina: tratamento estético-funcional dento-facial de mais de duas décadas

Cleft lip and palate is a very common congenital defect in which embryonic facial processes do not achieve the ideal facial formation during their development which can cause malformation. Multiple dentistry specializations, especially oral and maxillofacial, orthodontics, oral rehabilitation and dental aesthetics are required in order to correct lip and oral cavity malformations by this congenital defect with the objective of functional and aesthetics improvement. The clinical case reported show the multidisciplinary approach in a patient with cleft lip and palate implementing an aesthetic and functional dentofacial rehabilitation. The case involves a 27-year-old female patient LCLG, Caucasian, with the presence of unilateral congenital cleft lip and palate on the left side, who started rehabilitative and reparative treatment at 3 months of age. She then started pediatric orthodontic treatment for angle class 3 crossbite correction at 7 years of age. After complete replacement of deciduous to permanent dentition at the age of 11, the patient started orthodontic treatment with a fixed appliance for several years and restorative treatment with composite resin reanatomize the anterior teeth due to agenesis of elements 22 and 25. After a few years when the resin restorations were no longer biologically favorable, an aesthetic rehabilitation treatment with ceramic laminates was planned through smile digital planning soon after completing the orthodontic treatment. This case report demonstrates that high aesthetic, functional and psychological expectations of a patient with congenital defect compromise throughout her life were met through a multidisciplinary dental treatment based on correct diagnosis and digital planning (AU)

A fissura labiopalatal é um defeito congênito muito comum, no qual os processos faciais embrionários não atingem a formação facial ideal durante o seu desenvolvimento, podendo causar malformações. Múltiplas especializações da odontologia, principalmente buco-maxilo-facial, ortodontia, reabilitação oral e estética dental são necessárias para corrigir as malformações labiais e da cavidade oral por esse defeito congênito com o objetivo de melhoria funcional e estética. O caso clínico relatado mostra a abordagem multidisciplinar em um paciente com fissura labiopalatal implementando uma reabilitação dentofacial estética e funcional. O caso envolve uma paciente do sexo feminino, 27 anos, LCLG, branca, com presença de fissura labiopalatal congênita unilateral à esquerda, que iniciou tratamento reabilitador e reparador aos 3 meses de idade. Após a substituição completa da dentição decídua pela permanente aos 11 anos de idade, a paciente iniciou tratamento ortodôntico com aparelho fixo por vários anos, e tratamento restaurador com resina composta para reanatomizar os dentes anteriores devido à agenesia dos elementos 22 e 25. Após alguns anos em que as restaurações em resina não eram mais favoráveis biologicamente, foi planejado um tratamento reabilitador estético com laminados cerâmicos através do planejamento digital do sorriso logo após a finalização do tratamento ortodôntico. Este relato de caso demonstra que as altas expectativas estéticas, funcionais e psicológicas de uma paciente com comprometimento de defeito congênito ao longo de sua vida foram atendidas por meio de um tratamento odontológico multidisciplinar baseado em diagnóstico correto e planejamento digital (AU)

Panoramic evaluation of mesiodistal axial inclinations of maxillary anterior teeth in orthodontically treated subjects.

INTRODUCTION: The objectives of this study were to evaluate, through panoramic radiographs, the mesiodistal axial inclinations of the maxillary anterior teeth at the beginning and end of nonextraction orthodontic treatment, and to compare the results with the mesiodistal axial inclinations of a control sample with normal (acceptable) occlusions. METHODS: The experimental sample consisted of 40 white patients (20 male, 20 female; mean age, 14 years) with Class I maloccusions who were treated orthodontically with a standard edgewise (not preadjusted) technique without extractions. The mean treatment period was 1.6 years. The control sample comprised 42 white subjects (14 male, 28 female; age range, 12-17 years) with untreated normal (acceptable) occlusions. Panoramic radiographs were taken of the patients at the beginning (T1) and end (T2) of treatment. The mean values of the mesiodistal axial inclination at T1 were compared with the mean values at T2, and both were compared with the mesiodistal axial inclinations of the control sample. RESULTS: The mesiodistal axial inclinations of the maxillary anterior teeth of the experimental group at T1 were different from those of the control group for 50% of the evaluated teeth. In contrast, the inclinations at T2 were consistent with the normal anatomical configuration of the controls. CONCLUSIONS: The panoramic radiograph is an effective tool for evaluating the mesiodistal axial inclinations of maxillary anterior teeth.

