Aim: Currently and with increasing frequency, treatments with Invisalign orthodontic devices are aimed also to adolescent patients: this evolution involves the management of some atypical characteristics, and among them also thumb- sucking.
Case report: A 13-year-old adolescent girl with protracted thumb sucking and dentoalveolar open bite is presented. Infantile neuropsychiatric assessment was required before and after treatment. Small areas of the aligners were occlusally flipped like a bite ramp, in particular on the palatal surface of the upper incisors, in order to discourage thumb sucking. The selection of an invisible orthodontic device was shown to be interesting because it does not impact on the fragile and complex neuropsychiatric situations. Moreover, the active daily application of the device further motivates young patients. The vertical attachments were fundamental in repositioning the front teeth and to close the dentoalveolar open bite. Treatment was ended in eight months with no behavioural or neuropsychiatric consequences in the short period. Invisalign was shown to be a useful device for orthodontic correction even in the complex management of adolescent thumb sucking.