{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T09:05:54Z","timestamp":1779181554943,"version":"3.51.4"},"reference-count":12,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T00:00:00Z","timestamp":1778284800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The majority of Class II malocclusions stem from mandibular deficiency, leading to chin retrusion. In growing patients, the ideal correction\u2014aiming for a skeletal mandibular response\u2014should avoid common pitfalls such as \u201cPoint B\u201d dropping postero-inferiorly, excessive labial proclination of mandibular incisors, or the lingual tipping and extrusion of maxillary incisors. When planning mandibular advancement (MA) using clear aligners with integrated advancement features, biomechanical forces are not the only consideration; precise management of the lower incisor position is critical for success. Current literature highlights not a good control in digital planning software: these platforms are primarily dentoalveolar-based and lack integrated cephalometric analysis. Consequently, mandibular advancement is often defined by standard linear parameters (typically 2 mm per step), while incisor position is managed through virtual alignment without correlation to cephalometric landmarks like the Pogonion, NB line, or IMPA. The software cannot monitor real-time sagittal or vertical skeletal relationships, the software will elaborate the treatment planning after doctor\u2019s prescription, the clinician must manually adjust incisor positioning based on external cephalometric analysis to prevent dental compensation or excessive proclination. Aim: This clinical case demonstrates a specific arch preparation protocol designed to optimize mandibular advancement in a growing patient with mandibular retrusion. Methods: A 12-year-old female presented with a skeletal and dental Class II malocclusion, characterized by increased overjet and a normal overbite. Treatment was conducted using Invisalign\u00ae clear aligners (22 h\/day wear, weekly changes). The treatment objectives were: transverse: Correct upper dentoalveolar contraction and coordinate arch form while restoring midline alignment; sagittal: establish Class I molar and canine relationships by correcting the overjet and reducing the labial inclination of the lower incisors; vertical: level the curve of Spee. A key clinical condition of our protocol was the pre-advancement phase: the lower arch was reshaped by reducing the buccolingual inclination (retroclination) and intruding the lower incisors. This was specifically intended to increase the available overjet space, creating the necessary room for subsequent mandibular advancement. Results Treatment was completed in 24 months with high patient compliance. Objectives were successfully met, including the correction of skeletal and dental discrepancies, the establishment of harmonious arch forms, and precise overjet reduction through enhanced control of the mandibular incisors. Conclusions: This case report outlines an optimized clinical strategy for Class II correction. Cephalometric Integration: Perform an initial analysis outside the digital planning software to define the ideal IMPA and NB angles. Anatomic Verification: Utilize radiographic overlays to ensure tooth movement remains within alveolar bone limits. Pre-MA Optimization: Prioritize a \u201cpre-advancement\u201d phase to maximize the sagittal inter-arch space (overjet). A larger overjet allows for a more significant orthopedic effect from the MA features. Stepwise Advancement: Implement mandibular advancement in increments (\u22652 mm) with periodic clinical reassessment to facilitate the adaptation of the muscular sling and functional occlusion.<\/jats:p>","DOI":"10.3390\/jcm15103647","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T17:17:42Z","timestamp":1778519862000},"page":"3647","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Digital Design for Lower Incisor Position Correction in a Growing Patient with Mandibular Retrusion with ClinCheck\u00d2 Software: A Case Report"],"prefix":"10.3390","volume":"15","author":[{"given":"Lupini","family":"Daniela","sequence":"first","affiliation":[{"name":"Universit\u00e0 degli Studi di Trieste Trieste, 34127 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caruso","family":"Sara","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7289-0637","authenticated-orcid":false,"given":"Cozzani","family":"Mauro","sequence":"additional","affiliation":[{"name":"Istituto Giuseppe Cozzani, 19125 La Spezia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caruso","family":"Silvia","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,9]]},"reference":[{"key":"ref_1","first-page":"26","article-title":"Mandibular advancement with clear aligners in the treatment of skeletal Class II. 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