Treatment effects produced by Fränkel appliance in patients with class II, division 1 malocclusion.

The purpose of this investigation was to evaluate the dentoalveolar and skeletal cephalometric changes produced by the Fränkel appliance in individuals with a Class II, division 1 malocclusion. Lateral cephalograms of 44 patients of both sexes were divided in two groups of 22 each. The control group was comprised of untreated Class II children with an initial mean age of eight years and seven months who were followed without treatment for a period of 13 months. The Fränkel group had an initial mean age of nine years and was treated for a mean period of 17 months. Lateral cephalometric headfilms of each patient were obtained at the beginning and end of treatment. The Fränkel appliance produced no significant changes in maxillary growth during the evaluation period, while a statistically significant increase in mandibular length was observed. The maxillomandibular relationship improved mostly because of an increase in mandibular length. In addition, there were no statistically significant differences in the craniofacial growth direction between the Fränkel and the control group, both showing a slight downward rotation of the palatal plane. The Fränkel appliance produced a labial tipping of the lower incisors and a lingual inclination of the upper incisors as well as a significant increase in mandibular posterior dentoalveolar height. It was concluded that the main effects of the Fränkel appliance during this time period were mostly dentoalveolar with a smaller but significant skeletal mandibular effect.

Age assessment based on dental calcification in individuals with Down syndrome.

It is important to estimate both chronological age (CA) and maturational age of an individual, in order to perform orthopedic treatment or surgery, and in cases of lost documentation. Use of dental age (DA) for these purposes has been widely studied; however, the literature is scarce with regard to individuals with Down syndrome (DS), a prevalent condition worldwide. In this study the chronology of dental maturation was evaluated by analyzing the DA of individuals with DS based on the Chronological Mineralization Table proposed by Nolla (1960). Thus, second molars were evaluated in 57 panoramic radiographs of male and female individuals with DS, between 5 and 16 years-old. These data were compared with a control group of 191 nonsyndromic individuals of the same age group. Correlation between CA and DA was ascertained using Pearson's correlation coefficient (r), and the difference between these variables was measured using Student's t-test for paired samples and the method proposed by Bland and Altman. The difference between DA and CA was compared between the control and DS groups using Student's t-test for independent samples (α=0.05). DA was slightly lower than the CA; however, this difference was only significant for females. The difference between DA and CA was not significant between individuals with DS and control group (both genders, p=0.945; males, p=0.542; females, p=0.381). We concluded that dental maturation in individuals with DS occurs similarly to that of nonsyndromic individuals.

Dentoalveolar changes after unilateral extractions of mandibular first molars and their influence on third molar development and position.

AIM: To investigate the spontaneous tooth position changes after unilateral extraction of mandibular first molars and the influence on third molar position. METHODS: Panoramic radiographs of 111 individuals (mean age 19 years 8 months) in whom one mandibular first molar was extracted at least 5 years prior. Comparison of all measurements of the control and the affected side was performed by paired Student t test. RESULTS: The mandibular second molars tipped mesially, whereas the premolars, canines, and incisors moved distally toward the extraction space. Vertical alveolar resorption was significant, particularly in older patients. Mesial inclination of the third molar occurred in only subjects in whom this tooth was completely developed. No significant vertical change of the third molars was observed. CONCLUSION: Unilateral extraction of mandibular first molars causes a significant displacement of all teeth of the affected side toward the extraction site and a progressive vertical bone resorption of this area. The closer the teeth are to the extraction site, the more they are affected. No significant changes were observed on third molar vertical position.

Patients' report of discomfort and pain during debonding of orthodontic brackets: a comparative study of two methods.

