Please Help - Unhappy with final Invisalign trays

gs2013

I am nearing completion of the course of my invisalign treatment and although I appreciate the work my dentist has done to my teeth so far, I am not happy with the result. Previously my lower set were very crooked such that my bite resulted in a single lower incisors touching a single upper incisor.

However, my bite is still not correct and even though my bottom teeth are now straight, they are particularly visible (stick out if you will) when I talk. Additionally, when I bite my lower front teeth sit only slightly behind my upper front teeth.

I am aware that refinements are a possibility but when I spoke with my dentist at my last appointment two weeks ago, he did not seem to be open to the idea saying I would need fixed braces to pull my bottom teeth back (after extracting another molar).

I asked about the possibility of filing my bottom teeth and using trays to tip them inward, but he stated that even with a retainer, they would likely move back since he could only fix a retainer to 4 of my lower teeth. My opinion is that it would be worth trying even just to push them back slightly.

I am also wondering whether (at this stage) it may be possible to provide attachments to my upper front incisors to bring them downwards, over my lower incisors.

I would be grateful for any help. PS Apologies about the pics - I know I should have shaved!

Big_G

I'm not an Invisalign provider but I am aware of the limitations of this modality. It cannot do things that fixed treatment can do and your expectations should have been managed. Invisalign I think usually provides a prediction of the final result I order to construct sequential trays. If you had seen this you would have known the result.

I think it is a fantastic result all things considered. I'm not even sure of what you actually want. Your upper teeth don't overlap the lowers because of upper incisor wear and I suspect the underlying relationship between your jaws produces or contributes to this issue which may not be something that can be corrected with orthodontics. You might be able to mask it with incisal tipping. In your case this will probably produce an anterior open bite, which I think is not a desirable cosmetic result.

I will see if I can draw some lines on your photo to explain the problem.

Big_G

image.jpg

We don't have a fully retracted image (lips out of the way) so we can't see the level of your gums above your upper central teeth but I suspect that if you just had them added to you would have rabbit teeth because you would have teeth that are too long. I would suggest a combined fixed ortho (to bring the centrals down a bit) and possible restorative treatment (veneers or white filling additions). This is getting into the realm of specialist treatment in my opinion.

I don't think there is anything further to be done with the lower teeth. The problem (if there even is one, I think you have a good result) is with the uppers. And this is a problem that probably can't be adjusted using Invisalign. You will need the 'train tracks', although I'm open to correction by one of the orthos who post here.

btkm8unsl0w5r4

Looks to me like a reasonable result although I don't know where you started from. Invisalign is classed as "limited objective" orthodontics. This means there is only so much it can do.
Unfortunately this does not seem to gel with your expectations of treatment. Like a number of invasalign cases I have seen the control of the bite is limited. And the alignment of the teeth it done with tipping rather than bodily retraction. (when you wear aligners that don't allow the teeth to meet that's par for the course).

Best discuss treatment with you orthodontist and consider conventional braces if the final result is not good enough for you. There may be further fees.

gs2013

OK, thanks chaps.... I think my main concern is the horizontal distance between my upper and lower set which I am particularly self conscious of when I speak (in my last two sets my bottom canines where brought forward using the attachments) so my front bottom set feel particularly far forward... I could be being paranoid but I think it looks slightly odd...!

As a child I had two teeth extracted in my top set, so I guess there's not quite enough teeth present to fit snuggly over my bottom set (now that my lower ones are aligned).

I wonder, if there is much of a possibility of pulling my top front incisors 'down and over' using invisalign attachments as part of my 'refinements'. Not sure if refinements is only applicable if your aligners weren't fitting well etc. I was told previously that my upper front incisors were worn. Any further comments welcomed from invisalign experts or otherwise!

Thanks