Clear aligners for class III malocclusion and severe open bite camouflage: A case report

Dear Editor,

This is regarding the article titled “Clear Aligners for Class III Malocclusion and Severe Open Bite Camouflage: A Case Report” published in your esteemed journal in Volume 14, Issue 1, January–March 2024 (doi: 10.25259/APOS_76_2023). The case presented was very impressive with exceptional post-treatment results. The article piqued my interest while at the same time giving me food for thought from several angles. I had the following doubts, which if resolved would shed further light on this beautiful case.

1. The pre- and post-treatment cephalometric values show a decrease in Incisor-mandibular plane angle (IMPA) by 10° which is not evident in the superimposition.

2. The superimpositions depicted on the cranial base do not seem to be consistent with the superimpositions of maxillary and mandibular stable structures.

3. The values of Sella-nasion point A angle (SNA) are decreased post-treatment which does not agree with the values of point A-N perpendicular which shows an increase post-treatment.

4. Similarly, the values of Sella-nasion point B angle (SNB) are not correlating with the Pogonion-nasion (Pog-N) perpendicular which shows a drastic increase post-treatment.^[1]

5. The post-treatment values of Upper incisor to occlusal plane (U1-OP) show retroclination of upper incisors which is not consistent with the superimposition and the mechanics applied.^[2]