AIM: To examine the level of discomfort and pain reported by patients during debonding of orthodontic metallic brackets by comparing two of the most popular methods, since discomfort can negatively influence patients' motivation to undergo orthodontic treatment. METHODS: This split-mouth designed study involved 37 patients. Two methods were used for bracket removal: a lift-off debonding instrument and a ligature-cutting plier. The level of discomfort during debonding was evaluated on a scale of 0 to 4; The Adhesive Remnant Index (ARI) was taken into consideration, as well. Comparison between the methods was statistically analyzed by using the Wilcoxon signed rank and chi-squared tests (P<.05). RESULTS: Regarding the remnant adhesive, no significant difference was observed between the methods. Patients' reports of pain (score ≥2) were observed in 24.3% of teeth when the brackets were removed using a ligature-cutting plier, while there was a 12.8% report of pain when the lift-off instrument was employed (odds ratio [OR]=2.17, P<.001, χ(2)=17.7). Statistically significant lower scores for maxillary (P=.02) and mandibular central incisors (P=.02), maxillary lateral incisors (P=.02), mandibular canines (P=.00), and mandibular premolars (P=.00/.02) were reported when the lift-off instrument was employed. CONCLUSION: For the removal of orthodontic brackets, the lift-off instrument is better accepted by patients compared to the ligature cutting pliers, given that reports of pain are about two times lower with the former. The ARI was the same for both methods.

Optimization of orthodontic treatment using the Centrex System to retract anterior teeth / Otimização do tratamento ortodôntico utilizando o Centrex System para retração dos dentes anteriores

INTRODUCTION: In the end of 90's the adoption of mini-implants as Anchorage allowed a paradigm change influencing even the way of thinking orthodontic mechanics. The overlapping of the specialties of Orthodontics and Implantology started with orthodontic preparations for prosthetic implants insertion, aroused with the use of palatal implants and late with the introduction of mini-implants. The improvement of mini-implants insertion technique with the appearing of self-drilling screws has allowed orthodontists to plan and to place this precious Anchorage piece. Taking into account the versatility of positioning of these screws it was developed a concept that allows the construction of force action lines aiming at optimize the planning and predictability of orthodontic motion. OBJECTIVE: To present some clinical results treatments conduct using Centrex System of orthodontic treatment, approximating the force line action of resistance center of units to be moved. The traced way to its development, previously treated in this journal, will be detailed for better understanding of its functioning.

INTRODUÇÃO: a Ortodontia passa, atualmente, por um momento de importantes inovações e grande efervescência criativa. Somente para citar algumas mudanças introduzidas ou aprimoradas nos últimos anos, nós podemos relembrar a "popularização" dos braquetes autoligáveis e o surgimento da ancoragem absoluta com a utilização de implantes ortodônticos. No final da década de 1990, a adoção dos mini-implantes como ancoragem permitiu uma mudança de paradigma que tem influenciado até mesmo a forma de pensar a mecânica ortodôntica. A imbricação das especialidades de Ortodontia e Implantodontia, cujo início se deu com os preparos ortodônticos para posterior inserção de implantes protéticos, floresceu com o uso de implantes palatinos e, posteriormente, com a introdução de mini-implantes. O aprimoramento da técnica de inserção de mini-implantes com a introdução de parafusos autoperfurantes tem permitido, inclusive, o requinte do ortodontista concentrar em suas mãos o planejamento e a colocação dessa preciosa peça de ancoragem. Levando em consideração a versatilidade de posicionamento desses pequenos parafusos, foi desenvolvido um conceito que possibilita a construção de linhas de ação de força que buscam otimizar o planejamento e a previsibilidade da movimentação ortodôntica. OBJETIVO: apresentar alguns resultados clínicos de tratamentos conduzidos com o uso de um sistema de tratamento ortodôntico, o Centrex System, que aproxima a linha de ação da força do centro de resistência das unidades a serem movimentadas. O caminho trilhado até o seu desenvolvimento, cuja teoria mecânica foi apresentada anteriormente nesse periódico, será detalhado para uma melhor compreensão de seu funcionamento.

