Deep Overbite Correction With Aligners Triggers Adult Condylar Adaptation

The correction of deep overbite and scissors bite represents a critical challenge in adult orthodontics, with multifactorial implications ranging from occlusal instability to temporomandibular joint degeneration. Recent advancements in clear aligner technology, particularly when augmented with TADs offer novel biomechanical strategies for vertical dimension control while potentially modulating condylar adaptive responses A 28-year-old female presented with chief complaints of excessive gingival display during simile and joint reciprocal clicking. Clinical evaluation revealed characteristic Class II Division 2 malocclusion with mandibular retrognathism (SNB 70.7°, ANB 11°), accompanied by 7 mm anterior deep overbite with retroclined maxillary incisors (U1-SN 71°), 15 scissors bite, Class II molar relationship, and restricted mandibular advancement pattern. The patient declined orthognathic intervention, opting for camouflage orthodontic treatment with aligners. Biomechanical protocol included sequential molar distalization, torque control of maxillary incisors, and anchorage reinforcement with bimaxillary TADs. Class II elastics were not used. Post-treatment records demonstrated Class I functional occlusion with 2 mm overbite and resolution of TMJ dysfunction symptoms. Cephalometric superimposition revealed forward mandibular reposition. CBCT volumetric analysis revealed 1.72 mm new bone deposition on the posterior condylar surface. Our findings challenge the conventional knowledge regarding age-related limitations in condylar adaptability. The observed bone deposition at the condyle surface suggests physiological mandibular repositioning with precision vertical and width control of aligners. The integration of aligner with TADs demonstrates significant potential for three-dimensional occlusal rehabilitation in adult patients, achieving simultaneous deep overbite and scissors bite correction, and promoting mandibular repositioning.