Opções de tratamento ortodôntico compensatório da classe III sem exodontias de premolares / Treatment options of compensatory orthodontic treatment without premolar extractions

O tratamento ortodôntico, em pacientes adultos com padrão esquelético apresentando pequena discrepância, pode ser realizado com a camuflagem ortodôntica, por meio das compensações dentárias. Essas compensações, muitas vezes, são consideradas como fatores de risco para a saúde periodontal, principalmente, quando associadas à movimentos de inclinação dos incisivos, tanto para lingual como para vestibular. A finalidade do presente artigo foi apresentar, através de dois de casos clínicos, duas opções diferentes de tratamento compensatório para a Classe III. A primeira com o emprego de bráquetes autoligáveis do Sistema Damon, com prescrição individualizada para os arcos dentários superior e inferior, além dos elásticos intermaxilares de Classe III. Essa modalidade tem sua indicação na correção dos problemas dentários com suave discrepância esquelética entre as bases ósseas, corrigindo os problemas oclusais sem grandes sequelas para os dentes e tecidos de suporte, devido ao torque diferenciado dos bráquetes. A segunda opção é a movimentação sagital dos dentes inferiores para distal por meio de ancoragem esquelética com miniplacas de titânio. Esses dispositivos de ancoragem temporária (DATs) oferecem uma estável e efetiva ancoragem para a movimentação ortodôntica no tratamento da Classe III.(AU)

Orthodontic treatment, in adult patients with a skeletal pattern presenting a small discrepancy, can be performed with orthodontic camouflage by dental compensations. These compensations are many times considered as risk factors for periodontal health, especially when associated with incisor inclination, both lingual and buccal. The aim of this paper was to present, through two clinical cases, two different options for compensatory Class III treatment. The first one with the use of self-ligating brackets (Damon System), with individualized prescriptions for upper and lower dental arches, in addition to Class III intermaxillary elastics. This modality has its indication in the correction of dental problems with mild skeletal discrepancy between bone bases, correcting the occlusal problems without major sequelae for teeth and supporting tissues, due to brackets different torque. The second option is retracting the whole lower dentition through skeletal anchorage with titanium miniplates. These temporary anchoring devices (TADs) provide a stable and effective anchorage for orthodontic movement in Class III treatment.(AU)

A oportunidade de tratamentos híbridos na era da ortodontia digital / Hybrid treatment option in the digital orthodontics era

Tratamentos híbridos associados à Ortodontia Digital são uma eficiente opção para tratamentos de casos clínicos simples e complexos. O propósito desse trabalho é atualizar os ortodontistas sobre a realidade e oportunidade de realizar tratamentos combinados, assim como usufruir das últimas tecnologias da odontologia digital para modernizar sua prática ortodôntica e consultório.(AU)

Hybrid treatments associated to Digital Orthodontics are an efficient treatment option to moderate and complex clinical cases. The aim of this paper is to offer an update to orthodontists about the reality and opportunity to perform combined treatments and to present the latest dental digital technologies for their practice as well.(AU)

Early cephalometric characteristics in Class III malocclusion

OBJECTIVE: Early identification of craniofacial morphological characteristics allows orthopedic segmented interventions to attenuate dentoskeletal discrepancies, which may be partially disguised by natural dental compensation. To investigate the morphological characteristics of Brazilian children with Class III malocclusion, in stages I and II of cervical vertebrae maturation and compare them with the characteristics of Class I control patients. METHODS: Pre-orthodontic treatment records of 20 patients with Class III malocclusion and 20 control Class I patients, matched by the same skeletal maturity index and sex, were selected. The craniofacial structures and their relationships were divided into different categories for analysis. Angular and linear measures were adopted from the analyses previously described by Downs, Jarabak, Jacobson and McNamara. The differences found between the groups of Class III patients and Class I control group, both subdivided according to the stage of cervical vertebrae maturation (I or II), were assessed by analysis of variance (ANOVA), complemented by Bonferroni's multiple mean comparisons test. RESULTS: The analysis of variance showed statistically significant differences in the different studied groups, between the mean values found for some angular (SNA, SNB, ANB) and linear variables (Co - Gn, N - Perp Pog, Go - Me, Wits, S - Go, Ar - Go). CONCLUSION: Assessed children displaying Class III malocclusion show normal anterior base of skull and maxilla, and anterior positioning of the mandible partially related to increased posterior facial height with consequent mandibular counterclockwise rotation.

Utilização de aparelhos autoligáveis nos tratamentos ortodônticos Fase I – relato de caso / Self-ligated brackets in Phase I orthodontic treatment – case report

A dentição mista é o estágio quando a maioria das más oclusões se manifestam. Opção de tratamento, para casos selecionados, são o alinhamento e nivelamento utilizando-se quatro bráquetes nos incisivos e dois tubos na região dos molares (4x2). É um aparelho versátil, fácil de instalar e bem tolerado pelo paciente, com benefícios morfológicos, estéticos e psicos-sociais. A época ideal para se iniciar essa mecânica é no final do primeiro período transacional ou início do período intertransacional da dentição mista. Após planejamento cuidadoso, essa mecânica é fundamental para se atingir os objetivos terapêuticos em um período de tempo relativamente curto, com pequena possibilidade de efeitos iatrogênicos como reabsorção radicular, impacções ou formação radicular abreviada. Recentemente, os benefícios da mecânica ortodôntica de baixo atrito foi incorporada a essa modalidade de tratamento, utilizando-se bráquetes autoligáveis passivos em protocolos de tratamento Fase I (Ortodontia interceptora). Essa mecânica utiliza fios termo-ativados com baixo nível de força que promove ganhos transversais na região posterior, consequentemente resultando em uma diminuição da necessidade de extrações seriadas ou expansão rápida de maxila. Sua indicação precisa é para casos nos quais existe apinhamento em que o tamanho dos dentes é normal, na presença de atresia dos arcos com compensação vestibulo-lingual. Este caso clínico ilustra essa opção de tratamento, utilizando mecânica com bráquetes autoligáveis passivos, na qual foi obtido espaço para os caninos superiores e inferiores com expansão transversal dos arcos dentários, com pequena inclinação e protrusão vestibular dos incisivos. Na avaliação de um ano pós-tratamento, com os caninos permanentes e pré-molares já irrompidos, o ganho de espaço e a posição dos incisivos permaneceu estável mesmo sem contenção.

Mixed dentition is the stage in which most malocclusions are manifested. One treatment option, for selected cases, is alignment and leveling with four brackets on the incisors and two tubes in the molar region (4x2). It is a versatile appliance, easy to install and well accepted by patients, resulting in morphological, esthetic and psychological benefits. The ideal time to initiate this mechanics is the late first transitional period or early intertransitional period of mixed dentition. After careful treatment planning, the technique is fundamental to achieve the therapeutic goal in a short term with little possibility of iatrogenic side effects such as root resorption, tooth impactions or interruption in root formation. Recently, the benefit of low friction mechanics has been added to this treatment modality, using the passive self-ligating brackets in a Phase I treatment protocol. This approach uses super elastic archwires that deliver light forces and promote transverse gains in the posterior region, resulting consequently in reduced need of serial extractions or rapid maxillary expansions. It is precisely indicated for correcting tooth crowding with normal sized teeth, in the presence of arches atresia with vestibular lingual compensation. This case report illustrates this treatment option comprising mechanics with passive self-ligating brackets in which space was achieved for the maxillary and mandibular canines with transverse dental arch expansion, with slight inclination and protrusion of vestibular incisors. In one year post treatment follow-up with the permanent canine and premolars erupted, space gain and the positioning of incisors remained stable even without retention.

Oportunidade do uso da corticotomia alveolar associado ao tratamento da má oclusão de Classe II com aparelho Invisalign® – relato de caso / Class II malocclusion treatment option with alveolar corticotomy and Invisalign® appliance – case report

Corticotomia alveolar é uma das diferentes maneiras de acelerar e aumentar a eficiência do movimento dentário. O propósito desse trabalho é apresentar o planejamento e execução da fase acelerada do tratamento ortodôntico da má oclusão de Classe II com aparelho Invisalign® e auxílio de corticotomias alveolares.

Alveolar corticotomy is one of the different ways to accelerate and increase dental movement efficiency. The aim of this paper is to present the accelerated phase planning and implementation of a Class II malocclusion orthodontic treatment with Invisalign® appliance and the aid of alveolar corticotomies.